Burn Cases Research Articles

MANAGEMENT OF FIREWORK INJURIES AT AN INDIAN REGIONAL BURNS AND PLASTIC SURGERY UNIT : TEN YEARS' EXPERIENCE

Celebration of various cultural and religious festivals as well as holidays involves use of reworks. Injuries due to reworks is essentially a preventable injury .The aim of this article is to review cases of burns and associated trauma due to reworks at a regional burns and plastic surgery unit in India .A retrospective review was performed in all patients presenting to our centre with burn injuries due to reworks over a period of ten years from March 2012 to March 2022. A Total 463 patients were identied. Cases were studied in terms of patients' demographics, trend of rework injuries throughout the year, mechanism of injuries, anatomical region wise involvement of burn injuries. Conservative and surgical treatment was provided according to the extent of burn injuries. Various treatment given and outcomes of treatment were recorded. Mean duration of hospital stay and recovery time was noted .Most injuries occurred in October and November (around the Diwali festival) Mechanism of injury were mostly ame burns, contact burns and injury from blast force. Most common injuries were sustained to hands, head and neck region and torso.A total of 54 (11.66 %) patients needed surgery. Fireworks can lead to burn injuries, a range of soft tissue injuries, fractures, as well as eye injuries.The severity of rework injuries can effectively by reduced by proper planning which involves preparedness of work force, awareness campaigns and educating public about safety measures.

Atypical Case of Fractal Wood Burning: Two Burned Bodies.

Fractal wood burning is a form of pyrography that uses high-voltage electricity to burn branching, Lichtenberg-type patterns into a wooden canvas. This process often uses electrical transformers salvaged from household appliances, such as microwave ovens, to amplify available voltage to potentially lethal levels. In this case, 2 individuals were found dead inside their burned residential garage. Initially, law enforcement was suspicious of a double homicide with subsequent arson. However, postmortem examination showed the decedents had neither fatal antemortem trauma nor significant natural disease. Findings consistent with smoke inhalation were absent, suggesting that the victims were deceased before the fire. Interestingly, one decedent had jumper cables in their hand, and their recent computer activity included fractal wood burning-related content. Upon further scene investigation, 2 microwave ovens were identified in the garage, one of which had been disassembled with its transformer found adjacent to the bodies. The decedents likely died from high-voltage electrocution with ignition of the wooden canvas starting the structural fire. Since the first reported case in 2016, there have been 33 reported deaths attributed to fractal wood burning. The current study would be the first to report multiple fatalities due to a single fractal wood burning event.

Analisis Hukum Pidana Islam dan Undang-Undang No 41 Tahun 1999 tentang Kehutanan Dalam Perkara Tindak Pidana Pembakaran Hutan:

A forest fire is a situation where a forest is engulfed by fire resulting in damage to the forest or forest products causing economic loss and/or environmental value. The research approach used is normative legal research, with the following conclusions: The results of this study indicate that in decision Number: 58/Pid .Sus/2016/PN Psp concerning the crime of forest burning which stated that the defendants Nelson Manurung and Muliadi Siburian had been proven guilty of committing the crime of forest fires and were sentenced to 1 (one) year in prison and a fine of Rp. 1,000,000,000 (one billion rupiah) by the Padangsidimpuan District Court. In this case it can be concluded that in their consideration the Panel of Judges did not consider the impact of the defendant's actions on the preservation of nature and the lack of firmness of the Panel of Judges in deciding cases which were considered relatively light. Criminal sanctions in the criminal act of burning forests in article 78 paragraph (3) of RI Law No. 41 of 1999 concerning forestry jo. Article 50 paragraph (3) letter d RI Law No. 41 of 1999, namely a maximum of 15 (fifteen) years and a maximum fine of Rp. 5,000,000,000 (five billion rupiah). Then, in view of Islamic criminal law, the author's findings in the criminal case of forest burning are subject to Ta'zir punishment, namely the punishment determined by the authorized government.
 Keywords: criminal act, forest burning, Islamic criminal law

A Review on Preparation of Calendula Oil

Calendula officinalis (calendula), belonging to the family Asteraceae, commonly known as English Marigold or Pot marigold. It is widely cultivated & can be grown in sunny locations. It is an annual or biennial plant attending a height of 30-60cm. It is a herb which is used in Traditional system of medicine for treating Wounds, Ulcers, scars, hair damage, Eczema, Diaper Rash, and Other Skin Conditions, it is mainly used because of its various biological activities to treat diseases as analgesic, antidiabetic ,antiulcers & antiinflammmatory it is also used for gastrointestinal diseases, gynecological problems , eye diseases, skin injuries & some cases of burns. An infusion or tincture of the flower taken internally is beneficial in the treatment of infections & diarrhea. An infusion of calendula officinalis may also be used to treat eye inflammation, boils & abscesses, eczema. This plant is reach in many pharmaceutical active ingredients like carotenoids, flavonoids, glycosides, steroids & sterols quinies, volatile oil & amino acids. Calendula oil is a powerful medicinal oil extracted from the petals of a common species of marigold. By using oil infusion, maceration method calendula oil is extracted, prepared & evaluated. In this review a detailed account of methods of preparation of calendula oil and their medicinal properties have been addressed.

Survival analysis of burn patients attending a tertiary care hospital of Western Maharashtra, India

Introduction: Burn injuries are a major problem in low-income and middle-income countries. High population density, illiteracy, and poverty are the main demographic factors associated with a high risk of burn injury. Social, economic, and cultural factors interact to complicate the management, reporting, and prevention of burns. Aim: The aim of this study was to discover attributes associated with the survival of burn cases. Objectives: The objective of this study was to assess the survival of burn cases. To identify the factors associated with the survival of burn cases. Materials and Methods: This observational, cross-sectional study was conducted for a period of 1 year started from January 2013 to December 2013, in the burn ward of Government Medical College, attached to the tertiary care hospital. Results: Overall, the mean survival time was 13 days (95% confidence interval = 10–16 days). Its time was significantly different (P = 0.000). The mean survival time was significantly associated (P = 0.007) with the nature of burn. It was a maximum (18 days) in patients having burn injury at workplace. It was 13 days in males as compared to 12 days in females. The mean survival time was maximum (20 days) in burn cases occurring between 6 pm and 12 midnight and minimum (10 days) in cases between 12 pm and 6 pm. Conclusions: The mean survival time was significantly associated with nature and mode of burn but was independent of age groups, time, place of occurrence, and sex of the patient.

Retrospective analysis of burn patients presenting to the emergency department

Aim: Patients who applied to our emergency department due to burning trauma; it was aimed to analyze demographic characteristics such as age, gender, burn causes, burn rates, and degrees. Materials and Methods: Retrospectively analyzed data of patients who applied for burns within 3 years and were scanned from patient files and computer records. The age, gender, time and date of admission to the emergency department, causes of burns, anatomical burn localizations, total burned body surface areas, hospitalization, and discharge status of the cases were analyzed. Results: 56.1% of the patients included in the study were male and their mean age was 21.28 years. It was found that 49.7% of our patients were between the ages of 0-17. Boiling liquids are in the first place with a rate of 43.4% as the cause of burns. The average burned body surface area was 29%, and 3rd-degree burns were the most common. The most frequently affected body areas were the upper and lower extremities. The peak application season was seen in winter with a rate of 33.9%. Conclusion: It is known that burn cases always maintain their importance. Since it is a life-threatening health problem and it is frequently seen in the young-child age group, it is necessary to increase the precautions.

Acute Burns during Pregnancy

Background: The incidence of acute burn injuries in pregnant women is very low. Burn injuries during pregnancy are often associated with a high rate of fetal and maternal mortality and morbidity. There is a paucity of published data on the specific problems of burns in pregnancy, despite the high mortality for both the mother and the fetus. Aims and Objectives: This study we aimed to review the cases of acute burn during pregnancy and evaluate the outcome of these patients in West Bengal, India. Materials and Methods: This was hospital based retrospective study conducted at SSKM Hospital in collaboration with Dept of Plastic Surgery, West Bengal, India from April 2019 to March 2022. Total 141 pregnant women with thermal injuries were included in the study. Template was generated and analysis was done on SPSS software. Results: Among 141 pregnant women with thermal injuries maximum were in the age group of 21-25 years (39.7%). Mean Age of the patients were 16.75 years. Accidental Burn was 114 (80.9%). Maximum burn was during 2nd trimester 83 (58.9%). IUFD was present in 4 (2.8%) of burn mothers, septicemia was present in 23 (16.3%) and maternal death was present in 22 (15.6%) of the burn mothers. Maximum maternal deaths 6 (4.3%) was found in 74%TBSA cases. Almost 90 to 100% maternal deaths were found in 70% to 100% TBSA cases. maximum deaths were in the age group of 18.20 years. Maternal deaths in accidental burn was 18 (12.8%) and suicidal burn was 4 (2.8%). Conclusions: Maternal mortality is correlated to the percentage of the total burned area and inhalation injury. Burns in pregnant women have a profound effect on the fetal wellbeing, with a high rate of mortality especially in the first trimester.

A Case of Abdominal Wall Burn Caused by Subcutaneously Embedded Molten Aluminum

A Case of Abdominal Wall Burn Caused by Subcutaneously Embedded Molten Aluminum

Guillain Barre Syndrome following Electrical Burn Injury: A Case Report

GuiIlain-Barre syndrome is an idiopathic acute or subacute inflammatory demyelinating polyneuropathy withascending and often bilaterally symmetrical paralysis. The diagnosis is made on the basis of clinical presentationwhich is mostly acute flaccid paralysis, and electrochemical analysis. We present a case of electrical burn injuryfollowed by GB Syndrome like features. Patient received the standard treatment of GB Syndrome that is I/Vimmunoglobulins and physiotherapy besides ventilatory support and supportive treatment of electrolyte andfluid management. He was discharged satisfactorily after two months of management in the hospital

Clinical Case of Hydrofluoric Acid Burn and Overview of Literature. Case Report and Review

We hereby report the case of a 31 years old male patient who attended our Accident and Emergency unit in May2022 complaining of pain and chemical burns on the distal phalanx of the five digits of the right hand. He reportedthat approximately 24 hours earlier, while cleaning the hull of a boat, his hand had been splashed with a cleaningsolution that contained hydrofluoric acid 10%. He had immediately rinsed his hand with water. Around 24 hoursafter the incident he began to develop blisters and increasing pain. On clinical examination, the patient presenteddeep burns and edema on volar and dorsal aspect of the distal phalanx of the right five digits .He presented a lightlydecreased capillary refill, but had normal pulses and sensation. The US scan showed the integrity of the digitalarteries and veins, as the flow was preserved. The patient was accurately and thoroughly irrigated with salinesolution. Full blood count, renal and hepatic function tests were performed. Ecg and abg were carried out. All testswere normal. Calcium gluconate was injected locally as per guidelines .One day later, the severe pain subsided aswell as the wounds and edema improved moderately.

Impact of Virtual Resources and Effect of COVID-19 Pandemic on Plastic Surgery Residency and Training among Residents in Southern Nigeria.

Despite the increased usage of virtual, nonphysical resources for medical education during the coronavirus disease-2019 (COVID-19) pandemic, plastic surgical training still suffered adversely in some aspects. The aim of this study was to explore the overall impact of virtual resources and effect of the COVID-19 pandemic on plastic surgery training among residents in Southern Nigeria. This was a cross-sectional study conducted among senior plastic surgery residents in southern Nigeria using a well-structured online questionnaire carried out over a 3-month period. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software program, version 25.0. Measures were taken to significantly minimise response, answer order, and other survey research errors/bias. A pilot study was done. Consent was obtained from all participants. A total of 29 plastic surgery residents completed the questionnaire. Mean age was 35.15 years with standard deviation of 6.31. The response rate was 72.5%. According to a majority of the residents, there were no significant changes in the frequency of burn, hand, and facial injury cases during the pandemic; training courses on plastic surgery (44.3%) and operative cases decreased (48.3%), whereas there was a significant increase in intraoperative teaching (27.6%) as well as simulations and conferences (41.4%). Majority of the respondents also alluded to the significant financial and psychological impacts of the pandemic on residents and a significant decline in cases with general anaesthesia as compared with cases with local anaesthesia. The COVID-19 pandemic has caused a mixture of significant positive and negative changes in the plastic surgery training of residents.

Sociodemographic Profile of Burns Case for Autopsy: One Year Study

Background: Burns constitute a major cause of deaths, both suicidal & accidental in the world & our country.As per the National crime record bureau of India, burns one among the common method of suicide and the rateof fatal suicidal burns was 2.6% in 2021. In Tamil Nadu, the rate of suicide is 11.5%, and also, being the secondhighest among the other states.(1) This study is undertaken with the aim to study sociodemographic profile ofburns case brought to autopsy at tertiary medical college, along with the pattern & outcome.Methods: A cross sectional study was done in a total of 53 cases of burns brought for medicolegal autopsy duringthe study period. Data including age, gender, socioeconomic status, manner of burns , % of burns, duration ofsurvival were all collected based on pre structured proforma & further was analysed using standard statisticalmethod.Results and Conclusion: Burns incidence is seen in mostly age group 31-40, with majority of them beingfemales(62.27%).suicidal burns are more common (73.59%), with >75%(66.03% ) burns being more. About 35.8%survived for 1-7 days prior to succumbing death.Enhancing a better mental& physical environment should be the priority. Early & effective treatment can be usefulin reducing the mortality due to burns.

Detection and Characterization of Gasoline based Polycyclic Aromatic Hydrocarbons on Different Materials by Gas Chromatography-Mass Spectrometry

Polycyclic aromatic hydrocarbons (PAHs) profile by gas-chromatography-mass spectrometry were recently used for the identification of sources of contamination in environmental forensic investigations. In present study, an effort is given to utilize gas chromatography-mass spectroscopy to obtain PAHs profile that could help forensic scientist in selection of evidence at the scene of fire. In forensic laboratories, the main evidence received in fire burning cases are fire debris which consists of soil, wood, paper, cloth etc. as a piece of individual evidence or mixture. In fire investigation, the type of material collected from the crime scene affects the investigation hence present study focused on which type of material is more suitable while utilizing a polycyclic aromatic hydrocarbon as a source identifier. Total of nine different materials like paper, cardboard, foam, cloth, metal, hair, soil, meat and wood were selected and these are burned with gasoline in partial burning and complete burning conditions. Debris obtained sonicated at room temperature and concentration of 18 PAHs were determined with gas chromatography-mass spectrometry. Results obtained were analyzed with the Principal Component Analysis (PCA) technique to generate a profile of PAHs. It is concluded that partially burned samples provide more information about the use of ignitable liquid to commit the crime as compared to completely burned samples. The meat, hair, metal and soil material provide more information about the presence of ignitable liquid based on the 18 PAHs concentration profile.

Bromelain-based enzymatic debridement in hand burns – an easier way to manage a difficult patient: case report

Introduction. Bromelain-based enzymatic debridement may be considered the standard in patients with upper extremity burns management, regarding the low risk of bleeding, wound infections, reduction of surgical timing, and the decreased risk of compartment syndrome development. Case presentation. We present the case of hand and face burns in a patient presenting deep venous thrombosis of the lower limb extended to the level of the vena cava, and bilateral pulmonary embolism. The enzymatic debridement reduced periprocedural bleeding and allowed a faster recovery and therefore the resumption of oral anticoagulation and antiplatelet medication in a patient with important cardiac, arterial, and renal comorbidities. Conclusion. Bromelain-based enzymatic debridement use is recommended in patients presenting upper limb deep burns, especially in anatomically challenging areas, like hand fingers, and especially in those with a previous medical history that predisposes them to periprocedural bleeding and increased risk of poor healing.

Role of Apparels in Burns due to Domestic Violence – A tool for assessing Degree of Burns

Background: Human life is subject to certain environmental, cultural and ethnic origin factors. Based upon the above facts loose and tight variety of clothing/apparel are commonly used. Fire and flames are an integral part of human life on the other hand and accidents do occur in natural course of history. In such accidents type of apparel one might be wearing play a great role in degree or severity of burns. Association and assessments need to be established in this regard. Methods: The study has been conducted on 250 cases of dry flame burns in AED of Mayo Hospital Lahore/Medicolegal Clinic of King Edward Medical University Lahore for a period of nine months in 2017-18. The population of 250 cases were selected through convenient non-probability purposive sampling technique. The study descriptive cross-sectional study design was applied to the above population selected for the study. Results: Our study revealed1.6% females were involved more than males in the burn incident during the period of study. A wide majority up to 70% used Shalwar and Kameez of loose wearable category as per culture of the country in comparison to the relatively tight clothing of Trousers and Pantaloons variety. A grossly significant role has been established with a p value of 0.024 that loose variety of apparel are responsible for causing greater degree of damage in burns as compared to that of tight variety of apparel worn at the time of incidence. Conclusion: The study concludes that wearing relatively short apparels or of tight i.e. Trousers and Pantaloons variety can be safe, protective and a healthy habit during cooking, working in fire burning vicinity like that of industry, hotels, restaurants and winter outdoor activities. The loose variety hereafter referred as Shalwarand Kameezvariety of cultural apparels can be dangerous and even life threatening when it involves higher percentages of burns. Keywords: Burns, Apparel, Clothing, Degree of Burns

Analisis Hukum Pidana Islam dan Undang-Undang No 41 Tahun 1999 tentang Kehutanan Dalam Perkara Tindak Pidana Pembakaran Hutan:


 A forest fire is a situation where a forest is engulfed by fire resulting in damage to the forest or forest products causing economic loss and/or environmental value. The research approach used is normative legal research, with the following conclusions: The results of this study indicate that in decision Number: 58/Pid .Sus/2016/PN Psp concerning the crime of forest burning which stated that the defendants Nelson Manurung and Muliadi Siburian had been proven guilty of committing the crime of forest fires and were sentenced to 1 (one) year in prison and a fine of Rp. 1,000,000,000 (one billion rupiah) by the Padangsidimpuan District Court. In this case it can be concluded that in their consideration the Panel of Judges did not consider the impact of the defendant's actions on the preservation of nature and the lack of firmness of the Panel of Judges in deciding cases which were considered relatively light. Criminal sanctions in the criminal act of burning forests in article 78 paragraph (3) of RI Law No. 41 of 1999 concerning forestry jo. Article 50 paragraph (3) letter d RI Law No. 41 of 1999, namely a maximum of 15 (fifteen) years and a maximum fine of Rp. 5,000,000,000 (five billion rupiah). Then, in view of Islamic criminal law, the author's findings in the criminal case of forest burning are subject to Ta'zir punishment, namely the punishment determined by the authorized government.
 Keywords: criminal act, forest burning, Islamic criminal law

Оказание медицинской помощи пациентам с острой глазной патологией в условиях пандемии

Purpose. Comparative assessment of frequency and structure of patients who underwent inpatient treatment for acute eye pathology before and during the coronavirus infection (COVID-19) pandemic. Material and methods. A quantitative analysis was carried out in 826 patients treated for various acute eye pathologies in the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution (the Branch) for the time periods: from May 2018 to February 2020 (the first) and from March 2020 to the end of December 2021 (the second). An assessment of frequency and nosological forms of diseases was carried out, examples of most severe cases of diseases and injuries were given.Results. For the first period, 318 patients were treated, for the second period - 508 patients. In the second period, there was significant increase in number of patients with acute eye pathology by 1.6 times. In both periods, patients with inflammatory lesions of tuveal tract prevailed: before the pandemic - 179 eyes, during the pandemic - 243 eyes. Also in the second period, 29 cases of severe burns of the cornea - II and III degrees were registered. Conclusion. All patients who applied to the Branch during study periods and needed emergency ophthalmic care were provided in timely manner and in full. The COVID-19 pandemic has made significant adjustments to work of the entire Branch, including work of Complex Rehabilitation Treatment Department in form of increase in number of patients with acute eye pathology by 1.6 times.

Energy Poverty, Burns and Health Risks in the Port Harcourt Metropolis, Nigeria

In the study, we examined the link between energy poverty and burns incidents among low-income suburban residents in the Port Harcourt Metropolis in Nigeria. Energy poverty manifests in many ways in low-income suburban areas. This includes frequent power outages, scarcity, the high cost of petroleum products and electricity, and the use of cooking systems devoid of energy efficiency. The residents respond to these challenges in ways that compromise their health and safety, resulting in preventable morbidity and mortality. In the study, we undertook a retrospective review of patients at the University of Port Harcourt Teaching Hospital Burns Centre. Burns incidents and fatalities from 2015 to 2021 were analysed with a focus on age, mortality, gender, causes of the injury and areas of residence. The results revealed that about 177 cases (48%) were caused by kerosene explosion. Flames from the ignition of fuel stored at home for power generating sets and from artisanal oil refining sites accounted for 113 cases (17%). Flames from candles for lighting during periods of power outages comprised 24 cases (4%). Fire caused by electricity constituted 28 cases (4%). Gas explosions caused by ignorance and poor housing conditions accounted for 177 cases (27%). The mortality coefficient of burns of 0.5 implies that at least five deaths resulted from every 10 cases of burns recorded in the hospital. In the study, we recommend that government implement policy on energy access and equitable distribution more vigorously to enable poor households to meet their energy needs in relatively safe and less risky ways.

Role of External Tissue Expansion Wound Closure in the Electrical Burn Wound to the Scalp

Electrical burns constitute 3–5% of all burn cases; in developing countries, this ratio increases up to 21–27% and the mortality rate is reported to be between 3.75% and 58.8%. Most of the acute burns are life threatening, and require various types of surgical interventions such as eschar excision or split thickness skin grafting, depending on the size, location and depth of the lesion. The deep electrical burns to the scalp were difficult to manage as it was more prone to exposure of the calvarial bone. In our case, a calvarial bone at the vertex was exposed post-eschar excision. Tissue expansion is based on the principle that all living tissues respond in a dynamic fashion to mechanical stress placed on them. Below we present a case of electrical burns wound to the calvarium utilizing the use simple cost-effective external tissue expansion technique for preventing wound retraction and for holding the dressing of the scalp wound.

The results of bacterial contamination of dangerous and borderline cases of burns

The aim is to study the microbiological picture of purulent inflammation of superficial local burns in the center of thermal lesions of Samara.Material and methods. The etiological structure of local burn infection was analyzed in 29 patients with limited, borderline burns of I-II degree in all phases of the wound process. The collection of wound material was carried out in accordance with the requirements of the Methodological Guidelines of MU 4.2.2039-05 "Technique of collecting and transporting biomaterials to microbiological laboratories". The material was delivered to the laboratory in test tubes with a transport medium under isothermal conditions at a temperature of 20–22 °C within a day after collection.Results. The analysis of the etiological structure of burn infection showed that staphylococcus (St. aureus, St. warneri, St. gallinarium, St. spp, St. epidermidis) plays a leading role in microbiological examination – in 26 patients (89.6 %) and E. coli (E. coli) in 11 (37.9 %). There were no significant differences in the studied signs in the comparison groups (p > 0.05, p = 0.55, χ2 = 3.841).Conclusion. The obtained results of the etiological structure of purulent inflammation of limited burns are statistically reliable and can be used in the development of antibacterial agents for the treatment of burn infection.