2nd Degree Burns Research Articles

Effect of Aloe vera extract in post-burn skin repair in rats

Background: Burn injury is a global health problem that is most often caused by heat. A burn injury can cause high morbidity and mortality and requires high cost. Therefore, the use of plants as an herbal medicine has the potential to be developed in Indonesia. Aloe vera contains various active ingredients that help the wound healing process, such as glucomannan and acemannan which have the effects on the proliferation of macrophages, fibroblasts, and re-epithelialization. This study aimed to determine the effect of Aloe vera extract in repairing post-burn skin in rats that were analyzed from the number of macrophages, fibroblasts, and epidermal thickness. Methods: This is an experimental study with a posttest-only control group design using 54 Rattus norvegicus Wistar strain rats. The sampling method was simple random sampling consisting of 3 groups, i.e., I. standard group, which were normal rats; II. negative control group, which were given second-degree burns and treated with gel base (without Aloe vera extract); III. treatment groups, which were given second-degree burns and treated with Aloe vera extract gel. Each group was subdivided into three smaller groups (n = 6) according to the time the lesions were evaluated. Skin tissue samplings were carried out on days 3, 14, and 21 after injury to observe the number of macrophages, fibroblasts, and epidermal thickness. Results: There were significant differences in the mean number of macrophages, number of fibroblasts, and epidermal thickness in all groups (p<0.05). Conclusion: Based on the result of the study, Aloe vera extract could fasten the healing process of 2nd degree burn wound in rats.

An Extended Model for Analyzing the Heat Transfer in the Skin-Microenvironment-Fabric System during Firefighting.

This study proposed an extended multi-layer heat transfer model to simulate skin burns of firefighters during firefighting. The proposed model takes into account the effect of fabric movement frequencies, fabric movement amplitudes and human body movement speeds on the heat transfer between the skin and the heat source under low-level radiative exposure. The simulation performance was validated against the simulations in the published literature in terms of the heat transfer in the multi-layer fabric system, skin temperature and skin burns. The results indicated that the fabric periodic movement caused by human body movement decreased the time to skin burns and the skin temperature increased with increasing fabric movement amplitude. During firefighting, the time to 2nd degree burn was 33.3-35.2% shorter at medium human body movement speed than at low and high movement speeds. Furthermore, at low movement speeds, the time to 2nd degree burn was negatively associated with fabric movement amplitude, whereas it was delayed by 12.9-29.8% at the fabric movement amplitude of 2.5 mm at medium and high human body movement speeds. This research provides foundational knowledge for the development of a new generation of firefighters' protective clothing (FPC) and the assessment of skin burns in firefighters.

Admission Frailty Score Are Associated With Increased Risk of Acute Respiratory Failure and Mortality in Burn Patients 50 and Older.

Herein, we assessed the utility of the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS) to predict burn-specific outcomes. We hypothesized that frail patients are at greater risk for burn-related complications and require increased healthcare support at discharge. Patients 50 years and older admitted to our institution for burn injuries between July 2009 and June 2019 were included. Demographics, comorbidities, pre-injury functional status, injury and hospitalization information, complications (graft loss, acute respiratory failure, and acute kidney disease [AKI]), mortality, and discharge disposition were collected. Multivariate analyses were performed to assess the association between admission frailty scored using the CSHA-CFS and outcomes. P < .05 was considered significant. Eight-hundred fifty-one patients were included, 697 were not frail and 154 were frail. Controlling for Baux scores, sex, race, mechanism of injury, 2nd and 3rd degree burn surface, and inhalation injury, frailty was associated with acute respiratory failure (OR = 2.599 [1.460-4.628], P = .001) and with mortality (OR = 6.080 [2.316-15.958]; P < .001). Frailty was also associated with discharge to skilled nursing facility, rehabilitation, or long-term acute care facilities (OR = 3.135 [1.784-5.508], P < .001), and to hospice (OR = 8.694 [1.646-45.938], P = .011) when compared to home without healthcare services. Frailty is associated with increased risk of acute respiratory failure, mortality, and requiring increased healthcare support post-discharge. Our data suggest that frailty can be used as a tool to predict morbidity and mortality and for goals of care discussions for the burn patient.

Examination of the effects of kefir on healing factors in a mice burn model infected with E.coli, S.aureus and P.aeruginosa using qRT-PCR

Burn areas are susceptible to bacterial growth and infections, particularly in cases with lengthy periods of hospital stay. Burn wound healing, which involves various molecular and cellular mechanisms, continues to be a significant problem. Growth factors and cytokines play an active and vital role in wound healing. In the present study, the effects of kefir on wound healing in a 2nd-degree mouse burn model infected with e.coli, s.aureus and p.aeruginosa were investigated in vitro. In order to clarify the effects of kefir in the wound healing process, the macroscopic changes in kefir-applied scar tissue as well as wound depth and width were examined and IL-1α, IL-1β, IL-6, IL-8, IL-10 and TNF-α, VEGF, TGF-β protein levels were determined using the qRT-PCR method. The findings of the present study show that kefir has a positive impact on the factors playing a role in wound healing and accelerates the healing process.

Effectiveness of Debridement Treatment in Neonatorum Epidermolysis Bullosa: A Case Report

Introduction: Epidermolysis Bullosa (EB) is an autosomal genetic disorder that characterized by blistering of the skin and mucosa following mild trauma such as frictional trauma. There is no definitive treatment has yet to be developed. The goal of surgical debridement is to achieve a clean wound bed in fastest way, reduce bacterial burden, remove as much nonvital tissue, speed up the healing process, which will shorten the length of stay in hospital. Case Finding: We have 3 days old newborn with clinical appearance similar to a second degree burn lesion bullous lesions and epidermal damage on her both feet, gluteal, and genital regions but without previous history of contact with thermal trauma consulted to patients. General physical examination showed no fever and vital within normal condition. In the perinatal history, the baby was delivered by caesarean section from a 37 years-old G3P2A0 mother with preeclampsia comorbid, normal gestational age, her birth weight was 3800 grams, her birth length was 51 cm, and with APGAR her scores of were 9 and 10 the 1st and 5th minute respectively. Our newborn patient was looked like 2nd degree burn injury with blisters and epidermolysis but without previous history of contact with thermal trauma. Consulted to plastic surgeon for further evaluation and management. The Baby was discharged day 9 or after 3 days debridement management in stable condition. Conclusion: The surgical debridement demonstrated greatly effective and efficient in achieving these aims. Observation on day 3 did not reveal any sign of infection, showing controlled symptoms and good healing process. We suggest that performing debridement on Epidermolysis Bullosa (EB) patient would shorten the duration of hospitalization. Therefore, it provides low-risk nosocomial infection and low-cost hospitalization.

Diencephalic storm in trauma patients: Is it really that rare

Introduction: Diencephalic storm is characterized by extreme episodic catecholamine release in the presence of a stressor and it is usually refractory to standard antihypertensives. The treatment of choice during the crisis is propofol and the best preventative measure is to remove the stressor (i.e. ventilator). Case presentation: A 32-year-old male sustained 2nd and 3rd degree burn to 25 percent of the body surface area that included a severe inhalation component. The patient was admitted to the Burn Intensive Care Unit at the Arnold Luterman Regional Burn Center in Mobile, AL. The patient had frequent episodes (3-5 per day) of severe agitation that were accompanied by extreme tachycardia of &gt; 200 beats per minute and hypertension (280/140). The inciting event was often endotracheal suctioning, but less noxious stimulation also resulted in similar episodes. During these episodes, the patient had significantly elevated catecholamine levels that improved after extubation. The patient’s symptoms were refractor to standard antihypertensives but immediately resolved when given propofol. Further episodes of the diencephalic storm were treated successfully with propofol. Once the patient was removed from mechanical ventilation, there were no further episodes. Conclusion: Diencephalic Storm may be difficult to diagnose due to a lack of familiarity with this rare entity. Any patient with severe agitation combined with the effects of episodic large catecholamine surges should be considered to have Diencephalic Storm. The standard immediate treatment is propofol due to the lack of responsiveness of standard antihypertensives and the removal of the stressor.

5 Admission Frailty Is Associated with Acute Respiratory Failure and Mortality in Burn Patients &amp;gt; 50

IntroductionPre-injury frailty has been shown to predict mortality of older burn patients. Herein, we assessed the utility of the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS) to predict burn-specific outcomes. We hypothesize that frail patients are at greater risk for complications such as graft loss, acute respiratory failure, and acute kidney injury and will require increased healthcare support at discharge.MethodsThis is a retrospective cohort study. Patients 50 years and older admitted to our Institution for burn injuries between July 2009 and June 2019 were included. Patients with inhalation injury only, no data on total burn surface area, or for whom medical history was incomplete were excluded. Demographics; comorbidities; pre-injury functional status; admission, injury, and hospitalization information; complications (graft loss, acute respiratory failure, and acute kidney disease (AKI)); mortality, and discharge disposition were collected. Patients were scored on the CSHA-CFS based on pre-admission health and functional status. The frail and non-frail groups were compared. Multivariate analyses were performed to assess the association between admission frailty and outcomes. P < 0.05 was considered significant.ResultsWe included 851 patients, 697 were not frail and 154 were frail. Frail patients were significantly older (66.1 ± 10.8 vs. 63.5 ± 10.9, p = 0.002), more likely Caucasian (98.1% vs. 91%, p = 0.027) and to have suffered flame burn injuries (68.8% vs. 59.8%, p < 0.001). Frail patients had a lower %TBSA (4.4 ± 8.1% vs. 10.1 ± 13.1, p < 0.001) but were more likely to stay longer in hospital relative to %TBSA (3.6 ± 6.7 vs. 1.9 ± 3.1, p < 0.001). Frail patients were less likely to have had skin graft procedures (27.3% vs. 57.4, p < 0.001). On multivariate analysis, controlling for age, sex, race, mechanism of injury, %TBSA, 2nd degree and 3rd degree burn surface, inhalation injury, frailty was associated with acute respiratory failure (OR = 2.599 [1.460-4.628], p = 0.001). Frailty was also associated with mortality (OR = 6.915 [2.455-19.980]; p < 0.001) when controlling for the same variables as well as acute respiratory failure and AKI. Frailty was also associated with discharge to home with healthcare services (OR = 2.678 [1.491-4.809], p = 0.001), to SNF, rehabilitation, or long-term acute care facilities (OR = 3.572 [1.933-6.602], p < 0.001), and to hospice (OR = 5.759 [1.519-21.827], p = 0.010) when compared to home without healthcare services.ConclusionsFrailty is associated with increased risk of acute respiratory failure, mortality, and requiring increased healthcare support post-discharge. Our data suggest frailty as a tool to predict morbidity and mortality as well as for goals of care discussions for the burn patient.

Adverse Events of Electronic Moxibustion Treatment for Knee Osteoarthritis: Case Reports and a Literature Review

Background: Electronic moxibustion has the advantage of temperature control and maintenance, and overcomes the limitations of the existing moxibustion process without the use of the combustion process. However, as the application of electronic moxibustion in clinical practice has increased, safety issues are emerging.Methods: Clinical cases of electronic moxibustion treatment for knee osteoarthritis where burns occurred were collected. In addition, adverse events reported in clinical studies using electronic moxibustion for patients with knee osteoarthritis were collected from studies retrieved from Korean and international databases.Results: There were 3 cases of superficial 2nd degree burns retrospectively collected through chart reviews. Among the selected 5 studies for literature review, 2 studies reported adverse events which were burns milder than those reported in these 3 cases in this retrospective case review.Conclusion: Since the risk of superficial 2nd degree burn was discovered in the cases reviewed, further research on safe electronic moxibustion treatment is required without compromising the effectiveness of moxibustion.

Immunohistochemical Analysis of Postburn Scars following Treatment Using Dermal Substitutes.

Background Post-burn hypertrophic scars commonly occur after burns. Studies that compare dermal substitutes with other treatment methods are insufficient. The purpose was to analyze the histopathological differences in hypertrophic burn scars after Matriderm®+split-thickness skin graft (STSG) and compare with AlloDerm®+STSG, STSG, full-thickness skin graft (FTSG), and normal skin. Methods Samples of unburned, normal skin and deep 2nd or 3rd degree burns were obtained from patients who experienced a burn injury in the past to at least 6 months before biopsy, which was performed between 2011 and 2012. All subjects received >6 months of treatment before the biopsy. Intervention groups were normal (63), STSG (28), FTSG (6), Matriderm® (11), and AlloDerm® (18). Immunohistochemical analyses of elastin, collagen I, collagen III, cluster of differentiation 31 (CD31), smooth muscle actin (α-SMA), and laminin from scar and control tissues were performed and compared. Results α-SMA vascular quantity and vessel width, stromal CD31, and basement membrane laminin expression were not significantly different between normal and intervention groups. Matriderm® group showed no significant difference in elastin, collagen III, stromal CD31 and α-SMA, CD31 vessel width, stromal α-SMA, vessel quantity and width, and laminin length compared to the normal group, meaning they were not significantly different from the normal skin traits. Conclusion Dermal substitutes may be an optimal alternative to address the cosmetic and functional limitations posed by other treatment methods.

Effect of a rehabilitation program on quality of life among 2nd degree burn adolescents

Background: Burn injuries can have profound physical, psychological, and social effects on adolescent when identity and self-esteem are developing. Adolescents with 2nd degree burn injury often face challenges on quality of life, which may include physical pain and discomfort, functional limitations, body image concerns, social isolation, and difficulties with school. Aim of the study: is to assess the effect of a rehabilitation program on quality of life of 2nd degree burn adolescents. Research design: A quasi experimental design was used in study. Study subjects consisted of 100 2nd degree burn adolescents. Setting: The study was conducted at burn unit of plastic surgery department and related outpatient clinic at Ain Shams University Hospitals, Cairo, Egypt. Tools: Data was collected using 1): Demographic characteristics of the studied adolescents and their medical data; 2): Pre-post Burn Specific Health Scores-Brief (BSHS-B) assessment; 3) Pre-post Burn Patients' health care needs assessment; 4) Pre-post Children’s Dermatology Life Quality Index. Results: It revealed improvement in the adolescents' posttest good quality of life from 31% to 61% after conduction of the rehabilitation program. Also, the total mean score of BSHS-B and total health care needs were improved by 75.26±18.6 and 39.25±3.79.

The use of a novel burn dressing out of bacterial nanocellulose compared to the French standard of care in paediatric 2nd degree burns – A retrospective analysis

PurposePaediatric burn care is a delicate discipline which benefits from special attention. Despite being highly effective, the current standard of care for second degree burns in the largest paediatric burn center in France – exposure to infrared light – involves long hospital stays, straining economic and professional resources, especially in times of a pandemic. The present study investigated this standard of care and compared it to the use of a bacterial nanocellulose dressing. Materials and methodsA retrospective analysis of two groups has been performed: the control group assessed thirty consecutive children treated with the standard of care, and the intervention group assessed thirty consecutive children treated with the bacterial nanocellulose dressing. Parameters evaluated were: healed wounds, additional treatments, rate of infections, hospital length of stay, pain experience and overall satisfaction. ResultsThe two groups did not differ significantly in terms of age and TBSA. A significant reduction in hospital length of stay (p < .001) and pain experience (p < .001) could be observed. In terms of healed wounds, additional treatments and infections, the two groups were equally matched (p > .05) with satisfactory results in both groups. Tendencies towards better results could be seen in the intervention group. ConclusionThe use of bacterial nanocellulose wound dressings is an important tool in the armamentarium of today’s burn surgeons. Satisfying results were achieved, ameliorating burn care for children. Future studies are indicated to further support its value and assess the economic impact.

The process to obtain reimbursement for enzymatic debridement in clinically deep burns

Introduction Burn eschar removal by enzymatic debridement with NexoBrid® (EDNX) results in a maximum preservation of all viable tissue, which is the main advantage over traditional tangential excision. The authors participated in a marketing authorization holder process to obtain reimbursement from the national health authorities in Belgium. Material and methods The reimbursement process consisted of three phases, as specified by the reimbursement regulations required by the Belgian National Institute for Health and Disability Insurance (NIHDI). Results Forty-one patients with clinically deep 2nd and 3rd degree burns, treated with EDNX in two Belgian burn centers, were included in the registry for the first phase of the reimbursement process. The total success rate of the EDNX treatment was 95.1% (39/41). Over half of the burn wounds treated with NexoBrid® (55.2%) did not require any additional surgical debridement or skin grafting. To obtain definitive reimbursement, an extra 16 patients were included. In this population, 51.4% did not require any surgical intervention. The total success rate of the EDNX debridement in this group was 100%. Based on an estimated market share of 12% and around 75 patients in the third year after final reimbursement, a market access consultant calculated that NexoBrid® will realize yearly savings for the Belgian Healthcare budget of at least €30.000. Conclusion Based on the results of this Belgian registry study in combination with the yearly healthcare budget savings, the NIHDI granted a final reimbursement for EDNX treatment in adults, endorsed by the Minister of Health on November 5th, 2019.

Impact of Topical Heparin on Healing of Skin Graft Donor Site in Burn Patients

Abstract Background The ability of topical heparin application to improve the healing outcome of burn wounds has been demonstrated by several studies. However, its impact on healing of skin graft donor site was not studied. Aim The present study was done to compare the healing outcome (healing time, pain, itching, scarring and complications) of topical heparin treatment with topical conventional treatment in the donor areas after skin grafting in burn patients. Methods This prospective, interventional, controlled, single-blinded clinical study was done on 40 patients with 2nd or 3rd degree burns of any etiology and &amp;lt;30% of body surface area requiring skin grafting, aged 18-65 years, of both sexes. Each patient was subjected to harvesting of two grafts. Patients served as their own controls. One donor area was treated with topical heparin and the other was treated with the topical conventional treatment. Immediately after graft harvesting, all donor areas were treated conventionally. Starting from the 2nd day, each donor area was treated once daily according to its group allocation. The topical heparin donor area was treated with heparin diluted in saline in a concentration of 250 IU/ml in a dose of 4200 IU/1% total body surface area (TBSA). The area was covered with gauze soaked with the solution for 5 days. The conventional treatment (control) donor area was covered by gauze soaked with an equivalent amount of normal saline on top of Vaseline gauze. Heparin was to be discontinued if the platelet count before each session was &amp;lt; 100,000 /mm3 and/or APTT exceeded double the reference value. Pain was assessed twice daily for 5 days. The patients’ donor areas were followed-up postoperatively for 8 weeks for healing time in days, itching over the wound and scarring using Vancouver Scar Scale. Complications in the form of wound site bleeding or infection were recorded. An analgesic was given twice daily for 5 days then as needed. Results There were no statistically significant differences between the two donor areas regarding the site and size. The healing time was significantly shorter in the heparin donor areas (P &amp;lt; 0.00001) with less scarring reported as significantly lower scores of the Vancouver scar scale compared with the control donor areas for each component and the total score (P &amp;lt; 0.05). Pain, itching and infection rate were insignificantly less in the heparin area. Bleeding was not observed in any of the areas in all cases and the daily values of platelet count and APTT in the five treatment days did not differ significantly compared with the preoperative values. None of the patients showed a platelet count &amp;lt; 100,000 /mm3 or APTT exceeding double the reference value. Conclusion Topical heparin treatment, compared with topical conventional treatment, of the donor areas after skin grafting in burn patients resulted in better clinical outcome manifested as significantly shorter wound healing time and significantly less scarring with no treatment-related complications.

EFEK EKSTRAK TANAMAN ASHITABA PADA KADAR SERUM ALKALIN FOSFATASE (ALP) PADA TIKUS YANG TERPAPAR LUKA BAKAR

Serum alkaline phosphatase (ALP) levels increases in burn tissue damage. Several bioactive compounds found in Ashitaba, are expected to reduce serum ALP levels and enhance the process of wound healing. This study aims to prove that administration of oral Ashitaba extract can reduce serum ALP levels in rats exposed to burn trauma. This study uses true experimental post-test control group design with a total of 20 Sprague dawley rats as samples. All samples were inflicted with 2nd degree burn wound and divided into 2 groups, treatment group (Ashitaba extract 300 mg/KgBW) and control group. Blood serum were analyzed for ALP levels on the 2nd, 8th and 14th days. Kinetic-IFCC method was used to find serum ALP levels. Data was analyzed using Mann-Whitney Test, paired T-test amd independence T-test. Scalded wound size was measured macroscopically over the course of 21 days to find contracture rate. In conclusion, Ashitaba extract is not proven to significantly reduce the serum ALP levels, increase contracture rate and enhance burn wound healing process. However, there was slight increase in contracture rate in treatment group as compared to control group. In addition, there was a lower ALP levels in treatment group as compared to control group in day 8.

Microwave Enabled Physically Cross Linked Sodium Alginate and Pectin Film and Their Application in Combination with Modified Chitosan-Curcumin Nanoparticles. A Novel Strategy for 2nd Degree Burns Wound Healing in Animals.

This study reports microwave assisted physically cross-linked sodium alginate and pectin film and their testing in combination with modified chitosan-curcumin nanoparticles for skin tissue regeneration following 2nd degree burn wound. Film was formulated by solution casting method and physically cross-linked using microwave irradiation at frequency of 2450 MHz, power 750 Watt for different time intervals for optimization. The optimized formulation was analyzed for various physiochemical attributes. Afterwards, the optimized film and optimized modified chitosan-curcumin nanoparticles were tested in combination for skin regeneration potential following burn wound in vivo and skin samples extracted and tested for different attributes. The results indicated that the optimized film formulation (5 min microwave treatment) physicochemical attributes significantly enhanced addressing the properties required of a wound healing platform. The vibrational analysis indicated that the optimized film experienced significant rigidification of hydrophilic domains while the hydrophobic domains underwent significant fluidization which also resulted in significant increase in the transition temperatures and system enthalpies of both polymer moieties with microwave treatment. The combined film and nanoparticles application significantly increased protein content in the wounds which were evident from higher absorbance ratios of amide-I and amide-II (2.15 ± 0.001), significantly higher melting transition temperature and enthalpy (∆T = 167.2 ± 15.4 °C, ∆H = 510.7 ± 20.1 J/g) and higher tensile strength (14.65 ± 0.8 MPa) with significantly enhanced percent re-epithelization (99.9934 ± 2.56) in comparison to other treatments. The combined application of film and nanoparticles may prove to be a new novel treatment strategy for 2nd degree burn wound healing.

On the question of embodying maternal impressions in the bud

One striking example of the influence of the spirit on the body will be those organic stigmata that are caused by verbal suggestion in hypnosis. Up to six times I myself had to get redness and blisters in such cases [1]), and this experiment was successfully repeated by my student, Dr. DA Smirnov in Moscow (1-7). The process proceeded in front of the witnesses present for several hours. The maturation of the blisters passed through the usual stages of 2nd degree burns, i.e., the whole complex of clinical symptoms of inflammation was present.

Influence of Ti-Si-N Nanocomposite Coating on Heat Radiation Resistance of Fireproof Fabrics.

Fireproof fabrics are commonly used for protection of fireguards. Such materials must be characterized by improved heat resistance, especially to radiation and flame. In this paper, fireproof fabric (NATAN and PROTON—trademark names) was covered with Ti-Si-N nanocomposite reflective coating using magnetron sputtering. The fabrics were subjected to heat radiation of heat flux density from 0.615 to 2.525 kW/m2. A testing stage equipped with a heat source, thermal imaging camera and thermocouples was used. Two variants of the coatings were studied: Ti-Si and (Ti,Si)N considering different thicknesses of layers. The temperature increment and time to reach the pain threshold (60 °C) which corresponds approximately to a 2nd-degree burn according to Henriques criterion were analyzed. In addition, the microstructural analysis of the samples using a scanning electron microscope (SEM) equipped with energy dispersive spectroscopy (EDS) system was performed. The improvement of heat resistance showed for Ti-Si-coated PROTON and NATAN for all tested heat flux densities. Time to reach 60 °C for PROTON fabric increased maximally from 11.23 s (without coating) to 13.13 s (Ti-Si coating) for heat flux density of 0.615 kW/m2 and for NATAN—maximally from 7.76 s (without coating) to 11.30 s (Ti-Si coating) for the same heat flux density.

On dual performance of protective clothing composites with different air gaps under hot steam exposure

Thermal protective clothing (TPC) may actually have a dual impact on human skin since it not only resists heat and mass transfer from thermal environment, but also imposes thermal hazard through thermal stored energy discharge. The air gap entrapped clothing is an important factor influencing heat and mass transfer properties. This study used several indices to qualitatively explore the impacts of air gap size and its position on the dual performance of protective textile composites. The theoretical heat and mass transfer across an air gap was also analyzed. The results demonstrated that with the increasing of air gap size, heat transmission through textile composites during both exposure and cooling periods decreased, and the 2nd and 3rd degree burn time increased. The thermal protective performance was more affected by an inner air gap rather than by a middle air gap. However, the thermal-hazardous performance caused by the stored energy discharge was more affected by a middle air gap. Empirical models were successfully established to predict the energy absorption of the skin throughout the test. Results from this study could provide proper guidance for researchers and designers to develop new protective materials to prevent burn injuries.

Supporting the Regional Network for Children with Burn Injuries in a Pediatric Referral Hospital for COVID-19.

Considerable reorganization of the regional network for pediatric burn treatment during the pandemic was required to cope with severe burn injuries in small children. In support of the emergency network for burns during the COVID-19 pandemic, we referred to regional indications for centralization in our hospital for all children aged less than 5 years who presented with severe burns, >15% of total body surface area (TBSA), or who necessitated admittance to the pediatric intensive care unit (PICU). A new service with a dedicated management protocol was set up to treat pediatric burns in our SARS-CoV-2 pediatric hospital during the lockdown period. A multidisciplinary burn treatment team was set up to offer compassionate and comprehensive burn care. Patient’s clinical data, burn features, treatment and follow up were recorded. A higher number of admissions was recorded from February to December 2020 compared with the same period in 2019 (52 vs. 32 admissions). Eighteen patients were admitted to the COVID-19 Service (10 M/8 F; 3.10 ± 2.6 yrs); ten children (55.5%) were hospitalized in the ward and eight in the ICU (44.5%). Fifty percent of the cases presented with lesions extending over >15% TBSA; in one case, TBSA was 35%. All patients suffered 2nd-degree burns; while five patients also had 3rd degree lesions covering more than 15% TBSA. All of the injuries occurred at home. No major secondary infections were recorded. Successful treatment was achieved in 94.4% of cases. The average length of stay was 15.2 ± 12.6 days. A proactive, carefully planned service, involving a multidisciplinary team, was created to ensure appropriate care in a pediatric hospital during the COVID-19 period, despite the effective pandemic associated challenges. Better health promotion in pediatric burn cases should also include dedicated TBSA assessment and a database of children’s burn characteristics.

Population Awareness and Attitude towards First Aid in Burn in Makkah Al-Mukarramah, Saudi Arabia – A Cross Sectional Study

Background: Worldwide, an estimated 180, 000 deaths per year are caused by burns. Majority occur in low- and middle-income countries. Inadequate awareness of burn first aid has been reported in both developed and developing countries. In Saudi Arabia, studies reported inadequate level of knowledge of general population of first aid in burns emergencies including communities of Al-Madinah Al-Munawwarah, Jeddah, Riyadh, Majmaah and Hail.&#x0D; Objective: we aim to assess the general knowledge and attitude regrading burn first aid among Makkah Al-Mukarramah population. Thus, the results of this study could help to understand the need of community to more implantation of Health Awareness Campaigns to help burn injuries managements.&#x0D; Methods: A cross-sectional study was performed using an online survey. A total of 1390 participants completed the questionnaire from 15 February to 15 March 2019.&#x0D; Results: Around 51.4% believed that washing burned area with cold water is the immediate first aid in 1st degree burns, 38.3% and 61.7% believed that going to the nearest emergency department is the immediate first aid in 2nd and 3rd degree burns, respectively. Around 46.7% agreed to remove the clothes stuck to the burned skin in case of burns , 34.5% applied traditional home remedy including toothpaste, honey, tomato paste or egg.&#x0D; Conclusion: we found that population of western region have fair knowledge and attitude towards first aid in burns. However, traditional home remedy practice still present. Health Awareness Campaigns still needed to improve community attitude towards burn injuries managements furthermore.