History Of Burn Injury Research Articles

The Influence of Video-Based Health Education on Burn First Aid: Family Knowledge and Actions

Burn injuries continue to be a global health issue. Incidents of burns often occur within households, where improper management can lead to increased mortality and disability rates. Therefore, health education related to burn management is crucial. The aim of this study was to investigate the impact of health education using videos on the knowledge and actions of families in providing first aid for burn injuries. This quantitative study employed a pre-experimental design with a one-group pre-test and post-test approach. The population consisted of families with a history of burn injuries within their households. The sample comprised 20 respondents selected through consecutive sampling technique. Data were collected using a knowledge questionnaire and an observation sheet for assessing burn first aid, which underwent validity and reliability testing. Univariate and bivariate analyses were conducted using the Wilcoxon test. The research findings revealed that the majority of respondents were aged 18-35 years (55%), with the most common occupation being housewives (55%), and the majority had a high school education (50%). The median pre-test knowledge score was 8, while the post-test knowledge score was 17. The median pre-test burn first aid action score was 3, while the post-test score was 8.5. The Wilcoxon test results for knowledge and burn first aid actions before and after health education using videos yielded a p-value of 0.000. In conclusion, health education using videos has a significant impact on the knowledge and actions of families in providing first aid for burn injuries. The researchers recommend that families acquire the proper skills for managing burn injuries to prevent complications.

Severe Systemic Allergic Reaction after Topical Application of Mupirocin

Mupirocin (MUP) is a natural derivative of crotonic acid extracted from Pseudomonas fluorescens. This antibiotic has a unique chemical structure and mechanism of action.It is often used topically for the treatment of cutaneous infections to prevent skin and soft tissue infections caused by S. aureus isolates and where the MRSA isolates are epidemic. Furthermore, MUP may be used as a choice drug for nasal decolonization.Despite some side effects, mupiro¬cin has been reported to be safe and to cause allergic reactions in only extremely rare cases. This paper is a report on a rare case of severe systemic allergic reaction resulting from treatment with mupirocin ointment in a 39 year old male patient who had a history of burn injury.

618 Clinical and Humanistic Burdens of Pediatric Burns: A Systematic Literature Review

Abstract Introduction Children face long-term clinical and psychological sequelae from burn injuries. This review summarizes the scientific literature on the clinical and humanistic burdens of pediatric burns. Methods A systematic review of literature published between Jan 2015 and Jun 2020 was conducted based on PRISMA guidelines in Embase, Biosis, and MEDLINE to identify publications examining the clinical, humanistic, economic, and/or epidemiologic burdens of illness associated with pediatric burns in the US. Results Of 2,286 unique articles identified, 28 met eligibility criteria. This analysis focused on studies relating to the clinical (n=8) and humanistic (n=9) burdens of pediatric burns. Across all studies, flame and scald were the most common burn etiologies. Among the 8 clinical studies, several evaluated outcomes (n=2) or treatments (n=3) in predominantly graft recipients. One study found that 64% of pediatric split-thickness autograft recipients exhibited hypertrophic scarring (HTS) at the donor site. Other variables (time to re-epithelialization, donor-site harvest depth, harvest in an acute burn care setting, thigh donor-site location) were associated with increased risk of HTS. An increase in percentage total body surface area (%TBSA) burned corresponded to increased number of autograft procedures, risk for HTS, and viral infection risk. Other reported outcomes included infections (eg, healthcare-associated, wound, viral), pain, inhalation injury, and sepsis. One study found that while the frequency and intensity of pruritis decreased over time, 63% of children continued to report symptoms at 2 years after injury. Among the 9 humanistic studies, 4 reported larger %TBSA corresponded to worse health-related quality of life assessed by various instruments. In a study of patients under age 5 with burns, Burns Outcomes Questionnaire (0–4) scores improved over time in multiple domains. In youth with a history of burn injuries, patient-reported pain interference with daily living was significantly associated with decreased physical functioning, depression, and impaired peer relationships. Two studies assessed caregiver burden, with one study finding that 19% of caregivers self-reported clinical or at-risk levels of distress following the child’s burn injury. Conclusions Pediatric burns place a substantial clinical and humanistic burden on patients and their caregivers. While outcomes appeared to improve over time, clinical and humanistic consequences of pediatric burns endured. More research on novel treatment products and procedures is needed to reduce the burden of burns for this population.

Errors in Differential Diagnosis of Burn Injury at the Prehospital Stage

Relevance. An important component of the diagnostic process in combustiology is the collection of anamnesis. At the same time, verification of the very fact of a burn injury of the skin, as a rule, does not seem to be a difficult task even for a novice doctor. However, specialists from the I.I. Dzhanelidze Institute regularly encounter errors in the differential diagnosis of burn injuries at the prehospital stage on the part of both ambulance teams (EMS) and surgeons (traumatologists) of non-specialized medical institutions. Each such case attracts attention and takes up a significant part of the time resource of the entire staff of the inpatient department of the emergency medical service for the process of clarifying and verifying the correct diagnosis, as well as determining the further routing of such a patient.Aim of study. To study the structure of diagnostic errors at the prehospital stage of the EMS to optimize patient routing by improving the existing organizational and methodological standards.Material and methods. A retrospective analysis of the case histories of all victims who were admitted to the inpatient department of the Emergency Medical Department of the I.I. Dzhanelidze St. Petersburg Research Institute of Emergency Medicine during the period from January 2018 to December 2019.Results. 4,951 patients were admitted with a leading diagnosis of the referring institution, suggesting a history of burn injury. The incidence of diagnostic errors at the prehospital stage of emergency care was 410 cases (8.3%), while burn injury was completely excluded in 178 cases (3.6%).Conclusions. 1. The results of the analysis revealed a high incidence of diagnostic errors at the prehospital stage of emergency care (8.3%), the main reason for which is the lack of awareness of differential diagnostics within the narrow specialty (combustiology) of primary contact physicians. 2. Shown is the introduction of training practice for doctors and paramedics of emergency medical services, surgeons and traumatologists of primary care in combustiology cycles in specialized burn departments. 3.In order to ensure continuity in the process of providing medical care to patients with burns, it is necessary to create a unified database of convalescents to form a feedback channel with the outpatient clinic during the implementation of the rehabilitation complex.

A Study on the Cause of Death Due to Burn Cases and Histopathological Changes in North Indian Setting-A Cross Sectional Study

Background: Fatal burns and related injuries are major cause of death and disability. There are certain pathological changes such as lungs shows necrotizing pneumonia, congestion of alveolar walls, capillary proliferation, intra alveolar oedema, giant epithelial cells Objective: To study on the cause of death due to burn cases and histopathological changes in north Indian setting. Method: This was a cross-sectional study. All autopsies with history of burn injury were studied to find out the significant histopathological change in lung. Cases was thoroughly studied using specially designed proforma that included demographic profile of deceased, history from relatives, police & hospital records, autopsy findings. Results: The most common cause of death due to burn injury was found to be Sepsis (48.2%) and neurogenic shock (29.5%). On histopathological examination, Congestion in trachea was present in majority 434 (78.9%) cases while Tracheal soot particles were present in only 40 (7.3%) cases. Specimens of 375 cases were available for histopathology out of which 52 (13.9%) specimens were autolyzed. Changes suggestive of Pneumonia (50.1%), Congestion (83.7%), alveolar and interstitial haemorrhage (63.2%) were present in majority of the cases while changes suggestive of alveolar interstitial edema (64.3%), alveolar wall disruption (66.1%), inflammatory cells (55.5%), hyaline membrane (79.7%) and Fibrin strands (79.7) were absent in majority of cases. Capillary dilatation was present in 39.2%. Conclusion: In the present study, an important observation in burn deaths is the Sepsis and Neurogenic shock. Congestion in trachea was most common on histopathological change.

Effect of Teaching Intervention on Mothers' Awareness about Preventive Precautions of Burn among Children at Home

death among children each year. Aim: To evaluate the effect of a teaching intervention on mothers' awareness about preventive precautions of burn among children at home. Research Design: A quasi experimental research design with a pre/post-test was adopted in the study. Setting: The study was conducted in the Pediatric Outpatient Clinic at Sohag university hospital and Mansoura university hospital. Subjects: A convenient sample of 200 mothers and their children was included to achieve the aim of the study. Tools of data collection: Structured interview questionnaire was included in two parts, (1) socio-demographic data sheet for mothers and their children, history of burn injury, and (2) questionnaire sheet regarding mothers' knowledge about burn injury and mothers' reported practices regarding burn injury. Results: Revealed that more than half of the children (58%) were male. There were significant differences between pre and post-educational nursing guidelines application in mothers' knowledge and reported practices. Mothers' knowledge and practices in the prevention of burn were correlated with their age and education, and child's age (P value is 0.001, 0. 001). Conclusion: Teaching intervention regarding preventive precautions of burn at home was effective in improving awareness of the mothers. Recommendation: The study recommended that teaching intervention regarding preventive precautions of burn at home should be applied in all pediatric care settings. Health promotion programs should be provided about the prevention of burn injuries to improving mothers' awareness.

Pain is Associated With Increased Physical and Psychosocial Impairment in Youth With a History of Burn Injuries

Burn injuries are significantly painful and associated with physical and psychological impairment. However, little research to-date has examined the potential role of the subjective experience of pain in either physical or psychological impairment in this population. This may be particularly important to examine, given that the pain experience can often be a significant barrier to recovery in other pediatric populations. The current study examined the cross-sectional and predictive relationships between patient-reported experience of pain (operationalized as PROMIS pain interference and self-reported pain intensity) and physical and psychosocial outcomes. Data were gathered as part of the Burn Model System National Database (1994–2018) with the data request inclusive of pediatric self-report PROMIS measures, child PTSD, and post-traumatic growth symptoms assessed at 6- and 12-month postdischarge following initial injury. A total of 65 youth between the ages of 6 and 16 years at the time of their injury were included in the dataset. Correlational and regression analyses indicated that pain interference was cross-sectionally and longitudinally associated with decreased physical functioning, depressive symptoms, and peer relationships. Pain intensity was significantly associated with and predictive of physical functioning and pain interference. Results of the current study are an important first step in understanding the pain experience and associated outcomes in youth with a history of burn injuries. Future research is needed to further examine these relationships. PerspectiveThis study presents preliminary findings from a national database on pain-related outcomes both cross-sectionally and longitudinally in youth with a history of burn injury. To-date, pain-related outcomes are poorly understood in this population and the results of this study serve to inform future research and treatment-related efforts.

The biopsychosocial model of pain in the context of pediatric burn injuries.

Burns are a common and traumatic source of childhood injury in the United States. The treatment and recovery from burn injuries can be significantly painful and may lead to chronic or persistent pain for years following the initial incident. Further, burn injuries in youth have been found to increase the potential for significant psychosocial (e.g., anxiety, depression, PTSD) and physical (e.g., decreased mobility) impairment. Relatedly, the general experience and processing of pain in youth can also be associated with greater psychosocial (e.g., anxiety, depression) impairment and functional disability over time. However, the phenomenology and associated characteristics of the pain experience following burn injury and, in particular, the potential for combined impact on physical and psychosocial outcomes in youth with severe and/or prolonged pain and a history of burn injury is poorly understood. A review of the literature was performed in the areas of burn injuries and outcomes associated with both acute and chronic pain with youth and adult populations. The current review highlights current gaps in the literature in important areas of function in youth with a history of burn injuries using the biopsychosocial model of pain. Future research and considerations for practice are also outlined. Gaining a greater understanding of the relationship between pain, physical impairment, and psychosocial functioning in these youth is significantly important in order to provide greater preventative and treatment-related intervention going forward. Using a biopsychosocial framework, this review highlights the need for a greater understanding of pain processing and the long-term potential for persistent pain and pain-related impairment (e.g., functional disability) in youth with a history of burn injuries.

VERAPAMILO EN CONJUNTO CON LAS PRENDAS DE COMPRESIÓN EN EL TRATAMIENTO DE LA CICATRIZPATOLÓGICA CAUSADA POR QUEMADURA

La cicatriz queloide y la hipertrofica son desordenes fibro-proliferativos unicos de los humanos, su tratamiento representa un reto con pocas opciones. El uso de prendas de compresion resulta util, sin embargo el proceso de maduracion no es tan rapido; decidimos usar verapamilo para facilitar este proceso y poder mejorar la calidad de vida de nuestros pacientes. El objetivo de este estudio es evaluar el uso del verapamilo y las prendas de compresion en pacientes con cicatrizacion patologica como consecuencia de quemadura. Metodos: incluimos pacientes con cicatrizacion patologica, ya sea queloide o hipertrofica, causada por quemadura. La cicatriz fue evaluada con fotografias seriadas, escala de Vancouver y Posas. Los resultados fueron comparados con la prueba de t de Student. Resultados: incluimos 13 cicatrices en 11 pacientes. La localizacion de las cicatrices fue en: brazos 4, piernas 4, cara y cuello 1, y abdomen 1. La dosis de verapamilo se calculo a .03 mg por kg de peso. Las inyecciones se aplicaron de manera intralesional y se administraron cada 7 a 10 dias, hasta completar 6 sesiones. Encontramos mejoria en los siguientes parametros de la escala de Posas: pigmentacion, pliabilidad, endurecimiento y superficie. En la escala de Vancouver: elevacion, pigmentacion, vascularidad, flexibilidad y prurito. No encontramos efectos adversos con la administracion de verapamilo. Conclusiones: el verapamilo fue util en conjunto con las prendas de compresion para mejorar las condiciones de la cicatriz queloide e hipertrofica causadas por lesiones por quemadura

Bacteriological profiles in burn patients within first twenty-four hours of injury

Background: Infection and sepsis are the main confounders of mortality and morbidity of burn injury. Burn wound surface thought to be sterile for few hours immediately after injury. Eventually microorganisms from skin surface area or hospital environment colonize the wound. The aim of this study is to observe the bacteria profile (i.e. form the first day of burn) and their subsequent changes. Materials and Methods: Fifty patients attending Burn emergency care Department with history of burn injury within 24hours was enrolled in this study. To observe the microbial profile at the site, three swabs (1ston 0 day i.e. the day of admission, 2nd after 24-48hours, and 3rd after 72-96 hours) were collected from the burn wound. Once collected, they were immediately transferred to a sterile test tube and transported to the Department of Microbiology for further processing and identification of bacterial flora. Results: Eighty percent of samples collected on day 0 were observed sterile. Staphylococcus aureus found to be commonest isolate among the isolates in the day 0 in comparison to gram-negative bacteria in 2nd and 3rd sample. Discussion and conclusion: Burn wound remains sterile for first few hours after injury. It subsequently colonized with the multidrug resistant microorganisms transmitted from the hospital environment or from the hospitalized patients in the same set up. Prompt effective treatment and regular hospital surveillance is necessary to reduce the infection of burn wound. Key words: Burn wound, Sterile, Bacterial flora

Rare presentation of breast carcinoma in an old burn scar

Malignancies from old burn scars (BSs) have been documented in literature but are rarely encountered in our day-to-day practice. Adenocarcinoma is an extremely uncommon while squamous cell carcinoma is the most common malignant entity seen as BS neoplasm. Breast cancer arising from an old BS is rarely reported in literature. Till now, to the best of our knowledge, only four cases have been reported in literature. Here, we are reporting an interesting case of 38-year-old female with a history of burn injury on her chest wall including left breast and axilla 20 years back which was left to heal secondarily, i.e., without any active intervention. Later, she developed an ulceroproliferative growth over her left breast for which she consulted a local physician. A diagnosis of infiltrating ductal carcinoma breast of the left side was made after biopsy and was referred to our hospital. Metastatic workup was negative, i.e., chest X-ray posteroanterior view, ultrasound sonography abdomen and pelvis with blood investigations were found to be normal. Right side breast, axilla, and supraclavicular region along with abdomen were found to be normal. Clinically, she was staged as T4b, N0, M0, Stage III B carcinoma breast left side. She was managed with upfront surgery, i.e., a simple mastectomy followed by adjuvant chemotherapy and radical radiotherapy. After completing the radical treatment, she was kept on tamoxifen 20 mg once daily for 5 years. At present, the patient is doing well with locoregional complete response after 6 years of regular follow-up.

Feasibility of an Exoskeleton-Based Interactive Video Game System for Upper Extremity Burn Contractures

BackgroundBurn contractures are common and difficult to treat. Measuring continuous joint motion would inform the assessment of contracture interventions; however, it is not standard clinical practice. This study examines use of an interactive gaming system to measure continuous joint motion data. ObjectiveTo assess the usability of an exoskeleton-based interactive gaming system in the rehabilitation of upper extremity burn contractures. DesignFeasibility study. SettingEight subjects with a history of burn injury and upper extremity contractures were recruited from the outpatient clinic of a regional inpatient rehabilitation facility. MethodsSubjects used an exoskeleton-based interactive gaming system to play 4 different video games. Continuous joint motion data were collected at the shoulder and elbow during game play. Main Outcome MeasuresVisual analog scale for engagement, difficulty and comfort. Angular range of motion by subject, joint, and game. ResultsThe study population had an age of 43 ± 16 (mean ± standard deviation) years and total body surface area burned range of 10%-90%. Subjects reported satisfactory levels of enjoyment, comfort, and difficulty. Continuous joint motion data demonstrated variable characteristics by subject, plane of motion, and game. ConclusionsThis study demonstrates the feasibility of use of an exoskeleton-based interactive gaming system in the burn population. Future studies are needed that examine the efficacy of tailoring interactive video games to the specific joint impairments of burn survivors.

Experience With Corrective Surgery for Postburn Contractures in Mumbai, India

Postburn contracture is a source of significant morbidity in India, even though its occurrence can be reduced significantly by comprehensive postburn injury care, including surgical intervention. This study investigates whether limited access to initial medical care after burn injury has been associated with increased contracture formation among lower socioeconomic class patients in Mumbai, India. During a surgical mission in Mumbai, India, patients presenting with functionally debilitating burn contractures and minimal income were surveyed for initial care received immediately after burn injury. The survey consisted of questions regarding the history of burn injury and details of any initial treatment. Demographic data were collected by chart review. Thirty-eight patients from the state of Maharashtra participated in the study (mean age 28.1 years). The most common etiology of burn injury was from kerosene stove blasts (74%), and the most common morbidities were contractures of the neck and upper extremity. On average, time elapsed since the original injury was 2.8 years. Nearly all patients sought initial medical care at hospitals (97%) with the majority receiving only dressing changes for their full-thickness or deep-dermal burns (61%). The most common reason for not seeking out delayed burn reconstruction was perceived cost (65%). Ultimately, 60 operations were performed, of which 9 (15%) developed postsurgical complications. These data suggest that a subset of lower socioeconomic class burn patients in Maharashtra received suboptimal initial intervention. Comprehensive initial therapy after burn injury may provide better outcomes and limit the number of patients requiring delayed reconstruction.