Case Of Burn Injury Research Articles

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Charting the recovery of dysphagia in two complex cases of post-thermal burn injury: Physiological characteristics and functional outcomes

Purpose: This study examined the physiological deficits, recovery pattern, and outcomes observed clinically and instrumentally in two participants with dysphagia post-thermal burn.Methods: Participants were followed prospectively using clinical and instrumental tools of assessment until dysphagia recovery. Clinical swallowing examinations were carried out every 1–2 days, or as clinically indicated. Instrumental assessment using fiberoptic endoscopic examination of swallowing was carried out at fortnightly intervals.Results: Despite variability in the achievement of oral intake milestones, both cases demonstrated protracted recovery from dysphagia contributed to by medical instability and lengthy periods of ventilation and intubation. Instrumental assessment confirmed silent aspiration in both participants, likely owing to decreased laryngopharyngeal sensation. By discharge, participants had returned to their pre-morbid diets.Conclusions: This study highlights the protracted and complex recovery pattern associated with dysphagia following thermal burn injury. The presence of silent aspiration emphasizes the need for instrumental assessment to objectively assess aspiration risk and to facilitate dysphagia recovery within this population.

The Protective Effects of Epigallocatechin Gallate Against Distant Organ Damage After Severe Skin Burns – Experimental Study Using a Rat Model of Thermal Trauma

Epigallocatechin gallate (EGCG), a green tea polyphenol, has potent antioxidant properties. The purpose of the present study was to examine the possible preventative effects of EGCG against internal organ injury due to large-surface skin burns in a rat model. The study design involved three groups of rats: a sham group and two groups with 25-30% full-thickness burns: (a) the sham group without burns or treatment (n=18); (b) the control burn group (burns+sterile saline, n=18); and (c) the burn treatment group (burns+treatment with EGCG, n=18). EGCG was administered intraperitoneally immediately after the thermal injury, and daily in 100 μmol/kg doses. Kidney and lung tissue samples were taken to determine the levels of malondialdehyde (MDA), superoxide dismutase (SOD), tumor necrosis factor-α (TNF-α), and glutathione peroxidase (GPX) after the first, third and seventh post-burn days. In the EGCG-treated burn group, SOD and GPX activity were significantly higher than in the burn control group. Additionally, MDA and TNF-α levels were significantly lower in the EGCG-treated burn group. Based on this study, it might be anticipated that EGCG treatment may be beneficial in burn injury cases.

Pattern of Pediatric Fatal Burn Injuries: A Retrospective Study

Globally, nearly 96 000 children under the age of 20 were fatally injured as a result of a fire-related burn in 2004 alone. The death rate in low-income and middle-income countries is eleven times higher than that in high-income countries 4.3 per 100 000 as against 0.4 per 100000. The fire related death rate for girls worldwide is 4.9 per 100 000 population versus 3.0 per 100 000 for boys. In our study of 81 autopsy cases of fatal burn injuries, 18(22.2%) were male and 63(77.8%) were female, 61(75.3%) cases were dry burns and 20(24.7%) cases were scalds, 45(55.6%) cases were death due to Septicaemia,, 26(32.1%) cases died due to shock and 10(12.3%) cases were death due to Toxaemia.

Geographical analysis of socioeconomic factors in risk of domestic burn injury in London 2007–2013

PurposeThis study aims to explore the geographical distribution of burn injuries in Greater London and the association of socioeconomic factors in areas at risk. MethodsData on burn injury cases classified as occurring in patients’ own homes in Greater London and admitted to a specialised burns service for ≥1 day during a 7-year period were obtained from the International Burn Injury Database (iBID). Age- and gender-adjusted standardised incidence ratios (SIRs) were calculated for each Lower Layer Super Output Area (LSOA) in Greater London. Bayesian methods were used to calculate relative risks as best estimates of spatially-smoothed SIRs. ResultsOf a total of 2911 admissions to specialised burns services in Greater London in the study period, 2100 (72.1%) cases occurred in patients’ own homes. Percentage of ethnic minorities (p=0.005), Income Deprivation Affecting Children Index (p<0.001), Health Deprivation and Disability Score (p=0.031), percentage of families with 3 or more children (p=0.004) and Barriers to Housing and Services Score (p=0.001) remained independently associated with the relative risk of paediatric domestic burn injury in a multivariate linear regression model. Percentage of ethnic minorities (p<0.001), Health Deprivation and Disability Score (p<0.001) and Barriers to Housing and Services Score (p=0.036) remained independently associated with the relative risk of adult domestic burn injury in a multivariate linear regression model. ConclusionsSocioeconomic factors are associated with an increased risk of burn injury in Greater London, but may be more important in children than adults. The specific factors identified are ethnicity, poor general health, household structure, housing issues and income deprivation affecting children.

Self-inflicted burn injuries in the Australian context.

The primary objective was to calculate the number of self-inflicted burn injuries of all admissions in an Australian hospital burns unit. The secondary objectives included examining the demographic profile, length of stay and co-morbidity of mental illness in these cases compared with the total admissions to the burns unit. A retrospective study of medical records was conducted at a tertiary burns unit over a 5-year period. A total of 33 self-inflicted burn injury cases were identified which represented 2.2% of all burns unit admissions. These patients were 70% male, the average age was 36.1 years and 11 were born overseas, which was similar to the profile of all admissions. Twenty-four (73%) patients were diagnosed with a mental illness, compared with 14% for all admissions. The average length of stay was 52 days, compared with the burns unit average of 12 days. While the percentage of self-inflicted burn cases of all burns unit admissions was low, these cases have a greater burden of care due to their longer admission time and higher frequency of co-morbid mental illness. This finding supports the need for close involvement of consultation liaison psychiatry teams within a burns unit.

Calcium carbide related ocular burn injuries during mango ripening season of West Bengal, eastern India

Calcium carbide used in fruit ripening industry as a cheap alternative to natural plant hormone ethylene produces highly inflammable acetylene gas. Inadvertent ignition of this gas can cause severe ocular burn injury with unilateral or bilateral blindness. To determine the characteristics and visual outcome of ocular burn injuries from calcium carbide during mango ripening season of West Bengal, eastern India. A prospective study of all cases of calcium carbide related ocular burn injury attending a tertiary care hospital during mango ripening season was carried out. The demographic features, characteristics of the injury, management and outcomes were recorded. Fifty five eyes of 33 patients were studied. Males were more commonly affected (20 patients, 60.6%) than females. The injury was bilateral in 22 patients (66.66%). Seventeen patients (51.51%) were below 20 years of age. Ten eyes had open globe injuries and 45 eyes had closed globe injuries. One eye of a patient had to be enucleated (3%). Children below 14 years of age were mainly injured while playing with indigenous fireworks of shooting carbide. Middle aged women were affected particularly during ignition of evening lamps. Carbide lamp was another source of injury. Males are more commonly affected by calcium carbide related ocular injuries. Children and young adults are the common victims. Such injuries can involve both the eyes and cause a permanent visual disability.

Unintentional domestic burns in Iran: Analysis of 125,000 cases from a national register

BackgroundThe aim of this study was to map out some epidemiological aspects of unintentional burn injuries among Iranian victims using a national injury registry data. MethodsInjury data were taken from a national injury surveillance system over the period 2000–2002. The study population comprised 31.5% of Iran's population. Burn-injury cases were retrieved and analysed. ResultsOf all the grossly 307,000 home injuries reported during the years 2000–2002 in Iran, about 125,000 cases (41%) were unintentional burn injuries. Women comprised 58% of the unintentional burn victims. The mean age among burn victims was 19.18±19 (standard deviation, SD) years. The age-adjusted incidence and mortality rates showed that children had a much higher incidence of domestic burns but the elderly suffered higher fatality in spite of lower incidence in this age group. Overall, 65.2% of the domestic burn injuries occurred in the living rooms or bedrooms followed by 27% in the kitchen. The hands and fingers were injured in 43.6% followed by the lower limbs in 37.6%. According to injury mechanism, scalds were the most common type of burn injuries comprising 77.7% of all burns. Of all the burn victims, 791 died, 48 victims became disabled and the remaining improved or were undergoing therapy when reported. ConclusionBurns form a major health problem in Iran. Due to high mortality rate, the elderly need specific attention regarding burn prevention and treatment in this age group. Moreover, in spite of lower fatality, any prevention programme should have a focus on childhood burns mainly due to the overwhelming distribution of burns in children and the young population of Iran.

Second Toe Plantar Free Flap for Volar Tissue Defects of the Fingers

BackgroundThe reconstruction of volar surface defects is difficult because of the special histologic nature of the tissue involved. The plantar surface is the most homologous in shape and function and could be considered the most ideal of reconstructive options in select cases of volar surface defects. In this paper, we evaluate a single institutional case series of volar tissue defects managed with second toe plantar free flaps.MethodsA single-institution retrospective review was performed on 12 cases of reconstruction using a second toe plantar free flap. The mean age was 33 years (range, 9 to 54 years) with a male-to-female ratio of 5-to-1. The predominant mechanism was crush injury (8 cases) followed by amputations (3 cases) and a single case of burn injury. Half of the indications (6 cases) were for soft-tissue defects with the other half for scar contracture.ResultsAll of the flaps survived through the follow-up period. Sensory recovery was related to the time interval between injury and reconstruction-with delayed operations portending worse outcomes. There were no postoperative complications in this series.ConclusionsFlexion contracture is the key functional deficit of volar tissue defects. The second toe plantar free flap is the singular flap whose histology most closely matches those of the original volar tissue. In our experience, this flap is the superior reconstructive option within the specific indications dictated by the defect size and location.

In the media: Burns as a method of assault

AimThe aims of this study were to determine whether a change occurred in the pattern of assault burn injury cases hospitalised to the adult state burns unit, Western Australia, from 2004 to mid-year of 2012, and to compare patient and burn characteristics of adult assault burns with those admitted for unintentional burns. MethodsStudy data were obtained from the Royal Perth Hospital (RPH) Burns Minimum Dataset (BMDS). Aggregated data of unintentional burn admissions during the same period were provided by the BMDS data manager to enable comparisons with assault burn patients. ResultsAssault burn admissions during 2004–2012 accounted for approximately 1% of all adult burn hospitalisations. All assault victims were burned by either thermal or scald agents. A high rate of intubation (24%) and ICU admission (1 in 3 cases) was observed in the fire assault group. The six assault cases undergoing intubation were severe burns, median TBSA 50%, most commonly affecting the face, head and torso, half of these cases had inhalational injuries and also required escharotomies.Comparison of admissions by calendar period showed no statistically significant differences in demographic, burn cause or TBSA%. However, statistically significant differences were found for pre-morbid psychiatric history (15% vs. 58%, p=0.025) and concomitant fractures or dislocations (46% vs. 2%), p=0.011). ConclusionsWhile the proportion of assault burn admissions per total burn admissions steadily increased from 0.4% in 2009 to 1.5% in mid-2012, this proportion did not exceed that peak level observed of 2.1% for 2004.

Demographic Profile of Fatal Burns in Bagalkot, North Karnataka

A retrospective study was conducted on the autopsy cases of death due to burns brought to the morgue of HSK Hospital, Bagalkot & District Civil Hospital, Bagalkot between period from October 2007 to September 2010. Out of 255 cases of burn injuries admitted to these hospitals in this 3-year's period, 115 cases of death were recorded. All these 115 cases were studied in relation with age, sex, marital status & occupation. Observations were also made in relation to total body surface area involved & cause of death. An attempt was made to analyze the manner of death.

Fatal burn injuries: A five year retrospective autopsy study in Cairo city, Egypt

Burn deaths are an important public health problem in a developing country like Egypt. The purpose of this study was to record and evaluate the causes and the magnitude of the fatal burn injuries retrospectively. An analysis of autopsy records revealed 106 (2.66%) cases of burn injuries among the total autopsies done over 5years period (2006–2010) in the mortuary of Forensic Medicine Institute, Cairo. The majority of deaths (66.1%) occurred between 11 and 50years of age group with a preponderance of males (67%). The flame burns were seen in 96.2% of the victims. The majority of burn incidents were accidental (55.7%) in nature followed by suicidal (22.6%) and homicidal (21.7%) deaths. The percentages of burns (TBSA) over 50% were observed in most of the cases (83%). Clear signs of vitality were found in 67% of the victims. The majority of deaths occurred within a week (82%) and most of the victims died from neurogenic shock (54.7%) followed by Septicemia & pneumonia (23.5%). The results of this study provide the necessary information to develop proper burn prevention programs, thereby reducing the frequency of burns and burn-related deaths.

Recovery from an Eighty-Percent Total Body Surface Area Burn Injury Sustained at Work

This article presents a case of severe burn injury at work involving 80 % of body surface area and patient treatment and rehabilitation, which resulted in preserved working ability. The worker was injured by hot water and steam. After initial treatment in the intensive care unit, he underwent comprehensive clinical and outpatient rehabilitation that took 92 weeks, after which he returned to work. His working disability was 100 % after the initial treatment in the intensive care unit, but rehabilitation improved it to 50 %. It should always be kept in mind that even patients with serious or life-threatening injuries can be reintegrated into the workforce if patients, physicians, occupational physicians, and employers all work together.

EPIDEMIOLOGICAL STUDY OF HOSPITALIZED BURN PATIENTS IN RURAL AREA

Background: Burns represent one of the major health problems in India.Objective: To study some of the important epidemiological factors in relation to burn cases. Methods: Present study was retrospective study of all burn injury cases admitted hospital situated in rural area. The information obtained was tabulated analyzed using the software GraphPad Instat. Results: Overall female burn patients were significantly higher than male. Majority of female patients had total burn surface area more than 35% whereas 48.70% of the male patients had a total burn surface area more than 35% (χ2= 7.99, p = 0.005). Thermalburn was the commonest cause of burn followed by scalds. In majority of the patients (91.8%) burns were caused by flame occurred at home.Conclusion: Public education on safer first-aid practices and availability of good burn care facilities is necessary.

PNEUMOTHORAX FOLLOWING ELECTRICAL BURN INJURY: A CASE REPORT

Electrical injuries are a common occurrence and they can be very trivial or fatal depending on the voltage.Electrical current causes tissue damage by producing heat due to local tissue resistance. Sometimes patients present with visceral damage, organ perforation or pneumothorax. Pneumothorax as an immediate complication of electrical burn injury is a rare entity since, it usually develops two days after significant electrical injury. We report one such treated case of electrical burn injury with right sided pneumothorax as an immediate complication.The outlook is very good in patients who survived the initial electrical exposure and received prompt treatment of complications.

Ten Cases of Extensive Burn Injury

Ten Cases of Extensive Burn Injury

Three Cases of Extensive Burn Injuries

Three Cases of Extensive Burn Injuries

A Case of Burn Injury of the Back due to Battered Child Syndrome

A Case of Burn Injury of the Back due to Battered Child Syndrome

Friction Burn Injuries to the Dorsum of the Hand After Car and Industrial Accidents: Classification, Management, and Functional Recovery

A total of 65 cases of friction burn injuries to the dorsum of the hand after car and industrial accidents were reviewed. The mean age of the study population was 31 years (range 18-68 years). The injury sustained from friction was graded into four grades: grade I (n = 6), isolated second-degree skin burn, grade II (n = 6), full-thickness skin burn without extensor tendon exposure, grade III (n = 45) the friction injury affected and exposed the extensor tendons, and grade IV (n = 8) the friction injury extended to bones and joints. Management was by dressing, split skin grafting, local/pedicle flap, and free muscle flap in grades I to IV, respectively. Functional recovery of the hand in terms of percentage normal range of motion and grip strength was best in grade I and worst in grade IV injury. Complications of reverse-pedicled forearm flaps were higher than free muscle flaps. However, the aesthetic appearance of grafted free muscle flaps on the dorsum of the hand was inferior to fasciocutaneous flaps.

Not all that glistens is gold: civilian white phosphorus burn injuries

White phosphorus is an incendiary agent used in particular types of ammunition. Exposure to phosphorus-containing compounds may cause severe burn injuries. Systemic effects may be fatal for the casualty even though only a small surface of the body is burned. We report 4 cases of white phosphorus burn injuries due to an exceptional accident mechanism. All casualties were holidaymakers in a coastal area at the Baltic Sea and confused white phosphorus ammunition residues with amber on a beachwalk. The supposed treasure was taken into the pants pocket. The phosphorus substances ignited spontaneously when they dried because of the body heat. Injury patterns combined simultaneous full thickness burn injuries of both hands with a burn injury of one thigh or the abdominal region. The acute treatment and the controversy surrounding decontamination of such patients are discussed. In addition, pathology of tissue damage and systemic injury are elucidated.