Burns : journal of the International Society for Burn Injuries
-
The estimations of blood loss and transfusion requirements during burns surgery are notoriously difficult. This clinical study investigated the effectiveness of estimates made by junior and senior burns surgeons and senior anaesthetists by comparing them with calculated blood losses. Regression analysis shows good correlation between these methods (r-value range 0.75-0.97), although 'eye-balling' the losses tends to underestimate the transfusion requirements (regression slope coefficients ranged between 0.56 and 0.87). ⋯ The mean blood loss for 1 per cent of burn excised or split skin donor site harvested was 117 ml in adult cases. Blood loss can also be expressed as a mean percentage of the patient's calculated total blood volume for each 1 per cent burn excised or autograft harvested, giving figures of 2.6 per cent for adults and 3.4 per cent for children. Gravimetric analysis of soiled swabs underestimates the blood loss by approximately 50 per cent.
-
A method for obtaining widely expanded postage stamp autografts, first described in 1963 by C. P. Meek, has been evaluated in our burns unit. ⋯ In a series of 16 consecutive skin graft procedures performed on 10 patients with extensive burns, the mean epithelialization rate was 90 per cent (range 70-100 per cent) within 5 weeks. Cosmetic results were comparable to those achieved with widely expanded mesh grafts. The Meek technique utilizes small pieces of autograft, and has proved to be a practical alternative to mesh grafts when donor sites are limited.
-
We have treated 25 pregnant patients with burns over a period of 6 years (1986-91). During this period total admissions to the burn unit were 1260. There were 187 women of child-bearing age, with burns ranging between 15 and 100 per cent TBSA. ⋯ Abortion was common in the first trimester of pregnancy. Septicaemia was the commonest cause of abortion. Fetal death is not always preceded by maternal death.
-
A woman with very extensive burns (of over 75 per cent TBSA and 45 per cent full skin thickness) received cyclosporin to extend the survival of skin allografts obtained from several unmatched donors. The patients' wounds appeared completely healed after 3 months when the cyclosporin was discontinued. ⋯ The burns were then successfully covered with autografts during two operations. The late functional results were excellent.
-
Haemodynamic monitoring is important in severely burned patients and repeated catheterization of the arteries of these victims seems to be inevitable. We present a 46-year-old female with 54 per cent TBSA burns who suffered from bilateral femoral mycotic aneurysms due to repeated arterial punctures.