Burns : journal of the International Society for Burn Injuries
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A retrospective analysis of 435 consecutive admissions to a regional burns unit over an 8-year period is presented. The majority were domestic accidents, while a few were suicidal and two were due to child abuse. ⋯ In spite of these known adverse factors the overall outcome was satisfactory, with a case fatality rate of 7.4 per cent and a residual disability rate of 10.8 per cent. Good initial resuscitation, a low infection rate (18.4 per cent) and the ready availability of appropriate surgical intervention (35.6 per cent), with good intensive care support, could account for the satisfactory outcome.
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A technique to overcome the problems of inlay grafting for burn scar contracture release is described. A greater release can be achieved by moving the point of release away from the flexure crease, with the added advantage of grafting on to a 'flat non-mobile' surface. A simplified method of graft fixation and compression is described, along with the use of contact media in the postoperative management to prevent graft shrinkage and the recurrence of contracture. During a 6-year period, burn scar contracture release with inlay grafting was performed on 24 patients (10 limbs with 17 split-skin grafts and 14 fingers with 21 full-thickness grafts) with no recurrence.
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Methicillin-resistant Staph, aureus (MRSA) colonization and infection was studied in 231 patients who were admitted to our burn unit and remained for 3 days or more between 1986 and 1994 (patients with inhalation injury only and no burn wound were excluded). The study was divided into two periods: from 1988 to 1989 and from 1990 to 1994. MRSA was found in 80 patients. ⋯ The effectiveness of these measures was confirmed. Moreover, the first operation was carried out significantly earlier in the later period. Early excision and early closure of the wound was more effective in preventing and controlling MRSA colonization and infection.
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High-voltage electrical injury has been well documented in a number of situations, such as the occupational hazard of linesmen and construction workers, and in the context of overhead railway power lines. Two cases of hang-glider pilots contacting 11,000-volt power lines have recently been treated in the Royal Brisbane Hospital Burns Unit. ⋯ Both patients sustained full-thickness patches of burn injury, with underlying muscle damage and peripheral neurological injury. This distribution of injury seems to be closely related to the design of the hang glider.