Burn Cases Research Articles

Deliberate Practice as an Effective Method for Reducing Diagnostic Error in Identifying Burn and Bruise Injuries Suspicious for an Abusive Injury

To examine the effectiveness of an education intervention for reducing physician diagnostic error in identifying pediatric burn and bruise injuries suspicious for abuse, and to determine case-specific variables associated with an increased risk of diagnostic error. This was a multicenter, prospective, cross-sectional study. A convenience sample of pediatricians and other front-line physicians who treat acutely injured children in the United States and Canada were eligible for participation. Using a web-based education and assessment platform, physicians deliberately practiced with a spectrum of 300 pediatric burn and bruise injury image-based cases. Participants were asked if there was a suspicion for abuse present or absent, were given corrective feedback after every case, and received summative diagnostic performance overall (accuracy), suspicion for abuse present (sensitivity), and absent (specificity). Of the 93/137 (67.9%) physicians who completed all 300 cases, there was a significant reduction in diagnostic error (initial 16.7%, final 1.6%; delta -15.1%; 95% CI 13.5, 16.7), sensitivity error (initial 11.9%, final 0.7%; delta -11.2%; 95% CI 9.8, 12.5), and specificity error (initial 23.3%, final 6.6%; delta -16.7%; 95% CI 14.8, 18.6). Based on 35,627 case interpretations, variables associated with diagnostic error included patient age, sex, skin color, mechanism of injury, and size and pattern of injury. The education intervention substantially reduced diagnostic error in differentiating the presence versus absence of a suspicion for abuse in children with burn and bruise injuries. Several case-based variables were associated with diagnostic error, and these data can be used to close specific skill gaps in this clinical domain.

Prevalence and characteristics of paediatric burns at the National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Ghana

IntroductionBurn injuries among children have emerged as a significant global public health concern, accounting for substantial morbidity and mortality worldwide. Low and Middle-Income Countries bear a significant burden of paediatric burn injuries. In Ghana, limited data exists on the prevalence, characteristics and outcomes of paediatric burns. This study provides vital data on the local burden and epidemiology of paediatric burns at Ghana’s main burns treatment center. The findings have significant value in informing prevention strategies, allocating resources, and improving quality of paediatric burn care. Study objectiveTo establish the prevalence and characteristics of paediatric burns injuries in Ghana’s leading burn center. MethodologyA retrospective cohort study analyzed data from 662 adult and paediatric patients who presented with burns from all over Ghana between 2020 and 2022. The study encompassed medical records of paediatric burn cases (aged 0–14 years) admitted to the center from January 2020 to December 2022. A purposive sampling technique was used to select cases based on the inclusion criteria and elimination of cases with 20 % missing data. A total of 335 paediatric records were reviewed. Data analytical methodsDescriptive statistics, such as frequencies, mean, percentages were used to establish period prevalence and demographic characteristics of paediatric burns. Chi-square analysis and univariate logistic regression was utilized to explore associations between categorical variables, and predictors of burn outcome. ResultsThe period prevalence of paediatric burns was found to be 50.6 %. Paediatric burn cases predominantly affected males (57.6 %). Majority of cases fell within the age range of 1 to 5 years (70.1 %). Hot water emerged as the leading cause (58.4 %), whiles superficial partial thickness burns (51.9 %) was the predominant type of burn. Most cases involved burns affecting less than 20 % Total Body Surface Area (59.0 %). Multi-part body injuries were common (87.2 %), with the lower limb being the most affected (25.36 %). The mortality rate was calculated to be 21.0 %. Higher TBSA was a significant predictor of mortality (p < 0.001). ConclusionThis study found a high prevalence of paediatric burns with hot water and foods being the predominant causes. Higher TBSA predicted lower chances of survival. The findings have scientific value in informing prevention strategies, allocating resources, and improving the quality of care.

Monodigital Double Cross-Finger Flaps-A Novel Approach for Coverage of Large Volar Defects.

A single cross-finger flap can only address digital defects of a limited size, and larger defects often require distant flaps such as abdominal or groin flaps that are cumbersome to perform and sometimes bulky. Two cross-finger flaps harvested from the same donor digit could offer a simple and effective solution for many such defects. In this study, we describe the technique of monodigital double cross-finger flaps and its clinical applicability, with evaluation of donor and recipient site morbidity. A total of 10 subjects with large volar defects were included in the study. The demographic data, etiology, defect size, flap donor, and recipient sites were tabulated prior to surgery. Each subject was assessed for postoperative complications at the donor and recipient site and followed up for 6-12 months to document any flap or donor site morbidities. The subjects included 9 males and 1 female subjects, with an average age of 35.6 years (21-67 years). Most patients had posttraumatic defects, with 3 cases of full thickness burns and one with postsurgical tissue necrosis. All defects were volar, with 4 on the little finger, 3, 2, and 1 in the ring, index and middle fingers, respectively. No major postoperative complications were noted in any case. All flaps survived well with good contour, and donor fingers achieved near-normal range of flexion with only minimal restriction (10-15°) at the distal interphalangeal joint that did not result in any overall functional disability. Monodigital double cross-finger flap technique offers a simple and effective solution for reconstruction of large digital defects that are not amenable for closure by a classical cross-finger flap, and is a good alternative for other procedures, providing supple soft tissue coverage and no significant morbidity at the donor digit provided that there is preservation of a small skin bridge across the proximal interphalangeal joint.

Application of cultured epidermal autograft, JACE®, improves survival rate in extensive burns: A propensity score matching study using Tokyo registry data.

Cultured epidermal autograft, JACE®, was introduced into the Japanese national health insurance system in 2009 and has been used in more than 1000 cases of extensive burns. The aim of this study was to investigate whether the use of JACE® contributes to survival rate in extensive burns. In this study, 119 cases were selected from 3990 cases in Tokyo Burn Unit Association registry data from 2009 to 2023, excluding cases with less than 40% total body surface area, cases of deaths within 4 weeks and cases with unknown length of hospital stay. In total, 25 patients treated with JACE® were selected and matched with another 25 patients who did not receive JACE® using propensity score matching. The results showed that patients treated with JACE® had a significantly higher survival rate than did those who were not treated with JACE® at all time points between 6 and 9 weeks post-injury. In addition, there was no significant difference in length of hospital stay between the groups. These results suggest that the use of JACE® in patients with extensive burns contributes to patient survival and does not prolong hospital stay.

The influence of supportive therapy with a six-component myophlebotropic preparation on the reduction of symptoms in patients with symptoms of hemorrhoidal disease

&lt;b&gt;Introduction:&lt;/b&gt; Hemorrhoidal disease is the most common disease treated in proctology ambulatories. Conservative treatment is the basic form of treatment for this disease. One of the elements of treatment may be preparations with myoand phlebotropic effects.&lt;b&gt;Aim:&lt;/b&gt; To assess the effect of a multi-ingredient myophlebotropic dietary supplement used as an adjunct on the rate and effectiveness of symptom relief in patients with stage II and III hemorrhoidal disease.&lt;b&gt;Material and method:&lt;/b&gt; Patients with stage II and III hemorrhoidal disease with clinical symptoms such as pain, burning, itching and bleeding were qualified for the study. The patients were divided into two groups. The control group (Group I) of 29 patients receiving standard local treatment plus placebo and the study group (Group II) of 32 patients receiving the same local treatment and a six-component myophlebotropic product. Symptoms were analyzed at the time of inclusion in the study (day 0), after 4 and 10 days of therapy. The severity of hemorrhoidal disease and the feeling of relief were assessed on the day of inclusion (W0) and after 30 days of therapy.&lt;b&gt;Results:&lt;/b&gt; There were no statistical differences between the groups in terms of disease advancement, age, gender, and duration of symptoms. Compared to the moment of inclusion in the study (W0), after 4 days (W1), after 10 days (W2) of taking the multi- -component product, there was a statistically significant improvement in the VAS scale: spontaneous pain and pain during defecation. In the qualitative assessment (yes/no), there were statistically significantly fewer cases of burning in the anus and itching. The treatment did not affect the rate of spontaneous bleeding, which was low at the beginning of the study, but significantly reduced the rate of bleeding during defecation. After 30 days of observation, it was found that the improvement in the severity of hemorrhoidal disease symptoms was significantly higher in the group using the tested preparation. Relief after a month of the study (one-question method) was noted in the group of patients receiving the tested product.&lt;b&gt;Conclusions:&lt;/b&gt; The tested six-component myophlebotropic product proved to be effective in reducing the severity of symptoms such as spontaneous pain, pain during defecation, burning/burning in the anus and bleeding during defecation. Statistical significance was demonstrated in the symptom’s relief and reduction in the severity of hemorrhoidal disease.

"Seasonal Dynamics in Burn Profiles: A Comprehensive Analysis at the Burn Care Centre, Islamabad."

Seasons have a major impact on the frequency and characteristics of burn injuries; in warmer months, thermal burns from outdoor activities are more common, while in cooler months, incidents involving heating sources and fires are more common. It is essential to comprehend these trends in order to customise safety precautions and awareness initiatives. Studies on the impact of seasonal variations help burn centres allocate resources more effectively in order to prepare for variations in patient volume and severity. Data from January 2016 to December 2022, with an emphasis on burn types excluding non-burn cases, were analysed retrospectively over a seven-year period at the Burn Care Centre in PIMS, Islamabad. The research examined hospital stays, demographics, burn causes, admissions, total burned surface area, and death rates while dividing the years into winter and summer seasons for analysis. With 4,014 admitted patients, the study found that winter admissions increased by 11.007%, with winter admissions accounting for 55.503% of all admissions and summer admissions for 44.496%. The gender distribution stayed the same, with 54.59% of the population being male and 45.99% being female. Hospital stays were longer for summer admissions (16.428) than for winter admissions (11.285). Summertime saw a rise in electric burn cases (307 cases), with a 43 case fatality rate. With 1699 cases, flame burns predominated in the epidemiology of burns, followed by scald burns with 1384 cases. In conclusion, seasonal differences have a substantial impact on burn profiles, with winter seeing a marked rise in occurrences. Men are also more likely to sustain electric burns, particularly in the summer. Effective management and prevention techniques depend on an understanding of these patterns.

Application of Free Flaps in Reconstruction of Head and Neck Soft Tissue Defects With Bone Exposure.

Reconstruction of head and neck soft tissue defects with bone exposure is both challenging and technically demanding for plastic surgeon. Objectives in head and neck soft tissue defects with bone exposure reconstruction are consistent restoration of functionality while also improving appearance. This study retrospectively analyzed the results of head and neck reconstructions using various types of free flaps over the past 4 years. A retrospective analysis was conducted from June 2019 to June 2023 on 12 patients treated at our hospital for head and neck soft tissue defects with bone exposure due to various causes. These included 4 cases of trauma from car accidents, 1 burn case, and 7 postoperative malignant tumor removals. The defect sizes ranged from 4 × 6 to 15 × 45 cm. Different free flaps were used for repair based on the defect, including 6 anterolateral thigh flaps, 3 forearm flaps, 2 latissimus dorsi flaps, and 1 dorsalis pedis flap. Flaps were designed and harvested to match the defect size and transplanted via anastomosed vessels. All 12 flaps survived successfully. One patient required flap thinning surgery postoperatively. All patients were followed up for over 3 months, showing good color and texture of the transplanted flaps, satisfactory healing, and significant aesthetic improvement. Donor sites showed significant scarring without functional impairment. Free flap repair for head and neck soft tissue defects with bone exposure is feasible and yields good results.

Chemical Scalp Burn after Hair Coloring-Case Report with Literature Review.

Hair dyeing is widely performed around the world. Chemical and thermal burns can result from the components present in brightening and coloring products, as well as the application process. We present a case of a chemical burn after applying hair dye and review the literature on similar cases, the composition of hair dyes, their mechanism of action, and the process of burns. The patient was a 17-year-old girl, who presented to the Dermatology Clinic with a 13 × 10 cm ulcer on the scalp after hair dyeing in a hairdressing salon. General and local treatment was applied, with particular emphasis on specialized dressings. The ulcer site was replaced by an area of scarring after 11 months of treatment. Based on the presented case and the review of the literature, we conclude that hair dye treatments warrant careful attention for potential scalp complications. The diagnostic and therapeutic approach demands a multidisciplinary effort, with ongoing patient-doctor cooperation throughout the treatment, which may complicate and span several months.

The Pattern and Trends of Burn Related Death

Background: Since ancient times fire has kept amusing mankind in various ways. Though it hashelped human to evolve but if mishandled can lead to serious consequences. We know that fire canbe a friendly, comforting thing, a sources of light and heat, yet fire can also be most dangerous anddeadly. Burn is the one of the commonest cause of unnatural death in the world.Objectives: To find out the causes, epidemiological factors and pattern and trends of burn relateddeath.Methods: The present study was conducted at Dhaka Medical College and Hospital, for a period of1 year from January 2022 to December 2022. A total number of 1792 autopsy was done among ofwhich 418 cases were burn. Convenience sampling technique was followed and sample size was418 cases of burn among 1792 cases .Data were collected from police inquest, department RegisterKhata from the department of Forensic Medicine and Toxicology at Dhaka Medical college..Datawere analyzed, tabulated and presented by using SPSS version 16.0.Results: During the study maximum death due to burns were found in labourers 233(55.74%).Maximum death due to burn were found in illiterate 158(37.79%). Maximum cause of death due toburns were found in low socioeconomic status 213(50.95%) and the maximum death due to burnwere found in the age group 21-40 years 234 (55.98%). Maximum cases of death due burns werefound in male which contributed to 293(70.09%) of the total death. The most common source offire in death due to burn was cylinder gas explosion 208(49.76%). Maximum cases of death due toburn occurred in workplace 184(44.01%). As a result of burn, shock was the predominant cause ofdeath 287(68.66%). Accidental 316(75.59%) burn was the most common manner of death due toburn.Conclusion: The most accidental burn cases were preventable. By giving proper education andawareness about the causes of burn, burn injury and post burn complications. So we should takeproper preventive methods that may reduce mortality and morbidity rate due to burn.

Multispectral-responsive Cu7S4@rGO bio-heterojunction for rapid sterilization through bacterial cuproptosis-like death

Bacterial infection is a significant challenge in the realm of wound healing, particularly in burn and trauma cases, as it delays wound healing, threatens patient health, and promotes the development of drug-resistant bacteria. Although phototherapy is widely employed in the field of antimicrobial therapy, these methods are typically applied in broad spectrum approach to treat various types of infectious diseases. Their selectivity is often limited, which may lead to an increased risk of tissue damage, thereby diminishing clinical applicability and specificity in particular contexts. To address this daunting issue, we have designed a multispectral-responsive bio-heterojunction (bio-HJ) (Cu7S4@rGO bio-HJ) to induce bacteria cuproptosis-like death. Cu7S4@rGO bio-HJ catalytically generates a considerable amount of ROS which assaults the membrane of extracellular bacteria under near infrared (NIR) or visible light. Additionally, Cu7S4@rGO bio-HJ can effectively kill bacteria by inducing localized hyperthermia under NIR. As a result, the multispectral antibacterial properties of Cu7S4@rGO bio-HJ has significantly enhanced its applicability and feasibility in medical settings. Cu7S4@rGO bio-HJ demonstrates potential for utilization in the treatment of oral infections, cutaneous infections (such as acne and herpes), and other superficial infections through its responsiveness to visible light, facilitating photodynamic therapy. Furthermore, in the context of deep-seated tissue infections, Cu7S4@rGO bio-HJ responsiveness to NIR renders it viable for the implementation of combined photodynamic and photothermal therapy. This study reveals the potential of Cu7S4@rGO bio-HJ in multispectral responsiveness and bacterial sterilization, providing new insights for novel biomedical applications.

The evaluation of burn knowledge and burn management skills of resident doctors of emergency medicine, general surgery and plastic surgery

Abstract Background/Aims: Our study aimed to assess the abilities of emergency medicine, general surgery, and plastic surgery resident doctors in diagnosing, treating, and managing burn patients. Methods: We conducted a survey study between 04.05.2015 and 04.08.2015 at university hospitals and training and research hospitals in Ankara. We collected information on the age, gender, experience, and hospital of the doctors, as well as their training and approaches to treating burn cases. We evaluated their knowledge in various areas, including clinical approaches to 2nd and 3rd-degree burn cases, escharotomy localizations, intubation indications, bulla treatment, referral and hospitalization indications, identification of inhalation burns, and fluid resuscitation. Results: The average age of the participants was 29.3±2.4 years, and 65.7% were male. We found that doctors who had received advanced burn life support training had better approaches to burn cases (p

Authority of the Environmental Service in Combating Pollution Due to Burning of Waste in Tangerang City

Tangerang City Regional Regulation Number 2 Year 2022 on Waste Management contains technical regulations on waste management and a prohibition on burning waste that is not in accordance with the technical requirements of waste management. This research focuses on: How is the Implementation of the Authority of the Tangerang City Environment Agency over waste management that affects pollution caused by waste burning based on Tangerang City Regional Regulation Number 2 Year 2022? How are the Obstacles and Solutions of the Tangerang City Environmental Agency in overcoming pollution caused by waste burning in Tangerang City? The theories used are Authority Theory and Law Enforcement Theory. The method used is the empirical juridical approach method so that the author uses a qualitative and descriptive type of research. The results obtained are that the Tangerang City Environmental Agency is responsible for managing waste by inviting the community to participate in the waste bank and waste alms program and supervising and enforcing the law on this waste burning case. There are obstacles, namely the difficulty of monitoring the waste burning area, illegal trash bins, lack of public awareness. The suggestion is to conduct an analysis in the implementation of the regulation, increase supervision at points where waste burning often occurs, eradicate illegal trash bins, improve waste management by cooperating with organizations regarding the development of waste banks, inviting the public to participate in socialization and conduct waste alms

Medial and Lateral Burns With Concomitant Infection After Genicular Nerve Radiofrequency Ablation: A Case Report

BACKGROUND: Knee osteoarthritis management might include medication, intraarticular injections, physical therapy, and surgical intervention. Genicular nerve radiofrequency ablation (RFA) is an effective therapy for patients who do not receive benefit from conservative medical management and are not surgical candidates (secondary to medical comorbidity, patient preference, and other factors). Genicular nerve RFA is generally safe and has a low complication rate. However, there have been case reports of minor and major complications after RFA. We report a case of burns after genicular nerve RFA. CASE REPORT: A 49-year-old man (92 kg; body mass index [kg/m2] 28.3), with a history of coronary artery disease and chronic tobacco use, presented with 20 years of chronic knee pain. He previously had short-term relief with an intraarticular steroid knee injection. He was found to be a suitable candidate for genicular nerve RFA and underwent the procedure successfully without any immediate complications. His pain decreased from 9/10 before the procedure to 5/10 after his RFA. On postprocedure day 33, a 1 cm circular lesion with drainage was noted on the medial aspect of his knee. A lateral lesion was discovered at a subsequent follow-up appointment. He was treated with antibiotics, chlorhexidine cleansing, and dressing changes which resolved the lesions without any long-term sequelae. CONCLUSION: Our case represents an instance of full thickness skin burns with concomitant infection post genicular RFA, uniquely in both the medial and lateral sites. Our patient’s risk factors of low body mass index, smoking, and vascular disease may have led to a delayed healing response. In addition, needle depth may also have contributed to his injury. Ensuring adequate needle depth and patient selection can minimize these complications. KEY WORDS: Radiofrequency ablation, knee pain, osteoarthritis, chronic pain, genicular nerve, RFA, adverse event, complication

Thermal Injuries in Children: A Literature-Based Overview

Burns are a significant cause of morbidity and mortality in children. While the majority of pediatric burns are not life-threatening, they can have a significant impact on a child's physical and psychological health. They pose a major social and financial burden, particularly in developing countries. The management of pediatric patients with thermal injuries requires a complex and multifaceted approach.&#x0D; Pediatric burns constitute approximately 40-50% of all reported cases of severe burns. The most common etiologies of pediatric burns include scalds, contact burns, flames, and chemicals. From 80% to 90% of burns occurred at home and were accidental. Despite advancements in treatment, severe burns can lead to life-threatening complications, such as sepsis, multisystem organ failure, and hypermetabolic response or even death.&#x0D; This article aims to provide a literature-based overview of pediatric burn trauma, outlining its unique characteristics, etiology, epidemiology, classification, and initial management.

Hematological Trends in Severe Burn Patients: A Comprehensive Study for Prognosis and Clinical Insights.

Severe burn injuries pose diagnostic challenges, contributing to increased fatality rates with delayed diagnoses. This study aims to identify early risk factors and understand their impact on clinical outcomes by examining hematological dynamics in severe burn cases. The focus includes age-related patterns, total body surface area (TBSA) affected by burns, hospital stay duration, and changes in hematological markers during burn injuries. An analytical cross-sectional study at the burn care center involved 135 participants hospitalized between January 2018 and December 2021. Demographic data and hematological markers were recorded, and statistical analysis was performed using IBM SPSS 25.0. Nonsurvivors exhibited a greater mean TBSA, shorter hospital stay, and an enhanced early immune response indicated by white blood cell count on the first day. Hematological markers, including hemoglobin, red cell count (RCC), and platelet count, showed dynamic patterns over the study period. Marginal variations in platelet counts and intriguing patterns in RCC suggested potential consequences like disseminated intravascular coagulation. The study provides crucial insights into hematological responses to severe burn injuries. Early identification of risk factors, particularly age-related patterns and immune responses, informs clinicians about predicting outcomes and guiding therapeutic interventions. Despite limitations, this work underscores the need for further multicenter research to comprehensively understand the complex relationships between burn injuries, hematological responses, and clinical outcomes.

Logistic regression analysis of risk factors for pediatric burns: a case-control study in underdeveloped minority areas in China.

Pediatric burns are common, especially in underdeveloped countries, and these can physically affect the children involved and have an impact on their mental health. The aim of the present study was to assess the effect of pediatric burns in underdeveloped minority areas of China. Case information from 192 children was collected from outpatient and inpatient clinics using a survey questionnaire. These included 90 pediatric burn cases and 102 controls who were children without burns. A stepwise logistic regression analysis was used to determine the risk factors for pediatric burns in order to establish a model. The goodness-of-fit for the model was assessed using the Hosmer and Lemeshow test as well as receiver operating characteristic and internal calibration curves. A nomogram was then used to analyze the contribution of each influencing factor to the pediatric burns model. Seven variables, including gender, age, ethnic minority, the household register, mother's employment status, mother's education and number of children, were analyzed for both groups of children. Of these, age, ethnic minority, mother's employment status and number of children in a household were found to be related to the occurrence of pediatric burns using univariate logistic regression analysis (p < 0.05). After a collinearity diagnosis, a multivariate logistic regression analysis of variables with tolerances of >0.2 and variance inflation factor <5 showed that age was a protective factor for pediatric burns [odds ratio (OR) = 0.725; 95% confidence interval (CI): 0.665-0.801]. Compared with single-child parents, those with two children were at greater risk of pediatric burns (OR = 0.389; 95% CI: 0.158-0.959). The ethnic minority of the child and the mother's employment status were also risk factors (OR = 6.793; 95% CI: 2.203-20.946 and OR = 2.266; 95% CI: 1.025-5.012, respectively). Evaluation of the model used was found to be stable. A nomogram showed that the contribution in the children burns model was age > mother's employment status > number of children > ethnic minority. This study showed that there are several risk factors strongly correlated to pediatric burns, including age, ethnic minority, the number of children in a household and mother's employment status. Government officials should direct their preventive approach to tackling the problem of pediatric burns by promoting awareness of these findings.

Ocular Trauma Characterization in a Reference Emergency Eye Centre in Colombia (FOSCAL).

Ocular trauma is one of the most important causes of ocular morbidity and inadequate visual acuity in developed and developing countries. In some countries, eye trauma is the leading cause of monocular blindness. Studies conducted in developing countries like Colombia suggest that there is a lack of awareness of preventive measures. In Colombia, there is no countrywide ocular trauma registry. The purpose of the present study is to describe and analyse characteristics of ocular trauma at a tertiary ophthalmology emergency department in Colombia. Patients who consulted or were referred to the ophthalmologic emergency department of FOSCAL due to eye injuries between March 1, 2022, and January 10, 2023, were included in this cross-sectional study. Of 1 957 patients, 2 088 eyes were included. Men comprised 78.5% of the patients, the median age was 36 years, and 75.0% lived in urban areas. The median latency between trauma and ophthalmology consultation was 21.8 hours. Of the eyes, 1 805 (88.4%) had suffered mechanical or mixed (mechanical plus burn) trauma. Of the injuries, 87.5% were unilateral. In terms of the circumstances, 45.9% of injuries occurred during working or educational activities (in 85.6% of these cases, without eye protection), 28.2% in home accidents, and 14.0% in transportation situations. According to the Birmingham Eye Trauma Terminology System (BETT), 1 735 eyes (91.1%) were closed globe injuries, and 49 eyes (2.7%) were open globe injuries. Fifty eyes (2.8%) could not be categorised according to BETT at the initial consultation and were classified as "still to be determined". In the Ocular Trauma Score (OTS), 85.8% were category 5. Of the ocular burn cases, 93.0% were categorised as grade I according to the Roper Hall classification. In line with global literature, a much higher proportion of men than women sought consultation for ocular trauma. The findings suggest a need for improvement in the referral process from institutions with the lowest level of care. Lack of awareness about eye protection is an issue. Surgical exploration or additional tests may be necessary for precise injury classification. We therefore propose adding a "still to be determined" category to the BETT initial classification. These cases may be reclassified later, thus improving the accuracy of OTS calculation.

Electric burn of the skull: treatment by applying trepanations and wound dressing. Illustrative case.

Although electric injuries to human tissue are uncommon in contemporary times, their occurrence implies a high degree of morbidity and mortality. These are primarily attributed to the impact of electric current on cellular membranes, resulting in the disruption of ionic changes. In this paper, the authors present the case of an electric burn on the skull in a 50-year-old male, treated by utilizing trepanation and daily sterile wound dressing. This approach differs from the conventional treatment involving tissue grafts. Although the techniques utilized in this case are not commonly chosen as the initial treatment option, they have demonstrated effectiveness. Despite the absence of tissue flaps or grafts, satisfactory coverage of the skull cap was achieved.

Analysis of cases of suicide by self-immolation in the post-mortem material of the Department of Forensic Medicine in Cracow.

Analysis of self-immolation cases and distribution of the resulting burns and their degree. The study included 16 cases from the Department of Forensic Medicine, Jagiellonian University Medical College in Cracow from 2000-2022 in which the cause of death was self-immolation. Based on the analysis of photographs and autopsy reports, drawings were made showing the exact distribution and nature of the injuries, moreover, the approximate percentage of body surface area affected was determined as well as the frequency of involvement of specific areas of the body, and the presence of previous diseases and mental disorders including previous suicide attempts. 81% of victims were male. Two age groups were predominant among the cases analyzed, namely, individuals around the age of 20, and those between 50 and 60 years of age. 44% of the deceased had burns exceeding 80% of total body surface. The most frequently involved body areas were the extremities and chest as well as head and neck. Fourth-degree burns were most prevalent on the head and neck, third-degree burns prevailed on the upper and lower extremities, second-degree burns were mostly found on the chest, and first-degree burns - on the lower extremities. There were no cases of fourth-degree burns of the buttocks. 38% of the subjects had a history of substance abuse, 56% suffered from mental illnesses, whereas 31% attempted suicide in the past. The distribution of burns in self-immolation cases is inhomogeneous. The most frequently affected area was the head, neck, chest and extremities, most likely due to victims dousing themselves with a flammable substance from the top of the head through the chest. In all cases, the immediate cause of death was burn disease, regardless of the size of the body surface area affected by the burns. The majority of victims had a history of mental illness, substance abuse or suicide attempts.

Screening and Phasewise Management of Burn Injuries.

Thermal, electrical, chemical, or electromagnetic radiationcan cause painful wounds or burns. Spilling hot liquids onto the skin can also cause these kinds of injuries. The two biggest factors contributing to burn injuries in the elderly are smoking and exposure to open flames, while scalding is the primary cause of burn damage in children. Newborns and the elderly make up the majority of burn casualties. In India, there are estimated to be 6-7 million burn cases per year. The high incidence is attributed to the population's illiteracy, poverty, and lack of awareness of safety. The problem is made much worse by the fact that basic and secondary healthcare levels do not provide systematic burn care.Coagulation necrosis is caused by denaturing proteins due to heat from burns. Platelets clump together, arteries narrow, and partly perfused tissue (called the stasis zone) may spread out around the wound. In the stasis zone, tissue is hyperemic and inflammatory. When the skin's natural barrier is breached, microorganisms can enter the body and cause poor temperature regulation, fluid loss, and invasion. Intravascular volume loss is typically worsened by injured or edematous tissues. Significant heat loss may occur from the wounded dermis' lack of thermoregulation, particularly in exposed wounds. The severity determines the different treatments.Serious burns require considerable care, while lesser burns just require cleaning and painkillers. Just-partially thickened burns must be cleansed with soap and water before being clothed. For full-thickness burns, surgery, including skin grafting, is frequently required. Extensive intravenous fluid doses are often required to treat serious burns resulting from tissue edema and capillary fluid leakage.