Burns : journal of the International Society for Burn Injuries
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Railway and subway-associated electrical trauma is rare and typically involves high voltage (> 20,000) arc injuries. Not all rail systems utilize such high voltage. We report 16 cases of electrical trauma due to 600 V direct contact with subway 'third' rails. ⋯ This is the largest report series of direct electrical trauma from a subway third rail. The high morbidity and mortality from this 600 V contact suggests that the traditional classification of low voltage (< 1000 V) exposure can be subdivided to reflect the serious and lethal potential of intermediate range exposures compared to household range exposures (0-220 V).
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Case Reports Clinical Trial
Reconstruction of burn deformity using artificial dermis combined with thin split-skin grafting.
Twelve patients with post-burn contracture were treated using artificial dermis combined with thin split-skin grafting during the period January 1994 to April 1996. Bilayer artificial dermis was grafted onto full thickness open wounds of the skin, after excision of scar contracture tissue. About 3 weeks later, the silicone layer was removed and thin split-skin, 8/1000 in. thick, was grafted onto the newly synthesized dermis-like tissue in the wound bed. ⋯ Postoperative management was performed in accordance with conventional skin grafting. Postoperative contraction or hypertrophic scar was observed in three cases, but a soft, favorable quality was obtained in the other nine cases. Treatment of burn deformity with artificial dermis may be beneficial in selected cases.
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Self-inflicted burns are a regular source of admissions to burns units world wide. This study examines the characteristics and outcomes of those who deliberately burn themselves. The medical records of all patients admitted to the Royal Brisbane Hospital Burns Unit and identified as having suffered a self-inflicted burn between 1990 and 1995 were reviewed. ⋯ Self-immolation with flammable liquid resulted in severe burns with a 45 per cent mortality. A number of differences was demonstrated between those patients who had attempted suicide and those who had deliberately burnt themselves without suicidal attempt. Self-immolators constitute a considerable proportion of major burns admitted to this unit.
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Ninety-one patients burn-injured in their childhood were assessed by mailed interview and clinical re-examination in 1994. On average, the patients had sustained injuries to 11.9 per cent (SD = 8.8) of their TBSA (maximum 50 per cent), the injuries were mainly scalds (90.1 per cent). Nineteen patients (20.9 per cent) remembered the event and 23 (25.3 per cent) remembered their hospitalisation. ⋯ Only five (5.5 per cent) with visible scars had no memories or special psychosocial sequelae. Almost everyone burn-injured in childhood will have some memories of burn care as an adult. However, the negative psychosocial sequale are modest after the typical paediatric burns, scalds, in early childhood.
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Review Case Reports
Burn scar carcinoma with longer lag period arising in previously grafted area.
A case of Marjolin's ulcer that arose in previously grafted area of right ankle 55 years after initial burn injury was managed by below knee amputation and right inguinal lymph node dissection. The characteristics of this malignancy were reviewed, and rarely seen features particular to this case, which are a longer lag period and rapid growth in a previously grafted area, were discussed.