Burns : journal of the International Society for Burn Injuries
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A case study of injury to the feet of children from Sri Lanka due to burning husk is discussed. The hot husk causes deep burns on the dorsum of the feet and spares the plantar surface. ⋯ These burn injuries need to be treated early, in specialized centers, to avoid long term complications. Health education of the public plays an important role in the prevention of these injuries.
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An elderly male patient sustained mixed depth burns of 5% total body surface area. The incident was associated with inappropriate behaviour and subsequent clinical examination confirmed the presence of confusion and a hemiparesis. ⋯ Despite early suspicions that tumour excision would be delayed, wound healing was achieved quickly following tangential burn wound excision and skin grafting, and prompt transfer to a neurosurgical unit was expedited. Cases of burns and concomitant intracranial tumours with deteriorating neurological signs may present clinicians with a dilemma in deciding whether or not to await burn wound healing before carrying out tumour excision.
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Enteral nutrition is recommended in burned patients. Depending on the amount administered, enteral feeding causes an increase of intestinal oxygen-demand. Since intestinal perfusion is decreased after major burns the aim of this study was to evaluate, whether duodenal feeding might be a cofactor for the development of a splanchnic O(2)-imbalance. ⋯ In none of the patients the CO(2)-gap increased during increase of enteral nutrition. In seven patients, the CO(2)-gap increased between the 6th and 13th day above 30 mmHg and fell significantly 1 h after reduction of enteral nutrition. Contrary to the early postburn phase, enteral feeding might have adverse effects on the oxygen balance of the intestine in the later stages of the critical illness phase.
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This study analyzes patient demographics and injury data of 342 patients transported by ambulance to emergency facilities in Akita Prefecture, Japan, between 1996 and 2000. Significant findings include the following. Fire was the most frequent cause of burn injury, and winter was the season with the highest incidence (40.6%) of cases. ⋯ Severely burned patients were not always transported directly to a core emergency facility and an unacceptable number (5.8%) of patients died at tertiary hospitals. This relatively high death rate is attributable to the limited facilities for treating burns in the tertiary hospitals and the long distance to core facilities, which sometimes precludes transport system for the prefecture will reduce transport time to the regional trauma center and thus enable more patients to undergo specialized treatment at an earlier injury stage. Additionally, tertiary facilities should improve their level of burn care (e.g., creating a burn unit and skin bank).
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Eyelid burns occur in about 10% of thermal injuries and pose a considerable challenge for the reconstructive surgeon. A consensus on a treatment regime has not been reached and plastic surgeons are divided on the subject. A case of severe bilateral eyelid burns was treated with full- and split-thickness skin grafts. The patient was first operated at 2 years post-injury, and a total of 5 operations in 5 years were necessary to address recurrent ectropion of both upper and lower eyelids.