Burns of all etiologies are among one of the leading causes of morbidity and mortality, especially those with poorer prognose. The fundamental aim of treatment is to restore the burn victim to his/her previous socioeconomic status by giving a reasonably good esthetic and functional outcome as we firmly believe that “Quality of life is as important – if not more – as life itself.” This goal can be achieved by applying the basic principles of proper evaluation, adequate resuscitation, thorough planning, and apt execution of the treatment plan and has been stressed upon since time immemorial. Through this case report, we desire to show light on the other, less talked about factors, for example, psychological support, motivation for physiotherapy, rehabilitation, and occupational therapy, which play a substantial role in reinstating the patient's socioeconomic lifestyle.

Aims and Objectives: This prospective study was designed to determine the outcome of split-thickness glabellar and nonglabellar skin graft for the coverage of defects on palmar aspect of hand after release of postburn contracture in terms of graft take, complications, recurrence, and patient satisfaction for color and texture match. Materials and Methods: This prospective comparative study was carried out on patients from December 2018 to December 2020. Fifty patients were randomly divided into two groups by simple randomization method. Group A was offered treatment with split-thickness graft from glabellar region and other Group B was offered treatment with split-thickness graft from nonglabellar skin. Frequencies and percentages of both recipient and donor sites complications such as infection, hypertrophic scarring on the Vancouver scar assessment scale, recurrence, and difficulty in walking were noted. Patient satisfaction for colour and texture match to neighboring skin at recipient site were assessed 3 months after the operation using five points Likert scale. Results: At follow-up of the Group A, the donor areas were completely healed in all the cases 100%. The grafted area showed excellent color and texture match with the adjacent palmer skin. The graft was mobile, stable and without any pigmentation. There was also no hypertrophic scarring, hyperpigmentation or pain at the donor site as compared to ordinary skin graft. Walking and weight bearing were smooth and the instep curvature appeared normal. In Group B, 100% of patients had hyperpigmentation, 20% had marginal scarring and scar hypertrophy at hand. While 40% had scar hypertrophy at 80% had hyperpigmentation over the donor site. Recurrence was noted in 32% of patients in Group B as compared to 8% in Group A. Conclusions: Glabellar skin of the instep is the best replacement for the palmar skin of the digits and hand because of the similarities in their characteristics. Results are excellent in terms of color and texture match, no hyperpigmentation, less marginal scarring, scar hypertrophy, and less recurrence of contracture in patients with area grafted with glabellar skin. Donor site morbidity is very low and hardly any donor site scar is visible. So in conclusion for the management of postburn flexion contracture of the finger. An ideal skin substitute is glabellar skin grafts from the instep region of foot.

Electrical injuries are a commonly encountered hazard at both home and the workplace. While most electric-induced arrhythmias are conduction abnormalities or ventricular tachycardia, atrial fibrillation is uncommon. Sparse literature and lack of systematic recommendations on this topic create a challenge in treating such patients. We present a case of a young man who developed atrial fibrillation with fast ventricular rate after an episode of electrical burns, which was reverted successfully with beta-blockers.

In modern times, the use of electricity has increased many times and so has the incidence of high-voltage electrical injuries. The incidence of high-voltage electrical injuries is much higher in developing countries when compared to developed countries, lack of proper transmission systems being the cause. Electric burn injuries lead to debilitating morbidity to the affected patients and are often deadly. In such cases with exposed vessels in the neck, major flaps such as the deltopectoral flap or forehead flap or free flaps increase the hospital stay or two-staged procedures and hence increase the morbidity of such patients. Here, we present a case of a young male patient who sustained an electric injury to his foot, neck, and shoulder, which was managed with the platysma flap and parascapular flap with no donor site morbidity.

Introduction: Although the mortality and morbidity from burns have diminished significantly over the last few decades, these do not truly reflect whether the victim could lead a normal life, owing to postburn contractures (PBCs) and other deformities, which have functional and aesthetic implications. Objective: The main objective of this study was to compare the improvement in cervico-mental angle after surgery, using a goniometer; and to assess the postoperative complications, cosmetic outcome and patient satisfaction after contracture release and split-thickness skin grafting. Methods: In this prospective study, we have studied a total of 20 patients with PBCs of neck, who underwent contracture release and split skin grafting. The preoperative cervico-mental angles were compared to postoperative measurements using a goniometer. Results: In this study, we observed that the mean cervicomental angle before the surgery was 85.5° ± 12.8° and after the surgery was 106.4° ± 7.8°. The percentage improvement was 24.3% which was found to be statistically significant (P < 0.001). Patients were also classified based on age, gender, mechanism and classification of burns, time elapsed since burn injury. Postoperative complications, cosmetic outcome and patient satisfaction were also studied. Conclusion: PBCs can affect a patient's life functionally, aesthetically, and psychologically. Split-thickness skin grafting is a safe and reliable option for PBC neck. This causes improvement in cervicomental angle and thus range of movements of the neck in different axes (as measured by a goniometer). lthough the mortality and morbidity from burns have diminished significantly over the last few decades, these do not truly reflect whether the victim could lead a normal life, owing to postburn contractures (PBCs) and other deformities, which have functional and aesthetic implications. In this prospective study, we have studied a total of 20 patients with PBCs of neck, who underwent contracture release and split skin grafting. The preoperative cervico-mental angles were compared to postoperative measurements using a goniometer, and a significant improvement was noted. Overall patient satisfaction was also very good. Hence, split thickness skin grafting is a safe and reliable option for PBC neck.

Introduction: In Indian culture, it is considered auspicious to conduct prayers before beginning one's day or even before starting to celebrate any of the festivals. The variations in conducting the prayers are numerous, but one thing which is constant is fire, which in the form of diya or candle or incense stick is always present. This many a times becomes the source of clothes catching fire leading to burns. The flame burns can cause serious complications depending on the age and the percentage of the body involved. Herein, we are presenting an article regarding the same. Methods: All burns which occurred while praying from September 2019 to September 2021 were included in the case series. Results: In our study, the patients above 60 all had comorbid conditions, and 5 out of 8 (five out of eight) patients expired that is 62.5% of the study group. These patients had the accident at home while praying where the flame from diya which is lit on the temple floor near the idol of god caught fire to the clothes. Indian females prefer to wear clothes with flairs such as chaniya choli, long Indian skirt, or saree which increases the chances of contact with diyas or source of flame leading to accidental burns. Considering that 5 (five) patients were more than 50 years of age, they survived for mean days of 16.2 days and then expired, the three younger patients recovered with an average stay of 47.3 days. Even with extensive burns due to younger age the patients recovered and did require skin grafting in the course of their treatment. Discussion: Diminished alertness of the senses, impaired mentation, slower reaction time, reduced mobility, and decreased ability of elderly people to identify the severity or risk of a situation as well as their capacity to escape from harm, puts them at higher risk of sustaining burn injury. These circumstances will also lead to larger increased total body surface area (TBSA) and deeper burns; moreover, there is an increased risk for the development of inhalation injury. These factors are closely related to a higher mortality rate. Conclusion: Age plays an important role in treatment response in a major trauma like burns. Increased age with associated co morbidities add to the severity of the burns. Younger age group however have better survival chances, though even they required prolonged hospital stay in our study considering the higher percentage of burns involved.

Introduction: Hypertrophic scars (HS) remain the main cosmetic concern after complete healing of burns for both patients and treating burn surgeons. HS are managed conservatively using compression therapy, but in our study, we attempt fat grafting with compression therapy to identify which treatment modality leads to better outcomes in patients. Materials and Methods: A total of 84 patients (42 in each arm) in this prospective single-blind randomized controlled study had undergone fat transfer with compression therapy and compression therapy alone at a tertiary care burn center for treatment of HS from July 2015 to June 2017. Results: Out of the total of 84 patients, 54 were male and 30 were female with the mean age being 26.19 and 37.93 years in the case (test) and control group, respectively. Among them, 54 were flame burns and 20 were electrical burns. Mean total body surface area of 23.67% and 44.36% in the case and control, respectively, represents the extent of burns in majority of patients. Assessment of scars was done using the Patient and Observer Scar Assessment Scale which was found statistically significant (<0.005) in both patient and observer assessment in case group, i.e., fat grafting with compression therapy at all times during follow-up. Early complications in form of erythema and swelling in 20 cases, swelling in 13, erythema in 4, and none in 5. Conclusion: Our study suggested the superiority of fat grafting with compression therapy in the improvement of HS. Patients tolerated outpatient procedures well with minimal morbidity and self-limiting complications.

Objectives: The primary objective of this study was to evaluate the efficacy of Calendula officinalis in the wound healing of burn wound in comparison with standard povidone-iodine solution. Materials and Methods: A prospective randomized controlled study with 3 weeks of intervention and follow-up was conducted at the Department of Burns, Plastic and Maxillofacial Surgery, Safdarjung Hospital and VMMC, New Delhi, in collaboration with Homeopathic Treatment Centre, Safdarjung Hospital, New Delhi, from January 1, 2017, to December 31, 2018. The patients between 15 and 60 years of age reporting to the burns outpatient department with burn wounds due to thermal bums having the involvement of 5%–20% of total body surface area within 24 h of injury were randomized to either the Calendula (n = 20) or Betadine (n = 20) group. Results: There was no significant difference between the Calendula and Betadine groups, however, by day 14, 75% of cases in theCalendula group showed 80% and above epithelization as compared to 45.0% of cases in the Betadine group. Similarly, there was no significant difference between the wound discharges between the two groups but 95% had no discharge by the 14th day in the Calendula group as compared with 65% in the Betadine group. The Calendula group had a reduced incidence of wound infection when compared with Betadine. Conclusion: Therefore, Calendula dressing had a positive influence in early epithelization, better control of wound discharge, and lesser infections but these need to be evaluated on adequate sample size for a definite outcome.

Tattoos are commonly accepted as a lifestyle choice, with an estimated 10-20% of the global population having a tattoo. Burn injuries in tattooed skin can be challenging to assess, and incorrect management can lead to an unnecessary burden on resources. This may lead to preventable patient morbidity. We present a case series of patients presenting to our unit with burn injuries on tattooed skin, and discuss recommendations for assessing and optimising care in this cohort. Four male patients aged 23 to 50 years old are discussed in this study, with burn injuries to limb tattooed skin. One patient underwent surgical management and upon a test shave of the apparent full thickness burn with tattoo pigmentation, showed a bleeding dermis which would indicate a more superficial burn. A second patient had burn depth masked a colour tattoo that mimicked a mid to deep dermal burn. We highlight the difficulties in assessing patients with burn injuries in tattooed skin and the importance of ensuring the correct diagnosis in depth of burn. This is to allow optimal treatment and avoid potential complications that may occur as a result of misdiagnosis.

Background: Burn injuries involving the dorsum of the hand are very common. Most burn injuries heal with dressings or skin grafting. Deep burns can lead to soft tissue defects and require durable cover to protect the underlying extensor tendons and the bone. Dorsal metacarpal artery-based flaps are reliable locoregional flaps that provide good soft tissue cover. Materials and Methods: This study included nine patients with postburn dorsal finger defects who underwent debridement and coverage using dorsal metacarpal artery perforator (DMAP)-based flaps from January 2019 to January 2022. Parameters in terms of flap dimensions, reliability, complications, and donor-site morbidity were assessed. Results: The flap size ranged from 5 cm × 2.5 cm to 7 cm × 2.5 cm. Two flaps had marginal necrosis, and one had venous congestion, which settled over time and healed with dressings. All the flaps settled well with a satisfactory outcome. The patients were followed up for 6–24 months. Conclusion: DMAP-based flaps are reliable in providing good soft tissue cover for reconstructing postburn dorsal finger defects with acceptable donor-site morbidity.