Burns : journal of the International Society for Burn Injuries
-
Comparative Study
Plasma tumor necrosis factor-alpha, its soluble receptors and interleukin-1beta levels in critically burned patients.
Levels of plasma TNF-alpha, interleukin-1beta(IL-1beta ), soluble TNF-receptor I (sTNF-R I) and soluble TNF-receptor II (sTNF-R II) were determined in 16 critically burned patients. Seven of the 16 patients showed hypovolemic shock (shock group), 9 with sepsis (sepsis group), 8 with multiple organ dysfunction syndrome (MODS group) and 6 of them died (non-survival group). Plasma TNF-alpha, sTNF-R I and R II were significantly higher in the shock group, the MODS group and the non-survival group than each of the control groups. ⋯ TNF-alpha, sTNF-R I and R II correlated positively with Goris' multiple organ failure score. Molecular sTNF-Rs/TNF-alpha ratios were lower in the sepsis group than in the non-sepsis group. These results suggest that circulating TNF and soluble TNF receptors system play an important role in the development of burn shock and MODS; high molecular ratios of endogenous sTNF-Rs might not reduce the morbidity of MODS and the mortality in critically burned patients.
-
Home oxygen therapy has been used to provide symptomatic relief of breathlessness for more than 20 yr. Continuous low-flow oxygen can improve exercise tolerance and decrease pulmonary hypertension in patients suffering from chronic obstructive airway disease. The majority of these patients have been long-time smokers. ⋯ Two patients required split-thickness skin grafting. Whether chronically ill patients on domiciliary oxygen who continue to smoke covertly are amenable to medical advice to abandon this habit is questionable. A more aggressive education about the explosive nature of their activity should help to prevent them from using tobacco and oxygen at the same time.
-
Comparative Study
A profile of methicillin resistant Staphylococcus aureus infection in the burn center of the Sultanate of Oman.
A retrospective study of patterns of infection in 168 patients admitted during 1995 and 1996 in the burns-unit of Khoula hospital at Muscat, Oman was performed. Out of 819 isolates positive for pathogenic bacterial culture, there were 326 (39.8%) isolates positive for methicillin resistant Staphylococcus aureus (MRSA) infection. Incidence of MRSA infection was marginally more than that of Pseudomonas aeroginosa. ⋯ Vancomycin was the antibiotic to which most MRSA cultures were susceptible, but partial resistance was reported due to very low susceptibility observed in 1.4% of the isolates in 1995 and 1.1% of the isolates in 1996. The control measures being practiced in the burns-unit of Khoula Hospital, especially mechanical cleaning and chemical disinfection of all surfaces, are discussed in detail. This paper emphasizes the need for preventive measures against MRSA infection in the burns-unit.
-
Two patients with diabetes mellitus sustained spontaneous calcaneus fracture after deep heel burns. Both cases had avulsion type fracture of the os calcis. The authors discuss the incidence and possible etiology with literature review.
-
Severe thermal injuries to the external ear, in most cases, lead to a total destruction of the pinna. Total ear reconstruction in such cases of burns is one of the most difficult problems faced by a plastic surgeon. This is because of the paucity and poor quality of the skin available in the auricular region. ⋯ A temporoparietal fascial flap was the cover of choice if local skin was not healthy. During the past eight years, seventy six cases of total ear reconstruction were done for post burn ear deformities. The technique and results are presented here.