Burns : journal of the International Society for Burn Injuries
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Upper extremity contractures still happen and constitute one of the most trying challenges in burn patients. This series comprised of 4 radial forearm flaps, 14 dorsoulnar artery flaps, and 4 medial arm flaps, all of which were used in a reverse pattern for upper extremity postburn contractures. The reverse flow radial forearm flap (RRFF) was chosen for reconstruction of extensive palmar contractures after burn. ⋯ In the following 3 cases the flap was supercharged with anastomosis of the brachial vein into the antebrachial vein. Both RRFF and RDUF may provide a smooth and efficient solution. However, RMAF has a significant venous problem, which may result in flap loss, therefore, this flap should not be considered as a first option in the elbow area.
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A retrospective study on burns patients admitted to the Sint Elisabeth's Hospital on Curacao was conducted during the 11-year period from the years 1992 to 2002. This is the first such study performed in Curacao. Curacao does not have an established burn center, therefore severe burns cases are treated in a general hospital. ⋯ Scald and fire were the major causes of burns, being preventable injuries. Especially in young children the need for a prevention program is essential. Also, there is a need to inform people from all ages on the danger of fire injuries, especially during public holidays and other festivities when the incidence is the highest.
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This study aimed to investigate changes in the expression of human leukocyte antigen-DR (HLA-DR) on CD14+ monocytes in the peripheral blood of burn victims with delayed resuscitation in relation to the development of sepsis, and the effect of carbachol in vitro. The study population comprised 25 people with burns of at least 30% of total body surface area and delayed resuscitation, and 20 healthy volunteers as controls. Peripheral blood was collected on post-burn days 1, 3, 7, 14 and 28. ⋯ In vitro, HLA-DR expression on monocytes also decreased with lipopolysaccharide (LPS) stimulation, but after treatment with carbachol, rose in a concentration-dependent manner. Thus expression of HLA-DR on CD14+ monocytes may be a useful parameter for monitoring the immune function of burn victims with and without sepsis. Carbachol significantly inhibited LPS-induced immunosuppression in human monocytes in vitro.