First-degree Burns Research Articles

Characteristics of patients with burn injuries managed at a tertiary care centre

IntroductionBurn injuries are becoming a growing burden, negatively impacting both individuals and society. They affect a person’s health and lead to psychosocial and economic problems. This study evaluates the prevalence, characteristics, and short-term outcomes of patients with burn injuries admitted to a tertiary care hospital in Northern Sri Lanka. MethodsThis prospective cross-sectional study was conducted on patients with burn injuries admitted to Tertiary care centre Jaffna over six months in 2023. Ethical clearance was obtained from the Ethics Review Committee of the Faculty of Medicine, University of Jaffna. Baseline characteristics and clinical features during hospitalisation were recorded. Categorical variables were compared using the Chi-square test, with post hoc Tukey tests conducted where applicable. ResultsThis study included 57 patients aged 1 to 88 years, with a mean age of 35.19 ± 21.16 years. Most participants were female (53.4 %), and most had completed secondary education (62.1 %). Approximately 65.5 % were employed in unskilled jobs, with the remainder in skilled professions. Accidental burns were the most common cause (72.4 %), with 84.5 % of injuries occurring at home, though suicide-related burns accounted for 24.1 %. Flame-related burns constituted 50 % of injuries, with first-degree burns being the most common (44.8 %). The availability of first aid significantly influenced outcomes, with 74.1 % receiving assistance, primarily through removing clothing (43.8 %) and using running water (15.8 %). A combined approach of care was received by most patients (52.7 %), while 8.8 % were hospitalised in the plastic and reconstructive surgery department. Many patients had burns covering less than 10 % of their body surface area (46.6 %). ConclusionThe findings of this study on patients with burn injuries underscore the importance of understanding the causes of burns, administering appropriate first aid, recognising different injury types and severities, assessing the total burn surface area, and tailoring patient treatment. These insights are crucial for informing prevention strategies and healthcare planning, aiming to mitigate the impact of burn injuries and improve patient outcomes.

Concise Review on Scientific Approaches to Burns and Scars.

Burns are large open surgical lesions bathed in virulent pus that result in rupturing of the cutaneous membrane, which has serious consequences such as an extensive loss of proteins, and body fluids, increased chances of infections, and sometimes death. These can be classified based on their penetration levels, i.e., first-degree burns penetrating the epidermis, second-degree burns including both epidermis and dermis, third-degree burns to both layers including the hair follicular cells, sweat glands and various core tissues, fourth-degree burns to adipose tissue, fifth stage burns to muscles, and sixth stage burns to bones. Wound healing/wound repair is a very perplexing process in which the tissues of the affected/burnt area repairs themselves to attain their original form and functionality but develop a scar at the wound site. This article mainly focuses on the algorithms to differentiate various degrees of burns, general first aid approaches to burns and scars, the rationale of treatment of burns, basic mechanisms highlighting the healing processes in humans in terms of free from scar formation as well as with scar formation at their elementary levels including cellular as well as biochemical levels, utility, and progression of pre-clinical data to humans and finally approaches for the improvement of scar formation in man.

123 National Study of the Increased Incidence of Complex Regional Pain Syndrome Following Severe Burn Injury

Abstract Introduction Complex Regional Pain Syndrome (CRPS) is a clinical condition that presents after an operation, trauma, or burn injury with allodynia, hyperalgesia, and myasthenia. The etiology of CRPS remains poorly understood and there is a notable gap in literature linking the severity of burns to the risk of developing CRPS. Our study aims to address this by investigating retrospective patient data to determine the relationship between the degree and total body surface area (TBSA) of burn injury and the incidence of CRPS. Methods Patient records were accessed through a national database of de-identified electronic patient medical records from 2010 to 2019. Specific ICD-10 codes were used to define cohorts and outcomes. Three cohorts were established among patients with a history of burns- those with first-, second-, and third-degree burns. Two additional cohorts of TBSA of burns of ≤20% and >20% were established. These cohorts were analyzed for the risk of developing CRPS (type 1 and 2) within 6 months of first instance of burn injury. A z-test was performed after propensity score matching with age, sex, race, and ethnicity with significant p-value < 0.05. Results 0.274% of third-degree burn patients (n= 2,682), 0.213% of second-degree burn patients (n= 2,009), and 0.221% of first-degree burn patients (n= 2,686) were diagnosed with CRPS within 6 months of the first instance of burn injury. Patients with third-degree burns were at a significantly higher risk for developing CRPS compared to patients with first-degree burns (p= 0.0270), second-degree burns (p=0.0102), and first- and second-degree burns combined (p < 0.001) within 6 months post-burn injury. Patients with more severe burns of TBSA>20% (n= 6,628) were more likely to develop CRPS with a risk of 0. 422% (p= 0.0305). Additionally, burn patients with CRPS were more likely to be female than without CRPS for first- (74%), second- (67%), and third- degree burns (53%), and TBSA>20% (62%). Conclusions Patients who undergo third-degree burns or burns of TBSA>20% have a significantly greater risk for developing CRPS post-injury. Based on hypothesized mechanisms, the extensive tissue damage of more severe burns will result in a higher incidence of CRPS. Applicability of Research to Practice These results indicate a need for a proactive risk assessment and more comprehensive post-hospital care to limit and manage the risk of CRPS in burn patients. Future research can inquire about other predisposing factors and complications of CRPS in the burn population and explore incidence of CRPS for other time periods post-injury.

610 From Flames to Facts: Unveiling Discrepancies in Burn Patient Documentation

Abstract Introduction Comprehensive and accurate burn documentation is essential for initial and ongoing patient care. However, the challenge of inaccurate and incomplete records poses preventable risks. Our study evaluates burn documentation at a tertiary care burn centre, focusing on discrepancies between initial Emergency Department (ED) assessments and final evaluations by the Plastic Surgery Burn Consultant (PS). We hypothesize that the ED reports inaccurate and incomplete burn injury details, leading to differences in burn size and severity compared to PS assessments. Methods We conducted a retrospective review of our provincial burn registry from January 1, 2016, to December 31, 2021. We included patients admitted for burns warranting a PS consultation, excluding isolated first-degree, ocular, and inhalational burns, and those not requiring burn unit admission. Data covering time, date, etiology, injury details, treatment, and follow-up were collected and compared between ED and PS records. Incomplete entries lacked burn-specific data points. Mann-Whitney and Kruskal-Wallis H tests were used to compare continuous outcomes, while Pearson’s Chi-Square test was employed for categorical outcomes. Wilcoxon’s Signed-Rank test was used to identify significant variations in TBSA estimates, with PS considered the "gold" standard. Statistical significance was set at p< 0.05. Results 358 patients were included, with most burns in male patients (76%) occurring at home and involving the head and neck. Burn etiology, circumstances, place, and anatomic location were well reported and consistent across PS and ED documentation. However, there were significant differences in TBSA estimates. The ED calculated a median TBSA of 20 (IQR: 19.8), while PS estimated a median TBSA of 14 (IQR: 16) (p< 0.0019). Notably, TBSA estimates for burns < 10% and 10-25% showed significant differences (p< 0.0001), tending toward overestimation by the ED. Deeper burns were consistently over-reported during initial ED assessments compared to the final PS determinations. Furthermore, 81% of the initial records were incomplete: 66% lacked initial treatment data, 49% missed TBSA, and 39% omitted burn depth. Conclusions Significant discrepancies were appreciated in the initial ED documentation of burn injuries at our tertiary care burn centre, with overestimations in TBSA and burn depth. Over 80% of initial documentation was incomplete, with TBSA omitted in 49% of charts in both local and peripheral transfer consultations. There is a collective urgent need for enhanced awareness and education on the importance of accurate and comprehensive burn patient documentation. Applicability of Research to Practice This research emphasizes the need for improved documentation strategies for burn patients seen in the acute care setting, raising the potential to venture into modalities such as artificial intelligence and electronic health record systems to enhance burn documentation.

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.

Assessment of burn first aid knowledge among the general population of Riyadh, Saudi Arabia

Background: Burn injuries are a prevalent public health concern globally, necessitating effective first-aid practices for optimal outcomes. This study aims to assess the knowledge and practices of adults in Riyadh, Saudi Arabia, regarding first aid for burns, recognizing the importance of understanding current awareness levels and identifying potential areas for targeted interventions. Methods: A cross-sectional survey design was employed, the study included 388 adults aged 18 and above in Riyadh, utilizing non-probability convenience sampling. A structured questionnaire, developed in Arabic and English, covered demographics, burn causes knowledge and first-aid practices. Statistical analyses, including descriptive statistics and Chi-square tests, were conducted using Statistical Package for the Social Sciences (SPSS) version 26. Results: This study involved 388 participants and found that the majority (59.3%) were aged 18-29, with 38.1% male and 61.9% female. Furthermore, 81.2% had a university education. Participants showed a strong awareness (89.8%) of hot water as a leading cause of burns, with 93.0% correctly identifying the kitchen as a likely place for burns. Positive practices, like not touching blisters from first-degree burns, were observed in 76.6% of participants. However, misconceptions, such as using ice directly on burned areas (29.9%), were also prevalent. In addition, 33.6% relied on peers, colleagues, or family members for knowledge acquisition. Conclusion: The study underscores the importance of targeted educational interventions to address knowledge gaps and correct misconceptions related to burn first aid. Emphasizing evidence-based practices, particularly in scenarios where misconceptions exist, can contribute to improved community response to burn injuries. Collaboration with healthcare professionals, leveraging digital platforms, and incorporating community influencers in educational campaigns are recommended strategies.

Perioperative cutaneous complications in an elderly patient due to inappropriate use of a forced-air warming device and underbody blanket: a case report

Forced-air warming is commonly utilized to prevent perioperative hypothermia. Underbody warming blankets are often employed to secure a larger area for patient warming. While forced-air warming systems are generally regarded as safe, improper usage poses a risk of cutaneous complications. Additionally, the influence of underbody blankets on cutaneous complications remains uncertain. We present a case of cutaneous complications resulting from the improper utilization of a forced-air warming device and an underbody blanket. A 79-year-old man presented to the hospital for robotic proctectomy under general anesthesia. The surgery lasted for 7 hours, and the forced-air warming device with underbody blanket operated continuously for 5 hours intraoperatively. The surgery was completed without any incidents. However, first-degree burns on the patient’s back, along with superficial decubitus ulcers on his right scapula, were observed after surgery. To prevent cutaneous complications, clinicians must adhere to the manufacturer's guidelines when utilizing a forced-air warming system. Compared to overbody blankets, underbody blankets have limitations in monitoring cutaneous responses. Ensuring patient safety requires selecting an appropriate blanket for scheduled operations.

Knowledge and Practices of Public Related to Burns Management in Saudi Arabia: A Cross-Sectional Study.

Burn injuries are a significant global health challenge, with physical and psychological consequences affecting 180 000 people annually. This study aimed to evaluate public knowledge and practices regarding burn management. This cross-sectional survey included 582 participants to assess their knowledge and practices related to burn management between January 2023 and May 2023. Non-healthcare participants in Al Ahsa city in Saudi Arabia were asked questions about demographic data on age, sex, education, and nationality, along with assessing knowledge of burn first aid, sources of information, awareness of burn degree, chemical burn management, personal burn exposure, and traditional treatments. Our study of 582 participants highlighted significant findings related to sex and educational levels in burn management knowledge and practice. Females were more likely to receive information about burn first aid (69.3%), with a preference for social media as their information source, while males favored official courses (31.3%). Males displayed higher self-perceived knowledge were more inclined to consider first-degree burns the most dangerous (44.7%) and were better informed about managing chemical burns (24.2%). Females reported higher burn exposure (72.5%) and were more likely to manage burns themselves (76.5%). Informed participants with prior knowledge exhibited a greater interest in learning more about burn first aid (97%) and were more knowledgeable about burn degree and chemical burn management. These findings underscore the importance of tailoring public health education to burn first aid based on sex and education level. Such targeted approaches can enhance population-level preparedness and reduce burn injuries' affect more effectively.

Fabrication and evaluation of 3D bio-scaffold wound dressings for monitoring of chronic pH wounds using fuzzy logic analysis

Different types of wounds, such as surgical wounds, first-degree burns, and graft sites are among acute wounds. However, chronic wounds are the ones that have a gradual onset, and the healing process is stopped in terms of factors, such as poor blood flow, local pressure, diabetes and other factors. In this study, a novel wound dress made of carboxymethyl chitosan was composed of titanium nanoparticles (TiNP) using the freeze-drying technique. The wound dress contained pH-sensitive mini-emulsion, in which time and temperature are controlled, and adjusted by pH sensors. A heater was connected to the wound temperature sensor and, as the wound temperature drops below the specified range, it automatically turned on and raised the temperature to the maximum range. The mechanical strength, and biological behavior of tissue were evaluated to find an optimized sample. The prepared wound tissue was characterized using a scanning electron microscope (SEM) and the biodegradation rate was evaluated using weight change analysis. The obtained results show that the stress-strain diagram sample containing polyvinyl alcohol (PVA) had the lowest amount and the sample with TiNP had the highest strength. The results indicate that TiNP has the highest mechanical strength compared to other samples due to its inherent antibacterial properties. Moreover, fuzzy logic modeling was used to find a linguistic model for obtained experimental data. After developing the model, the results found by the model were compared to the experimental outputs. The results show that the developed method was efficient which can be used to predict the output of given data before performing any test practically.

Firework Injuries to the Hand in the United States: An Epidemiological and Cost Analysis.

Although prior literature has evaluated firework injuries broadly, there are no focused investigations examining trends, etiology, and costs associated with firework injuries to the hand. The 2006 to 2014 National Emergency Department Sample (NEDS) was used. International Classification of Diseases, Ninth Revision (ICD-9) codes identified patients presenting to the emergency department with a firework-related injury of the hand that resulted in a burn, open wound, fracture, blood vessel injury, or traumatic amputation. A linear regression model was used to identify significant changes over time, with a significance threshold of P<.05. A total of 19,473 patients with a firework-related injury to the hand were included, with no significant change in the incidence from 2006 to 2014 (7.5 per 1,000,000 population). The greatest number of injuries occurred in July (57.1%), January (7.4%), and December (3.7%). Age groups affected were young adults (18-35 years; 43.6%), older adults (36-55 years; 19.2%), adolescents (12-17 years; 18.6%), and children (0-11 years; 16.1%). Nearly 74% of the injuries resulted in burns, 24.5% resulted in open wounds, 8.0% resulted in fracture, 7.6% resulted in traumatic amputation, and 1.4% resulted in blood vessel injury. Of 14,320 burn injuries, 15.2% had first-degree burns, 69.9% had second-degree burns, and 5.1% had third-degree burns involving the skin. The median emergency department charge was $914 and the median hospitalization charge (for inpatient admittance) was $30,743. Incidence of firework-related injuries to the hand has not changed over time. There is a need for better dissemination of safety information to mitigate the occurrences of these avoidable accidents. [Orthopedics. 2023;46(3):180-184.].

The effects of the posttraumatic stress and general health status on paediatric burns and their sleep habits

BackgroundBurns are serious injuries that can require hospitalization and have physical and emotional sequelae. Sleep disturbance can occur after trauma as evidenced by posttraumatic stress symptoms such as re-experiencing of a trauma with repetitive dreams, memories and flashbacks. This area has been minimally examined with pediatric burn survivors; therefore, the aim of this study was to investigate the effects of posttraumatic stress and general health on sleep habits of pediatric burn survivors from. MethodThis is a correlational descriptive study. Its sample included 7–18-year-old inpatients at the burn clinic of a university hospital from January to November 2019. This study used the Posttraumatic Stress Disorder Reaction Index, the General Health Questionnaire (12) and the Children’s Sleep Habits Questionnaire for data collection. ResultsOf the participants, 58.6% were male, 46.5% were primary school students, and 62.6% had no diseases other than their burns. 20.2% of the children had epilepsy, 14.2% had diabetes and 3% had pneumonia. Of the child burn victims, 45.5% were brought to the hospital because of contact with fire. All of them had first-degree burns, 59.6% had second-degree burns, and 80.8% had third-degree burns. After their burns, infections developed in 20.2% during trauma and in 43.4% during burn treatment. A structural equation model indicated that the child burn victims’ general health perceptions did not significantly affect their sleep habits (p > 0.05). A significant correlation was found between the children’s posttraumatic stress disorder and their sleep habits (p < 0.05). Posttraumatic stress disorder explained 7.2% of their sleep habits. A positive and significant correlation was found between the children’s general health perceptions and posttraumatic stress disorder (r = 0.74, p < 0.05). ConclusionBurns of any kind can cause posttraumatic stress, sleep disorders and impairment of health status in children.

A Safe and Aseptic Method of Benzalkonium Chloride Dilution for Preoperative Facial Skin and Mucosa Preparation

Background: Benzalkonium chloride (BAC) is widely used as an effective antiseptic and disinfectant not only in plastic surgery, but also in everyday life. BAC has an advantage over other antiseptics used for preoperative skin preparation, such as povidone-iodine and chlorhexidine because it causes less irritation of the skin and mucosa and is less toxic. Nonetheless, when BAC is used at higher than desired concentrations, there is a possibility of adverse effects.Methods: Prior to May 2020, 10 mL of 10% BAC was mixed with 1,000 mL of distilled water and diluted to 0.1% on a weekly basis. Afterwards, the method of diluting BAC was modified; for each patient, 1.3 mL of 10% BAC and 100 mL of normal saline were mixed immediately before facial surgery.Results: From March 2007 to May 2020, 0.1% BAC was used for preoperative skin and mucosa preparation. Erroneous dilution of BAC has caused four cases of chemical burns. All the cases were attributed to human error that resulted in higher than desired concentrations of BAC in the antiseptic solution. All the affected patients suffered from first-degree and superficial second-degree chemical burns; however, they were healed uneventfully through proper wound management. Since the application of the dilution method changed since May 2020, no complications have been reported.Conclusion: We have devised a safe and aseptic method for diluting BAC. The new dilution method, which yields a constant concentration of BAC, can be used for preoperative skin and mucosa preparation without accidents.

Modeling of Pool Fire Risk in a Chemical Warehouse

Background: Pool fire is a phenomenon caused by the leakage of flammable materials on the ground leading to serious hazards, irrespective of its consequences. The proximity and high volumes of chemicals in warehouses require that the characteristics of various materials in warehouses be taken into account for calculating the chain effects of the pool fire. Methods: One of the effective parameters in expanding the impact of pool fire chain is heat flux value. There are different models for calculating and predicting it. In this study, two approaches of computational fluid dynamic (CFD), fire-driven fluid flow, fire dynamics simulator (FDS), and solid flame model were used to predict heat flux values. Results: In both models, the calculated heat flux was used to evaluate the effects on humans (first-degree burns, second-degree burns, and deaths) and the materials. The CFD results were compared with the results of the solid flame model, which indicated that there was little error in the predicted heat flux values. Conclusion: The results of this study can be used to better understand the effects of pool fire on chemical warehouses, and provide appropriate control measures to prevent such accidents in warehouses.

Reflection of the problem «Burns» in the publications of Russian surgeons in the XIX – early XX centuries

In modern scientific literature, the opinion is firmly established: «... a systematic study of burn injury in our country began in the mid-30s of the XX century». How historically accurate is it? This fact determined the relevance of the study of the Russian medical periodicals on the topic «Burns» for the period of the XIX – early XX centuries. The obtained data testify to the active work of Russian specialists not only in the study of the peculiarities of local and general manifestations of burn injury, but also in the development of diagnostic and treatment methods. They collected and analyzed the statistics of burns of various etiologies, under various conditions of human life, and also carried out experimental work. They published the obtained results in various medical publications: newspapers, magazines, manuals, encyclopedias, etc., which were published on the territory of the Russian Empire. Our doctors have formulated a number of fundamental conclusions that are not disputed by anyone in the 21st century. For example: even superficial first-degree burns, manifested only by hyperemia and moderate edema of the skin, with a large lesion area can lead to death, in contrast to skin inflammatory diseases characterized by similar local manifestations and proceeding relatively favorably for the general condition of a person. In addition, it became clear that the pathology under consideration should be treated by a doctor who knows its features and optimal treatment methods. Otherwise, long-term wounds can be fatal at a time when the threat to the victim’s life seemed to have passed. Experimental studies conducted since the middle of the 19th century have not only strengthened the evidence base of research works, contributed to the writing and defense of thematic dissertations, and had a significant impact on the scientifically grounded development of new methods of treatment.

Characteristics of burn casualties treated at role 2 in Afghanistan.

Role 2 medical treatment facilities (MTFs) are frequently located in austere settings and have limited resources. A dedicated assessment of burn casualties treated at this level of care has not been performed. Therefore, the objective of this study was to characterize burn casualties presenting to role 2 MTFs in Afghanistan, along with the procedures they required, complications, and mortality to begin understanding the resources consumed by their care. We identified burn casualties from the Department of Defense Trauma Registry (DODTR). The inclusion criteria were (1) experienced burn injuries in Afghanistan between October 2005 and April 2018 and (2) had documentation of treatment at role 2 in the DODTR. We excluded casualties with only first-degree burns, not otherwise specified burns, or only corneal burns. Casualty demographics, injury characteristics, procedures, and outcomes were reported. We identified 453 burn casualties with a median (interquartile range) Injury Severity Score of 10 (4-22) and percent total body surface area burned of 11 (5-30). There were 123 casualties (27.2%) with inhalation injury, and the casualties experienced 3,343 additional traumatic injuries and needed 2,530 procedures. Casualties with documentation of resuscitation information received a median (interquartile range) of 1.9 (0.7-3.7) L of crystalloid fluids. Complications were documented in 53 casualties (11.7%). Final mortality was reported in 36 casualties (8.0%), and mortality at role 2 MTFs was reported in 7 casualties (1.5%). Burn casualties had many injuries and needed many procedures, including those related to airway management, resuscitation, and wound care. Given the urgency of these procedures, ensuring that there is enough equipment and supplies will be important in the future. Although infrequent, some casualties experienced complications. Factors that may influence resuscitation include injury severity, concomitant traumatic injuries, and available supplies. Obtaining more contextual information on the patient care environment will be useful going forward. Epidemiological, level III.

Clinical, epidemiological, and management aspects of burn injuries in Saudi Arabia - A cross-sectional study.

BackgroundBurns are a deleterious, but largely preventable health problem foisting physical, economic, social, emotional, and relational issues worldwide.MethodsA cross-sectional study was conducted at the King Khalid Hospital and Prince Sultan Center for Health Services, and Prince Sattam Bin Abdulaziz University hospital in Al Kharj in the Kingdom of Saudi Arabia. The study included patients who presented themselves to the emergency department of the targeted hospitals with at least one documented burn injury between October 2018 and October 2019. The patients were followed from presentation to discharge. The etiology, location, severity, and options of treatment offered to them were recorded. The SPSS version 22.0 was used to analyze the data. Descriptive statistics were used to summarize the data as means, frequencies, and standard deviations. Categorical variables were compared using the Pearson's chi-square test.Results180 patients with burn injuries were included in the study. The majority were adolescents and adults under the age of 40 (n = 171). The prevalence of first-degree burns was 12.8%, that of second-degree burns was 71.1%, and that of third-degree burns was 16.1%. The most common cause, area, and type of treatment were hot water injuries (36.1%), upper limbs (62.2%), and skin debridement respectively.ConclusionAdolescents and young adults are the most frequently affected by burns while skin debridement was the most common treatment offered to the patients. In this context emergency hospital staff was required to be adequately equipped and trained.

Wildland firefighters’ thermal exposure in relation to suppression tasks

The main purpose of this study was to characterise the thermal environment and risk of heat burns of wildland firefighters in relation to the suppression tasks performed in real wildland fires. Measurements of air temperature and heat flux were performed by affixing heat flux and ambient temperature sensors on the outer and inner surface of the wildland firefighters’ protective garments. Suppression time was divided according to the task performed in direct attack, backfire, mop-up and patrol. These tasks accounted for 95.2 ± 78.4, 103.3 ± 41.7, 80.5 ± 24.8 and 71.3 ± 53.0 min, respectively. Overall, the mean heat flux was higher during backfire (2165 ± 1604 W m−2) than in direct attack (558 ± 344 W m−2), mop-up (371 ± 254 W m−2) and patrol (354 ± 307 W m−2). However, during the direct attack, average and maximum thermal dose was ~94 and ~110 (kW m−2)4/3 s, respectively. These values are within the threshold of pain and first-degree burns. However, no first-degree burns were reported for the sample. Overall, the thermal exposure measured may be considered light. However, high thermal exposure values may be obtained at specific moments, which may cause first-degree burns in wildland firefighters.

Characteristic Of Hospitalized Burn Injury Patients In Zainoel Abidin General Hospital Year 2016-2017

Background: The epidemiology pattern of patients with burn injury varies widely in different parts of the world. This study aimed to identify epidemiological data from hospitalized burn injury patients in Zainoel Abidin General Hospital, a referral Hospital in Aceh. Methods: All hospitalized burn injury patient data from January 2016 to December 2017 were collected from the medical record. Data taken included Gender, age, length of stay (LOS), mortality, severity, and extent of the burn, and etiology of burn. Results: From all hospitalized patients with burn injury, the male to female ratio is 1,6:0,9. The mortality rate is 9%, while the others survive. From all etiology of burn, 57% is flame injury, 19% is electrical injury, 18% is scald burn injury, 4% is contact burn injury, and 1% is a chemical burn injury. No patient with first-degree burns was hospitalized, while 13 patients had third-degree burn injuries, and the rest had second-degree burn injuries. Conclusion: An increasing number of hospitalized patients from 2016 to 2017, from 25 patients to 42 patients. It might happen because of increasing knowledge about burn injury in society and physicians in rural areas to refer patients to the hospital with better facilities.

Towards quantitative assessment of burn based on photoacoustic and optical coherence tomography.

Accurate and timely assessment of the severity of burn is essential for the treatment of burns. Currently, although most first-degree and third-degree burns are easily diagnosed through visual inspection or auxiliary diagnostic methods, the second-degree burn is still difficult to distinguish due to the ambiguity boundaries of second-degree with first-degree and third-degree burns. In this study, we proposed a non-invasive technique by combing photoacoustic imaging (PAI) and optical coherence tomography (OCT) to multi-parameter quantitatively assess the burns. The feasibility and capacity of the dual-mode PAT/OCT for assessing the burns was first testified by tissue-mimicking phantom and burn wounds in mouse pinna in vivo. The further experiments conducted on the back of rats showed that the changes in skin scattering structure, vascular morphology and blood flow provided by the dual-mode PAI/OCT system can determine distinct boundaries and depth of the burns. The experimental results prove that combined PAI/OCT as a novel method can be used to assess the severity of burn, which has the potential to diagnose the burns in clinic.

Moxibustion-Induced Burns in a Burn Unit in Northeast China: An 8-Year Retrospective Analysis.

The purpose of this paper was to analyze the characteristics of burns caused by moxibustion. A retrospective survey of the medical records of patients was performed on patients who visited our center from January 2009 to January 2017, treating for burns caused by moxibustion. Data were extracted and evaluated, including demographics, site and extent of burns, type and treatment duration of moxibustion, practitioners, and cost. A total of 82 consecutive patients treated for moxibustion-induced burns were included. The average patient age was 42.4 years, with the male to female ratio of 1.2:1. Burns caused by direct and indirect moxibustion were 7 and 75 cases, respectively. Averagely, moxibustion was performed 3.6 times a week for 3.7 weeks and lasts for 16.2 minutes each treatment. The average distance for indirect moxibustion was 3.4 cm (ranged from 2 to 5 cm) away from the acupoints. First-degree and superficial partial thickness burns, deep partial thickness burns, and full thickness burns were present in 16, 59, and 7 cases, respectively. Most of the burns were minor burns, with diameter less than 2 cm (69 cases). The most common sites were the lower extremities (46 cases), followed by abdomen (29 cases) and upper extremities (5 cases). The average cost for inpatients and outpatients was 5 164 and 2 192 RMB, respectively. Majority of moxibustion-induced burns are minor burns, and there is a high probability of the burn being deep if it occurs in the lower extremities.