Burns : journal of the International Society for Burn Injuries
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Among domestic injuries in children, skin burns deserve special attention because they can lead to severe residual lesions. Their frequency has been reported to range from 3 to 8 per cent of all childhood injuries, but few epidemiological data have been collected in France. This study was undertaken to improve our knowledge of this public-health problem. ⋯ However, grafting was required in 35 per cent of patients. Epidemiological surveys provide objective information on hazardous agents and on the settings in which burns are most likely to occur. They are essential for the development of appropriate preventive strategies, which are still receiving insufficient emphasis in the European Economic Community (EEC).
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An unusual and perhaps the first epidemic of burns occurred between 15 February 1994 and mid April 1994 in four districts of the State of Rajasthan in India. The cause of this epidemic was the accidental mixing of petrol in kerosene oil which was inadvertently overlooked. This mixture of kerosene and petrol was used mainly by people of low-income groups for lighting lamps. ⋯ This indicates the need for renewed emphasis not only of the necessity of training general surgeons, nursing and paramedical staff at district level in the management of burns, but also of the need to manage these cases at district level. This idea needs serious consideration and sincere efforts to implement it at the national level. The paper has been split into two parts: epidemiological aspects and management of patients.
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The use of tear gas in controlling riots has been an accepted practice in many countries for the past four decades. In a recent event, a large quantity of tear-gas canisters were used during a situation of unrest in a Hong Kong Refugees' Detention Centre. We report 96 cases of acute burn injury as an unpredicted side effect of o-chlorobenzylidene malononitrile (CS) tear gas. ⋯ The mechanism of burn injury was due to the flame generated from the grenade explosion, direct contact between the hot canister and the victim's skin, and the effect of the chemical powder inside the canisters when it splashed onto the victim's body. We suggest that the noxious transient effects of tear gas are underestimated, furthermore varying cutaneous effects and deep burns may result from its uncontrolled use during riots. There is a continuing need to reassess the potential toxic effects of CS tear gas as a riot control agent and to debate whether its future use can be condoned under any circumstances.
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From 1 January 1979 to 31 December 1993, 1109 patients were admitted to our burn unit located at Hacettepe University. Of the patients, 638 (57.5 per cent) were children (under the age of 16 years). The male to female ratio was 1.4:1 in children, and was approximately 2.6:1 for patients over 16 years of age. ⋯ The overall mortality rate was 34.4 per cent. The epidemiological pattern of the burns showed that emergency measures should be taken to prevent scalding accidents to children throughout the country, and for electrical burns in adults, particularly those living in the Black Sea Region. In establishing, implementing and directing prevention programmes, regional differences should be taken into consideration.
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This study determines the nature of microbial wound colonization in 28 patients with large burns admitted to the Burn Centre, Haukeland University Hospital, Bergen. Altogether, 748 swabs were taken in 141 sampling procedures. A total of 414 microbial isolates were detected and their resistance patterns to a variety of systemic antimicrobial agents determined. ⋯ The time-related changes of burn wound colonization showed that on admission and during the first week, staphylococci and alpha-haemolytic streptococci were dominant. During the next weeks, these bacteria were gradually superceded by enterococci, gram-negative opportunists (mainly Pseud. aeruginosa, Acinetobacter calcoaceticus and Escherichia coli) and Candida species. The nature of microbial wound colonization and how the flora changes with time should be taken into consideration by those treating thermally injured patients.