Accidental Burns Research Articles

Comparison of accidental pediatric scald burns in a tertiary care center: hot cauldron burns versus accidental spill burns.

Background: Scald burns result from exposure to high-temperature fluids and are more common in the pediatric age group. They occur mainly by two mechanisms: (i) spill and (ii) immersion (hot cauldron) burns. These two patterns differ in clinical characteristics and outcomes. Scalds cause significant morbidity and mortality in children. The objective of this study was to compare accidental spill burns and hot cauldron burns in a hospital setting. Methods: An analytical cross-sectional study was conducted by reviewing the secondary data of scald cases admitted during the years 2019 and 2020 in a burn-dedicated tertiary care center. Total population sampling was adopted. Data analysis was done partly using SPSS, version-23, and Stata-15. Mann Whitney U-test and Chi-square/Fisher's exact test were done appropriately to find associations between different variables. Regression analysis was performed taking mortality events as the outcome of interest. Results: Out of 108 scald cases, 43 (39.8%) had hot cauldron burns and 65 (60.2%) had accidental spill burns. Overall mortality was 16 (14.8%), out of which hot cauldron burns and accidental spill burns comprised 12 (75.0%) and 4 (25.0%), respectively. Multinomial logistic regression analysis showed the type of scald, age, and Baux score found to be associated with mortality. Every one-year increment in age had a 29% lower odds of occurrence of mortality event (adjusted odds ratio [OR], 0.71; 95% confidence interval [CI], 0.50-0.99, p=0.042). Likewise, every one-point increment in Baux score was associated with 19% higher odds of mortality (adjusted OR, 1.190; 95% CI, 1.08-1.32; p<0.001). Conclusions: Accidental spill burns were more common but mortality was significantly higher for hot cauldron burns. The majority of burn injuries occurred inside the kitchen emphasizing appropriate parental precautions. The risk of mortality was significantly higher in burn events occurring outside the house, and burns involving back, buttocks, perineum, and lower extremities.

Maternal mortality due to thermal injury in pregnancy

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Human physiology is altered during pregnancy and adds further stress to systems that are already modified. Mother and foetus are placed at increased risk by burns injury, which is often associated with a high rate of both fetal and maternal mortality and morbidity.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods: &lt;/strong&gt;All pregnant patients with burns injuries admitted at our tertiary hospital under department of general surgery from June 2017 to May 2019. This study included 20 pregnant patients with burns injury.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the total 20 cases, the percentage of TBSA varied from 5% to 100%. There were 19 cases of accidental burns and one case of homicidal burns. There were 11 preterm deliveries of which two stillbirths and nine spontaneous abortions occurred. In all, ten out of twenty mothers died after severe burns amounting to total maternal mortality at 50%.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Burns during pregnancy demands special management and requires early and adequate resuscitation with the use of a limited choice of antibiotics and local antibacterial agents. Early surgical intervention and a special obstetric protocol are required in the management of these patients to improve maternal outcome.&lt;/p&gt;

Accidental Trichloroacetic Acid Burn Injuries on Genital Area during Gynecological Procedures

Accidental Trichloroacetic Acid Burn Injuries on Genital Area during Gynecological Procedures

English

BACKGROUND The skin is the largest organ of our body with a complex function. Burn injuries result in damage to the skin by electrical, chemical, thermal or radiation energies or a combination of them, by far the most common being the thermal injuries. However, most burn injuries are preventable and hence need preventive strategies. Outcome is dependent on various factors. The focus of this study is to provide an overview of various factors and clinical presentation of burn injury and their correlation of these various factors with outcome of burn injury. METHODS A retrospective facility-based document review analytical study was conducted on 215 patients admitted in the emergency (burn ward) department of Government Medical College and Hospital, Srinagar, Kashmir from September 2019 to September 2020. RESULTS In our study, out of total 215 hospitalized burn patients, 101 (47 %) were female and 114 (53 %) were males. In 103 (47.9 %) patients, burn injury was caused by scald burn, kangri burn was present in 3 (1.4 %) patients; 207 (96.3 %) patients had accidental burns and 8 (3.7 %) patients had suicidal burn injuries; 181 (84.2 %) had received good pre-hospital intervention; 165 (76.7 %) patients were discharged without complications. Various parameters – degree of burn, cause of burn, nature of burn, nutritional status and antibiotic coverage show statistical significance with P-value &lt; 0.05. CONCLUSIONS Kashmir is a valley surrounded by mountains, has cold weather for about threequarters of year. People here are more prone to burn injuries especially thermal injuries. Outcome of burn injuries is better for lesser degree of burns and mortality increases with severe degree of burns. Patients without complications, patients with good nutritional status at presentation and patients with proper antibiotic coverage had good outcome. KEYWORDS Burn Injury, Kangri, Outcome of Burn

502 Adapting to COVID19: Can Virtual Burn Camp be as Impactful as Last Year’s In-person Camp?

IntroductionSkin is not the only casualty following a burn accident. Many children suffer long term, debilitating emotional effects from their burn injury (Abdullah et al. 1994; Kornhaber et al. 2018). Armstrong-James et al. (2018) and Maslow and Lobato (2010) found that summer camps explicitly designed for burn survivor children can positively impact children’s adaptability to stares and comments and improve their sense of self-esteem. Camp Susquehanna has been a summer camp for burn survivors for the past 25+ years. When the COVID19 pandemic closed many businesses, we decided to transition our in-person camp to 100% online. Researchers demonstrated the positive effects of summer camp for burn survivors (Maslow & Lobato, 2010; Bakker et al. 2011). However, the effects of a 100% online camp are not known. Our concern was, are we able to transition and be as impactful as it is face to face at camp? What will the schedule and activities look like in this new format? How will we ensure all children participating will have access to online and the supplies necessary?MethodsWe opted to select a three-week format with two sessions a day divided into two age groups. We ensured every child had internet access then mailed out a “camp in the box.” It contained all the things needed for each planned activity. The critical question remained, however, will we be as impactful? The current research looks at quantitative and qualitative measures of self-esteem, happiness, and satisfaction following participation in a three-week summer program held in July 2020. We make comparisons to previous years’ results. The authors expected that self-esteem, happiness, and satisfaction levels matched or exceeded last years’ levels.ResultsWe collected data from 42 campers and 22 volunteer camp counselors. Results show that campers were able to receive the support they needed, not only from the staff but also from their peers.ConclusionsThe delivery method was indeed different this year, but the positive effect on our campers remained the same.

70 Measuring Itch Intensity in Young Children with Burns: What We Learnt from Parents. A Mixed-Methods Study

Abstract Introduction Despite the persistence and debilitating symptoms among inflicted children and their families, little is known about children’s itching behavior as perceived and described by parents. This study examined the parental description of young children’s itching behavior corresponding to the itch intensity rating, which can inform the future development of itch measurements for young children. Methods This analysis was part of a larger descriptive study that examined parental behavioral and psychological responses to children’s itch following the child’s unintentional burn injury. Parents of young children with deep second or third-degree burns were recruited. Parents were asked to rate the child’s itching intensity under four situations during the 7-day time frame using a 0–10 numerical rating scale (0 indicates no itch, and 10 indicates the worst itch possible). Parents were subsequently interviewed to describe the child’s observed behavior that reflected the itch intensity rating. The four itch situations were the current itch, the worst intense itch, the least intense itch, and the itch by a mosquito bite. Qualitative data were analyzed using inductive content analysis methods. Results Twenty parents of children 34 (±11.5) months old participated in the study. The average length of time since the child’s burn accident was 6.4 (±3.1) months. The mean ratings of the current itch, the worst intense itch, the least intense itch, and the itch by a mosquito bite were 3.45 (±2.4), 8.35 (±2.3), 1.5 (±1.7), and 4 (±1.2), respectively. Two themes that described a child’s itching behavior were identified: the level of a child’s needs for parental comfort and the frequency and disturbance (to activity and sleep) of scratching behavior. Conclusions Results suggest that the parent’s description of a child’s needs for parental comfort and scratching behaviors may serve as objective indicators of itching intensity. Interpreting inching intensive based on a child’s needs for parental comfort offered a creative way to evaluate itch considering the developmental perspective in young children. Future development of itch measures for children under 5 years of age shall consider these two important aspects.

601 Burn Injuries Associated with At-home Hair Braiding

Abstract Introduction Hair braiding that incorporates synthetic extensions has increased in popularity across all age groups. During the styling process, the ends of the braid are commonly dipped in hot water. As a result of this practice, an increasing number of patients have presented to our Burn Center after containers of recently boiled water are accidentally tipped over and spilled onto patients. Here, we report on patient demographics, outcomes, and our experience managing this injury pattern. Methods A retrospective chart review was performed of all patients who sustained burn injuries associated with at-home hair braiding presenting to an ABA-verified Burn Center between January 1, 2006 and July 31, 2020. Data on patient demographics, injury characteristics, wound management and, burn outcomes was collected. Results A total of 41 patients presented over the study period with burn injuries related to at-home hair braiding. The frequency of this type of burn increased over time, with 54% of injuries occurring in the last three years (2018–2020). The mean patient age was 7.5 years (range 0.7 – 32 years). Demographically, the vast majority of patients were under 18 years of age (90%), female (95%), and African American (98%). Seventy-three percent of injuries occurred at the patient’s home and 88% of incidents involved another person in the hair braiding process. The mean total body surface area of burn was 5% (range 1–20%). The most commonly involved areas were the back (54%), thigh/leg (37%), neck (24%), shoulder (24%), and arm/forearm (22%). Ninety percent were entirely partial thickness injuries with 10% of patients suffering some degree of full thickness injury. Ninety percent of patients required inpatient admission, and 36% of patients required at least one operative procedure. For those managed as inpatients, the average length of stay was 5.4 days (range 1–30 days). Three patients were reported to experience complications with one developing respiratory failure and two with delayed wound healing. Conclusions Hair braiding, with the use of scalding water to seal and set the ends of braids, can lead to significant accidental burn injuries. At our institution, these injuries occur predominantly in young African-American females. These burns can result in acute hospitalization and the need for surgical intervention. This is the largest series of this injury type to date with trends towards increasing frequency in the most recent time period.

Study of Road Traffic Accidental (RTA) deaths in and around Jamnagar Region of Gujarat

Paediatrics is a branch of medicine which is concerned with wellbeing of infants, children, adolescents, their physical, mental, and psychological development. Paediatric forensic autopsy is useful to evaluate us the natural and unnatural childhood deaths, their reasons, steps for prevention and their management, which is both useful to the branch of Forensic Medicine and the Medical researchers. A 3 year retrospective study was conducted in M.P. Shah Government Medical College, Jamnagar during the period of January 2014 to December 2016. Out of total 3743 autopsies performed, a total of 253 cases belonging to paediatric age-group were the material of the study. Accidental deaths are the most common manner of deaths and mostly affected age-group is 12-17 years. The leading cause of death are burns, drowning, road traffic accidents and snake bite. Accidental burns and suicidal hanging were more common in females in the age-group 12-17 years. Accidental drowning and RTA were common in the males. In the present study, snake bite envenomation was also one of the leading causes of unnatural deaths in children and was mostly seen in the age range of 2-10 years. In India, both natural and unnatural childhood deaths are emerging as major public health problem. Various educational programmes, preventive strategies, and dissemination of information are necessary to create awareness and is must to reduce the unnatural deaths. Keywords: Paediatric autopsy, Unnatural children deaths, Trauma, Manner of death.

Retrospective study of pediatric autopsy findings in a tertiary care center: an evaluation

Paediatrics is a branch of medicine which is concerned with wellbeing of infants, children, adolescents, their physical, mental, and psychological development. Paediatric forensic autopsy is useful to evaluate us the natural and unnatural childhood deaths, their reasons, steps for prevention and their management, which is both useful to the branch of Forensic Medicine and the Medical researchers. A 3year retrospective study was conducted in M.P. Shah Government Medical College, Jamnagar during the period of January 2014 to December 2016. Out of total 3743 autopsies performed, a total of 253 cases belonging to paediatric age-group were the material of the study. Accidental deaths are the most common manner of deaths and mostly affected age-group is 12-17 years. The leading cause of death are burns, drowning, road traffic accidents and snake bite. Accidental burns and suicidal hanging were more common in females in the age-group 12-17 years. Accidental drowning and RTA were common in the males. In the present study, snake bite envenomation was also one of the leading causes of unnatural deaths in children and was mostly seen in the age range of 2-10 years. In India, both natural and unnatural childhood deaths are emerging as major public health problem. Various educational programmes, preventive strategies, and dissemination of information are necessary to create awareness and is must to reduce the unnatural deaths. Keywords: Paediatric autopsy, Unnatural children deaths, Trauma, Manner of death.

Epidemiology of Pediatric Burn in a Tertiary Care Hospital of in a Northeastern State of India

Background: Burn injury is one of the biggest public health issue in terms of mortality, mor-bidity, and permanent incapacity. Pediatric burns have a longrun social impact. This impact is more distinguished within the north-eastern population of India, where their incidence and morbidity are high. The aim of this retrospective hospital based study was to produce a recent prospective to epidemiologic information on Pediatric burns in this region and to recommend future preventive methods. Methods: Children up to eighteen years age attending a State Medical facility at Dibrugarh between January 2018 and December 2020 were included in the study. Information relating to age, sex, etiology, total body area (TBSA), circumstances of injury, and clinical assessment were taken into thought and analyzed to confirm the predictors of outcome of the extent of Burns. Results: There have been three hundred children included in the study. Age, variety of burns, mode of injury, presence or absence of inhalation injury, gender, and time of year for admission were found to have an effect on the outcome of the Burn concerned. Fidgeting with flammable substances and unattended fireworks was conjointly found to be major explanation for burns in Children. Electrical burns conjointly fashioned a vital range of presenting burn patients, chiefly involving teenagers. Contrary to different earlier analysis that steered by a high incidence of suicidal burns our study failed to find any incidence of suicidal burns in Children. Conclusions: This study conjointly highlights many problems like overcrowding, lack of awareness, dangerous cookery practices, and improper use of fuel oil. Concerned authorities ought to acknowledge the issues, formulate methods, unfold awareness, and ban or replace unsafe substances answerable for most burn accidents.

Monitoring healing of accidental laser burns of the macula using optical coherence tomography

Patients with chorioretinal colobomas are at a risk of rhegmatogenous retinal detachment as a consequence of retinal breaks that occur in the abnormally thin colobomatous or extra colobomatous reti...

Analysis on burning failure of main transformer in 220kV substation

Neutral point ungrounded three-phase system is widely used in 10kV and 35kV low-voltage systems because of its higher power supply reliability. When the single-phase grounding short-circuit fault occurs in the system, the other two phases can continue to operate for a period of time to ensure the reliability of power supply. However, when the system operates under single-phase grounding fault, arc grounding overvoltage is easy to occur, which may damage electrical equipment or develop into phase-to-phase short circuit. This paper analyses a burning accident of main transformer caused by arc grounding overvoltage in 220kV substation, obtains fault recording information, points out fault causes and puts forward corresponding preventive measures.

Epidemiological Study of Burn Deaths at a Tertiary Care Centre in Mumbai

Death due to burns is an important cause of unnatural death commonly encountered in Medico-legal Practice.This prospective study was conducted on 100 cases of burn deaths caused by flames, hot liquids and flashof electricity. This study was conducted to know the demographic profiles, common risk factors, causes andmanners of death in fatal cases of burns. Most of the cases were in the age group of 21 to 50 years with apeak incidence in 21-30 years age group, with female predominance. In the study, maximum cases were dueto kerosene stove blast leading to accidental burns, followed by pouring of kerosene as a source of burn..

Clinicoepidemiological profile of thermal burn injuries and its mortality risk factors in a tertiary care center in Uttarakhand

Introduction: Burns are a major burden to the society in terms of lives lost, treatment costs, and postburn deformities. This study aims to identify the incidence, causes of burns, associated risk factors, and mortality in a tertiary care center in Uttarakhand. Patients and Methods: This study was an observational study conducted from October 2018 to April 2021 at a tertiary care center in Uttarakhand. It includes the patients with thermal burns who were admitted in the burns unit of the hospital. The interrelationship between various risk factors and mortality was studied. Results: A total of 247 patients were included in the study. Males outnumbered females constituting 55.47% of the population. Most of the patients were of age group 21–40 years and were from rural backgrounds, belonging to lower socioeconomic class. The literacy rate was 76.52%. Farming was the predominant occupation. Major cause of burns was flame burns with second-degree burns being the most common. Accidental burns were common, and mostly (39.68%) patients sustained burns with total burn surface area (TBSA) &lt;25%. The mortality rate was 11.34%. Majority (56.68%) of the patients belonged to Class IV socioeconomic class (modified BG Prasad classification). Conclusions: Young males of rural background and low socioeconomic strata were the most common victim of burn injuries. The majority of cases were accidental thermal burns. The mortality rate was high in patients with TBSA &gt;60%, third-degree burns and housewives. Appropriate measures need to be taken regarding the education of the public for prevention of burns and improvement in healthcare to decrease the incidence and improve the outcome of burn patients.

Accidental chemical burn injury associated with recreational thinner inhalation

Inhalation of thinners is known to have systemic toxic effects on the human body. Despite this, thinners have been abused for mood alteration. Accidental injury following thinner inhalation includes burns from the ignition of volatile substance or secondary trauma (as the patient loses consciousness). Chemical burn from prolonged contact with thinner-containing toluene may occur, although rare. We present a case of accidental burn injury resulting from prolonged contact with spilled thinner.

It's Hot Out:

"Heat wave's on. She cracks the car windows for circulation when she knows things will be how they are. Doesn't work. Seatbelts, Delinia said. Accidental burn. She heaved against the charter school guardrail, burned herself there too. Golly, Delinia said. I'm not sure how to move with all the ways my stuff hurts me. […]"

Psychotraumatism in Burning Accident Victims: About 50 Patients at the Abidjan Burns Center

Among the potentially traumatic events, burn accidents have the particularity of damaging the physical integrity of the victims while leaving psychological scars. The objective of this study is to investigate the attribution of post-traumatic stress disorder (PTSD) to the presence of extensive body burn. This was a cross-sectional descriptive and analytical study that took place from May to August 2017 and which involved (50) fifty patients labeled severe burns. The burns were second degree superficial (63.50%) and affected between 1 and 10% of the body surface in 72% of cases. The event appealed to a sense of horror at the mention (28%). Post-traumatic stress disorder was found in 6% of victims. The chi-square test found a significant dependence with a P-value of 0.0043 between the PTSD score and the body surface area burned. The extent of the burn injuries in the victims, in addition to reflecting the severity of the accident, is a risk factor associated with the occurrence of psychotrauma. In a dual preventive and therapeutic approach, psychotraumatological follow-up should be offered to any major burn victim.

Evisceration and enucleation cases in the ophthalmologic emergency department of a tertiary Brazilian hospital.

To analyze the epidemiological profiles of evisceration and enucleation cases in the ophthalmologic emergency department of a Brazilian tertiary hospital. Patients treated in the ophthalmologic emergency department of Hospital São Paulo (Universidade Federal de São Paulo) during the period 2013 to 2018 were retrospectively evaluated. Urgent cases of evisceration or enucleation surgery were included, and elective cases were excluded. The following information was extracted from the patients' medical records: demographic data, immediate and associated reasons for the surgical procedure, informed visual acuity, symptom duration until ophthalmologic care, complications, distance from the residence to the tertiary hospital, and time of hospitalization. In total, 61 enucleations and 121 eviscerations were included in this study. The patients had a mean age of 63.27 ± 18.68 years. Of the patients, 99 were male (54.40%), and 83 were female (45.60%). The indications for evisceration or enucleation were corneal perforation with (44.50%) and without (23.63%) signs of infection, endophthalmitis (15.38%), ocular trauma (14.29%), neoplasia (0.55%), burn accident (1.10%), and phthisis bulbi (0.55%). The self-reported visual acuity was no light perception (87.36%) or light perception (1.10%). However, 3.30% of the patients did not cooperate with the examination, and no information on visual acuity was available for the remaining 8.24%. The mean symptom duration before ophthalmologic care was sought was 18.32 days. Two patients had sympathetic ophthalmia after evisceration. More eviscerations than enucleations were performed throughout the study period. The most common demographic characteristics were age >60 years and male sex. The main indications for urgent evisceration and enucleation procedures were corneal perforation with and without infection, endophthalmitis, and ocular trauma. The findings from this study could guide clinicians in performing preventive measures to avoid destructive eye procedures.

Parents’ lived experiences of parental needs for support at a burn centre

ABSTRACT Purpose: A burn injury to a child is a traumatic event and the parent’s emotional reactions and coping strategies affect the child’s adaptive outcome. It is therefore important that parents get the right support. The aim was to explore parents’ lived experiences of their need for support when having a child admitted to a burn centre. Methods: Semi-structured face-to-face interviews were conducted with 22 parents of children age <12 years hospitalised with an accidental burn injury, 9 to 27 days after the burn accident, from April 2017 to July 2018. A Ricoeur-inspired textual analysis method was used. Results: Four themes emerged from the analysis and describe the parents’ needs for support. The parents wanted to be taken care of as a whole family and feel safe in the hands of professionals. This, in turn, depended on being informed about the child’s condition and treatment, but also on getting help in dealing with feelings of guilt. Not least, parents wanted opportunities to take care of their own fundamental needs in terms of hygiene, food, adequate rest and activities. Conclusion: As an overall understanding the healthcare providers should focus on the family as a whole in care and treatment.

Obstruction of the formation of granulation tissue leads to delayed wound healing after scald burn injury in mice.

BackgroundDelayed wound healing remains a common but challenging problem in patients with acute or chronic wound following accidental scald burn injury. However, the systematic and detailed evaluation of the scald burn injury, including second-degree deep scald (SDDS) and third-degree scald (TDS), is still unclear. The present study aims to analyze the wound-healing speed, the formation of granulation tissue, and the healing quality after cutaneous damage.MethodsIn order to assess SDDS and TDS, the models of SDDS and TDS were established using a scald instrument in C57BL/6 mice. Furthermore, an excisional wound was administered on the dorsal surface in mice (Cut group). The wound-healing rate was first analyzed at days 0, 3, 5, 7, 15 and 27, with the Cut group as a control. Then, on the full-thickness wounds, hematoxylin and eosin (H&E) staining, Masson staining, Sirius red staining, Victoria blue staining and immunohistochemistry were performed to examine re-epithelialization, the formation of granulation tissue, vascularization, inflammatory infiltration and the healing quality at different time points in the Cut, SDDS and TDS groups.ResultsThe presented data revealed that the wound-healing rate was higher in the Cut group, when compared with the SDDS and TDS groups. H&E staining showed that re-epithelialization, formation of granulation tissue and inflammatory infiltration were greater in the Cut group, when compared with the SDDS and TDS groups. Immunohistochemistry revealed that the number of CD31, vascular endothelial growth factor A, transforming growth factor-β and α-smooth muscle actin reached preferential peak in the Cut group, when compared with other groups. In addition, Masson staining, Sirius red staining, Victoria blue staining, Gordon-Sweets staining and stress analysis indicated that the ratio of collagen I to III, reticular fibers, failure stress, Young’s modulus and failure length in the SDDS group were similar to those in the normal group, suggesting that healing quality was better in the SDDS group, when compared with the Cut and TDS groups.ConclusionOverall, the investigators first administered a comprehensive analysis in the Cut, SDDS and TDS groups through in vivo experiments, which further proved that the obstacle of the formation of granulation tissue leads to delayed wound healing after scald burn injury in mice.