Burns : journal of the International Society for Burn Injuries
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Between 1 August 1988 and 31 January 1992, 421 burn patients were admitted to the Burn Unit at Beilinson Medical Center. Name, age, sex, month of the year, cause of burn, area and degree of burn and duration of stay in hospital were recorded. Of these patients, 37 per cent were treated surgically and the remainder were treated conservatively. ⋯ Patients treated by early tangential excision and skin grafting (204 operations on 157 patients) had a shorter stay in hospital than conservatively treated patients. In accordance with others, we suggest that early surgery of burn injuries decreases morbidity and mortality and leads to better aesthetic results and improved motor function. Secondly, burn injury can be prevented in children and the elderly by increasing safety measures at home, and in adults by enforcing strict safety measures at work.
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Six patients sustained a unique type of burn injury while working during the manufacture of cement in China. These patients suffered a combination of chemical and thermal injuries with extensive deep burns and inhalation injury, when they were involved in an accidental explosive leakage of cement from a manufacturing kiln. This report discusses the aetiology of the burn injury and the principles of treatment. All of these burns were preventable.
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This study investigated the effects of early excision of eschar and grafting with cyclosporin immunosuppression on immunological changes following burn injury. The immunological status of the rat was studied using two in vivo measures following a (30 per cent TBSA) full skin thickness burn injury. ⋯ The short course of the immunosuppressive treatment to delay skin allograft rejection did not cause a severe additional effect on cell-mediated immunity after thermal injury. Allograft survival appeared to be related to immunosuppression caused mainly by cyclosporin treatment and also by the immunosuppressive effect of the burn.
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A retrospective analysis of 812 patients admitted to the Ross Tilley Burn Centre between 1984 and 1992 resulted in 37 cases of burn injuries which were directly related to premorbid disabilities. The majority of these burns (83.8 per cent) occurred in the patient's home, most commonly as scald injuries in the bath tub, the shower, or following hot water spills. Nineteen patients were male, 17 were female. ⋯ The mortality rate was also much higher in the disabled population (22.2 per cent vs. 6.0 per cent). Most of these burn injuries were preventable. A series of burn prevention guidelines is presented, in an attempt to reduce the incidence of these burn injuries in disabled patients.
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Case Reports
Versatility of the free or pedicled superficial cervical artery skin flaps in head and neck burns.
The usefulness of the free or pedicled superficial cervical artery skin flap in reconstructive surgery of head and neck burns is reported. This flap can be made with the pivot point near the cervical region. Moreover, it can be elevated as a free or long vascular pedicled flap. Therefore, it is widely applicable in reconstructing the scar contractures of the head and neck, particularly in extensively and deeply burned patients.