Burns : journal of the International Society for Burn Injuries
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A case of a chemical burn following cutaneous exposure to vinylpyridine is presented. This unusual injury was distinguished by the delay in onset of pain and erythema, followed by gradual resolution leaving patchy skin discolouration. The properties of vinylpyridine are outlined. This case illustrates the dangers of long-term chemical storage and the importance of proper disposal.
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The case history of a 20-year-old male patient who sustained an 85 per cent total body surface area alkali burn to his skin, after falling into a caustic lime pit, is reported. Considerable problems regarding the correct estimate of burn wound depth, predominant location of the deepest burn on the posterior half of the body, appropriate wound coverage, and lack of sufficient skin graft donor sites required a complex treatment plan. ⋯ Human allografts and Biobrane were used extensively to achieve temporary wound closure, to provide mechanical protection of freshly autografted wounds, and to prevent desiccation following application of cultured epidermal autografts on to debrided wounds and split thickness skin grafted donor sites. The case illustrates a number of problems associated with the evaluation and treatment of patients suffering severe alkali burns, and demonstrates the implementation of both established and evolving technologies in the management of these injuries.
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Burns patients were assessed 12 months following their injury to determine the factors that predict development of post-traumatic stress disorder (PTSD). Among 35 patients, 31 per cent suffered PTSD, 29 per cent suffered subclinical PTSD reactions and 40 per cent displayed no PTSD symptoms. ⋯ The results indicate that postinjury adjustment factors are critical determinants of PTSD development following burns. Implications for therapeutic interventions are discussed.
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Case Reports
Magnetic resonance imaging: a new diagnostic aid in the care of high-voltage electrical burns.
Magnetic resonance imaging (MRI) can detect and delineate alterations in the hydration properties of tissues such as oedema and necrosis. The distinction between living tissue oedema and frank necrosis is also possible with MRI, by use of a spin-echo (SE) sequence and a fast spin-echo (FSE) sequence with a 1.5 T imager. With this background, the aim of this study was to examine the ability of MRI for early detection of concealed tissue injuries caused by high-voltage electrical burns, an entity not previously explored. ⋯ The T2-weighted images provided substantial information about the localization and amount of muscle necrosis, thus enabling increased surgical precision in the treatment of these high-voltage injury victims. FSE sequences produce T2-weighted images with increased speed of acquisition and/or increased image resolution compared to conventional SE sequence. Two illustrative examples are provided.