Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial Comparative Study Clinical Trial
A prospective randomised clinical and histological study of superficial burn wound healing with honey and silver sulfadiazine.
Histological and clinical studies of wound healing have been made on comparable fresh partial thickness burns with honey dressing or silver sulfadiazine (SSD) in two groups of 25 randomly allocated patients. Of the wounds treated with honey 84 per cent showed satisfactory epithelialization by the 7th day, and in 100 per cent of the patients by the 21st day. In wounds treated with silver sulfadiazine, epithelialization occurred by the 7th day in 72 per cent of the patients and in 84 per cent of patients by 21 days. ⋯ Fifty two per cent of the silver sulfadiazine treated wounds showed reparative activity with inflammatory changes by the 7th day. Reparative activity reached 100 per cent by 21 days with the honey dressing and 84 per cent with SSD. Thus in honey dressed wounds, early subsidence of acute inflammatory changes, better control of infection and quicker wound healing was observed while in the SSD treated wounds sustained inflammatory reaction was noted even on epithelialization.
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Comparative Study
A 3 year prospective audit of burns patients treated at the Western Regional Hospital of Nepal.
Burns in Nepal cause an estimated 1700 deaths per year and much suffering. We carried out a prospective 3 year audit of 237 burns patients admitted to the Western Regional Hospital in Pokhara. The aims were to assess the profile of burns injuries and what could be achieved in local conditions to guide colleagues in developing countries with limited medical facilities. ⋯ There were more female patients and females had more severe burns. No patients with greater than 40 per cent body surface area burns of any age group survived. Public education on burns prevention is needed but poverty, ignorance and a fatalistic attitude are difficult underlying causes to change.
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Early excision and skin grafting (EEG) is an established and accepted procedure for deep burn management. This is a retrospective analysis of 100 patients treated with early excision and grafting in burns of all types and up to 65 per cent TBSA. Excisional surgery was performed in the period from day 2 to day 7 post-burn in patients who did not have significant infection (<10(5)) in one to two stages. ⋯ The mortality in the operated group was 10.2 per cent. The main causes of mortality were smoke inhalation injury, septicaemia (probably originating from the non-excised tissue) and extensive burn injury. The functional and aesthetic outcome in EEG patients was far superior in comparison with the conventional method of treatment.
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Multicenter Study
The epidemiology of burns in secondary care, in a population of 2.6 million people.
The numbers of residents of the four counties in the west of Anglia and Oxford Region (UK) who were treated for burns (including scalds) in accident and emergency (A&E) departments or admitted to hospital in 1994-95 were obtained from A&E departments and district health authority records. Burns comprised about 1 per cent of the workload in the A&E departments. ⋯ Approximately half the patients admitted to hospital with burns were admitted to burns units, a quarter to plastic surgery wards and the rest to different specialties including trauma and orthopaedics, paediatrics, and ophthalmology. The median length of stay was 6 days for burns units and 3 days for plastic surgery units.
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In the Western World self-immolation is an uncommon but dramatic method of attempting suicide. In-patients who attempt suicide by fire-setting tend to be female with severe psychopathology. In a previous study from the South of Ireland, seven cases from a psychiatric and prison population were identified in a five year period from 1984 to 1989. ⋯ Ten of these patients had a previous psychiatric history and eight of them were resident on a psychiatric ward when they committed the act. Seven of the patients were found to have a high degree of suicide intent of whom four died of their injuries, which gives a mortality rate for this group of 33 per cent. Effective prevention policies are necessary if this increasing problem is to be curtailed.