Burns : journal of the International Society for Burn Injuries
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Over a 10-year period 110 patients over the age of 65 years were admitted to the Burn Center, Rui Jin Hospital and 36 (32.7 per cent) died. Significant differences between the survivors and non-survivors were related to the total burn surface area and full skin thickness burn size. Among the causes of death, pre-existing cardiopulmonary diseases and associated inhalation injury were particularly important since pneumonia was considered as a primary cause of death in 13 patients, myocardial disease in two, cor-pulmonale and heart failure in two. Care of the early fluid resuscitation, early excision of deep burn wounds and grafting, prevention or treatment of a variety of life-threatening complications, and nutritional supplementation appeared to decrease the mortality of aged burn patients.
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Expanding oral angle plasty using a subcutaneous pedicle flap to correct severe microstomia due to extensive facial scar contractures is described. This technique is especially suited for the elderly, who are unable to tolerate large skin grafting of the face, and for patients with insufficient normal donor skin to undertake extensive correction of scar contractures.
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Case Reports
Maintenance of stump length of both upper extremities after severe electrical burn injury.
A patient with electrical injury to both upper extremities which necessitated amputation above the elbow on both sides is presented. Further débridement on the stumps resulted in extensive exposure of bone with little coverage by skin and granulation tissue. Adequate coverage and maintenance of the length of both stumps was possible with bilateral myocutaneous latissimus dorsi flaps. This enabled the patient to carry out various activities and to wear a prosthesis.
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Over a 12-month period, 1704 children less than 15 years old with burn injuries seen in the accident and emergency departments of seven major regional hospitals in Hong Kong were analysed with respect to their epidemiological data. The age group with the highest risk for injury was 0-4 years (57 per cent) and with a maximum at 1-2 years of age. Boys showed a significantly higher incidence of burns than girls at any age. ⋯ In the great majority of patients the total body area of burn did not exceed 5 per cent. Younger children had a higher incidence of burns involving the head, face and anterior trunk, 39 per cent of the 0-4 year age group required hospital admission. During the winter months, the children tended to suffer from deeper burns.
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Cultured keratinocytes were used as allografts on burn wounds in two patients. In both patients successful covering of the wounds was obtained. DNA fingerprinting of the epidermis covering the wounds 21 days later showed that the cultured keratinocytes were replaced by the patients' cells.