Scald Burn Research Articles

772 Bismuth Tribromophenate Gauze is Superior to Silver Sulfadiazine Cream for Mixed-depth Scald Burns in Children

Abstract Introduction Silver sulfadiazine 1% cream was historically the mainstay initial treatment for burn wounds at our pediatric burn center. Over the last several years, we transitioned to using closed dressings of 3% bismuth tribromophenate petrolatum gauze in the initial care of partial thickness burns with the goal of reducing the pain experienced with daily wound cleaning necessitated when using silver sulfadiazine. The gauze adheres to the wound, allows exudate to drain through, and acts as a scaffold for re-epithelialization after which it falls off without traumatizing the healed burn. The purpose of this study is to compare our burn patient outcomes with the initial use of bismuth tribromophenate gauze to those in patients treated with silver sulfadiazine cream. Methods A retrospective chart review was conducted of our patients aged 5 years and younger presenting with mixed-depth scald injuries within two time frames: 1) years 2004-2008, during which silver sulfadiazine 1% cream was the standard initial choice for wound care at our institution, and 2) years 2015-2018, when 3% bismuth tribromophenate petrolatum gauze had become standard. Data collected included demographics, burn total body surface area (TBSA), length of hospital stay, need for excision or grafting, time to grafting, and graft size. Results Three hundred forty-seven patients were included, 200 of whom were treated with silver sulfadiazine cream and 147 treated with only bismuth tribromophenate gauze. Burn TBSA and rates of skin grafting were similar between the two groups; however, the mean area of the skin graft was significantly smaller (p = 0.027) among the patients in the bismuth tribromophenate group (147 cm2) compared to those in the silver sulfadiazine group (336 cm2). On the other hand, the time from injury to skin grafting was significantly longer in the bismuth tribromophenate group (24 days vs. 9.9 days, p = 0.002), with a larger proportion of these patients returning for elective grafting in the outpatient setting. Conclusions The percentage of patients who required skin grafting in both groups was similar; however, initial treatment with a closed dressing of 3% bismuth tribromophenate petrolatum gauze promotes healing in the zone of stasis, resulting in smaller skin grafts and hence smaller donor sites. The mechanical forces of daily wound cleaning when using silver sulfadiazine cream likely harm those areas at risk, leading to the need for larger skin grafts for coverage. Although time to grafting was longer when using gauze, these patients were in closed dressings with fewer painful changes. Applicability of Research to Practice Bismuth tribromophenate petrolatum gauze remains on a wound bed for up to three weeks, whereas silver sulfadiazine cream must be changed regularly resulting in constant disruption of the healing tissue. Fewer dressing changes combined with later skin grafting could allow burn wounds to demarcate and heal more effectively, benefiting both graft and donor sites.

A RETROSPECTIVE ANALYSIS OF PAEDIATRIC SCALD BURNS IN A TERITARY CARE HOSPITAL

Burns and burns -related trauma remains the most common form of injury in the children. Pediatric burns occur commonly in the developing countries, with the incidence many folds higher in the low- and moderate-income groups. Scalds consistently account for the majority of the burns in the childhood. The aim of this study was to provide recent epidemiological data on the pediatric scald burns. It was a retrospective study which encompassed a total of 150 admitted patients in the burns ward in a tertiary care hospital in Andhra Pradesh from Dec 2020 to Dec 2022. Aim of this study is to emphasize the recent demographic data, modalities and prevention of scald burns

Priming Factors Related to Burn Injury among People in Bangladesh

Abstract Background Burns cause the most severe injuries and are a major public health concern worldwide. It is common in third-world countries and it greatly increases mortality and illness there. Because of the long period of time spent in the hospital and the effort required to recover from a burn, it is one of the most costly injuries to treat. Objectives The aim of this study was to identify the priming factors related to burn injury among people in Bangladesh. Materials and Methods The study design was cross-sectional. Total 121 samples were selected conveniently for the study and the study was conducted in several hospital settings in Chittagong, Savar and Dhaka city like Chittagong Medical College Hospital, Enam Medical College Hospital, and Sheikh Hasina Burn Hospital. Data was collected by using a self-administered questionnaire. Statistical Analysis Descriptive and inferential statistics (chi-squared test) were used for data analysis that focused through tables. Results On average, people were 22.43 (14.399) years old. Of the total of 121 patients, 48.1% were female (n = 58) and 52.1% were male (n = 63). Among the participants, 56.2% (n = 68) were hurt accidentally, 33.9% (n = 41) were injured on the job, 2.5% (n = 3) were harmed intentionally, and 7.4% (n = 9) were injured while preparing food. In case of occurrence, 37.2% (n = 45) were burned by fire, 38.8% (n = 47) were electrical burn and 23.9% (n = 29) were chemical or scald type burn. Conclusions Most burn injuries are accidental, such as cooking fires, hot water, electric lines, and acid throwing that are significantly considered as the priming factors of burn injury among people in Bangladesh. The lack of awareness and ignorance causes these accidents and insufficient training causes most the electrical burns.

Running water while bathing is a risk factor for pediatric scald burns

IntroductionScalds are the most common mechanism of burn injury in pediatric populations and scald burns sustained during bathing present a unique opportunity for injury prevention. Evidence-based infant bathing educational resources recommend checking water temperature and having a caregiver present for the duration of the bath, but do not explicitly recommend avoiding running water or explain the associated risks. This study seeks to determine the incidence and role of running water in bathing scald burns at our institution. MethodsThis is a retrospective review of pediatric patients (<3 years) admitted to the University of Chicago Burn Center with scald injury from bathing between 2010 and 2020. Cases were reviewed to assess the following risk factors: whether there was running water, whether water temperature was checked before placing the child in water, and whether a caregiver was present for the entire bath. Injuries in which the manner of injury was abuse or indeterminate were excluded. ResultsThe study cohort included 101 cases of scalds due to bathing, with a mean age of 13 months and mean burn size of 7% TBSA. Of these 101 cases, 96 (95%) involved running water. Thirty-seven cases (37%) had only one of the three risk factors and 95% of those 37 cases involved running water. Twenty-nine cases (29%) involved all three risk factors while only two cases (2%) involved none of the three risk factors. Sixty-one cases (60%), thirty-nine cases (39%), and one case (1%) occurred in a sink, bathtub, or infant tub, respectively. ConclusionWe found that the vast majority of bathing scald burns involved running water, identifying a specific bathing recommendation that should be added to existing guidelines to reduce the incidence of bathing scald burns.

Role of Cyclic Negative Pressure Wound Therapy (NPWT) in Pediatric Scald Burn

Burns and related injuries are common causes of death and disability. The highest incidences of burn cases occur in children and adults. In children less than 2 years of age, contact with hot surfaces and scald burns are the most common presentation to the hospital. The practice of cooking at ground level or sleeping with a burning lamp are some of the causes. Early management of this type of burn results in better outcomes. In this case we describe the role of negative pressure wound therapy (NPWT) as an adjuvant in the management of paediatric thermal burns.

The cost burden of hospital-treated tap water scald burns in the United States

ObjectiveWe aimed to determine the cost burden and epidemiology of hospital-treated, tap water scald burns in the United States to inform consideration of policy proposals to require thermostatic mixing valves...

The Role of Fractional CO2 and Pulsed Dye Laser in Scar Management

Introduction: An estimated 100 million patients acquire scars of any type every year, a few of which will lead to hypertrophic, contracting scars or keloids. Management remains challenging and encompasses surgical and non-surgical treatment options. The introduction of fractional photothermolysis (FP) in 2004,marked a major advancement in treatment. Unlike classic non-fractional ablative lasers, FP uses well focused laser beams to create small columns of ablation called microscopic treatment zones (MTZ).FP has since been discovered to be particularly useful in relieving scar contractures with efficacy on improving functionality and cosmetic outcomes. We aim to present a case of a contracting scald burn over the buttocks improving exceptionally following pulsed dye (595 nm) laser and fractional resurfacing using an ablative CO2 (10600 nm) laser associated with transepidermal triamcinolone delivery. Materials and Methods: Case presentation of the management of a hypertrophic scar following a scald burn. Results: A 12 year old boy suffered a third degree scald burn on the right buttock requiring a split thickness skin graft. The follow-up was complicated by a contracting, hypertrophic scar with a negative impact on his soccer playing due to diminished running ability. we started treatment with pulsed dye laser (595 nm, handpiece of 12 mm, pulse duration of 6 ms, fluence of 5 à 6 J/cm2),fractional resurfacing treatments using an ablative fractional CO2 laser(10600 nm, Deep-Fx, 30 to 50 mJ/MTZ, 5% coverage)followed by topical triamcinolone application by the principle of fractional laser-assisted drug delivery. We applied a hydrocolloid dressing 24/7,wearing compression shorts and to massage the scar regularly. After a total of 19 treatments, we observed a smooth scar without any signs of contraction and a normal range of motion of the hip joint. The patient was highly satisfied with the functional and aesthetic result. Conclusion: Lasers are a safe and effective treatment option for traumatic scars. Choosing the appropriate laser with the appropriate dosimetry is one of the cornerstones to a good scar-management.

EVALUATION OF ETIOLOGY AND OUTCOMES OF PAEDIATRIC BURNS UNDER THE AGE OF ONE YEAR.

Between March 2012 and March 2022, 138 paediatric burns patients under the age of one year were hospitalized and managed at Department of Burns and Plastic surgery at Pandit Dindayal Upadhyay Civil Hospital, Rajkot, Gujarat, India. Out of these patients, 61.59% (n=85) were males and 38.40%(n=53) were females. Aetiology of burns was mostly ame burns, scald burns from water and milk and electrical burns. TBSA (total body surface area) percentage sustained from burn trauma ranged from 1% to 95 %. Flame burns and water scald burns contributed to higher percentage of burns as compared to milk scalds and electrical burns. Total mortality was 23.91% (n=33). Flame burns resulted in 16 mortalities and scald burns lead to 14 deaths. These results show that mortality in infant is higher than other paediatric age groups. Infants represent a specic vulnerable group because they are essentially non-walkers and entirely dependent on their parents. More often than not these burns are due to negligence on the part of parents. These burns can be prevented by awareness campaigns targeting education of parents and care givers.

Extracorporeal life support in pediatric burn care: A systematic review.

A systematic review of the role of extracorporeal life support (ECLS) in pediatric patients with burn and smoke inhalation injury was undertaken. A systematic search of the literature according to a specific combination of keywords to ascertain the effectiveness of this treatment strategy was conducted. A total of 14 articles out of 266 were considered suitable for the analysis in pediatric patients. The PICOS approach and PRISMA flow chart were followed for the purpose of this review. Despite the limited number of studies on the subject, ECMO in burn and smoke inhalation injury provides an additional level of support in pediatric patients leading to positive outcomes. V-V ECMO demonstrated the best overall survival of all configurations, with similar outcomes to non-burned patients. Prolonged mechanical ventilation prior to ECMO decreases survival and increases mortality by 12% with each additional day off ECMO. Good outcomes have been described for scald burns, dressing changes, and pre-ECMO cardiac arrest.

External Validation of Three Burn-Specific Mortality Prediction Models in Adult Burn Patients at a Tertiary Care Hospital in India.

Background Several burn-specific mortality prediction models have been formulated and validated in the developed countries. There is a dearth of studies validating these models in the Indian population. Our objective was to validate three such models in the Indian burn patients. Methods A prospective observational study was performed after ethical clearance on consecutive eligible consenting burn patients. Patient demographics, vitals, and results of hematological workup were collected. Using these. the Abbreviated Burn Severity Index (ABSI), the revised Baux score (rBaux), and the Fatality by Longevity, APACHE II score, Measured extent of burn, and Sex score (FLAMES) were calculated. The discriminative ability of the ABSI, rBaux, and the FLAMES was tested using the receiver operating characteristic (ROC) curve at 30 days and the area under the ROC curve (AUROC) compared. A p -value ≤ 0.05 was considered significant. Probability of death was calculated using these models. Hosmer-Lemeshow goodness of fit test was run. Results The ABSI (AUROC 0.7497, 95% CI 0.67796-0.82141), rBaux (AUROC 0.7456, 95% CI 0.67059-0.82068) and FLAMES (AUROC 0.7119, 95% CI 0.63209-0.79172), had fair discriminative ability. The Hosmer-Lemeshow test reported that ABSI and rBaux were a good fit for the Indian population, while FLAMES was not a good fit. Conclusion The ABSI and rBaux had a fair discriminative ability and were a good fit for the adult patients with 30 to 60% thermal and scald burn patients. FLAMES despite having fair discriminative ability was not a good fit for the study population.

Pediatric instant noodle burns: A ten-year single center retrospective study

IntroductionChildren are particularly vulnerable to scald injuries, and hot beverages/foods are often implicated in this subset of pediatric burns. Burns from instant noodles are common and thus an attractive target for burn prevention. The purpose of this study is to characterize the frequency, demographics, outcomes, and circumstances of pediatric instant noodle burns to guide future educational and prevention efforts. MethodsThis is a retrospective review of all pediatric patients (<18 years) admitted to the University of Chicago Burn Center with a diagnosis of scald injury between 2010 and 2020. Burns caused by instant noodles were identified and compared to all other scald burns over this period. ResultsAmong 790 pediatric scald burns, 245 (31.0 %) were attributed to instant noodles. Compared to other scalds, patients with instant noodle burns were older (5.4 vs. 3.8 years, p < 0.001), equally likely to be male (51 % vs. 54 %, p = 0.488), and more likely to be Black/African American (90.6 % vs. 75.2 %, p < 0.001). Patients with instant noodle burns lived in zip codes with a lower average childhood opportunity index score (9.9 vs. 14.6, p < 0.001). In terms of circumstances, children with instant noodle burns were more likely to be unsupervised at the time of injury (37 % vs 21 %, p < 0.001). Instant noodle burns were smaller (3.6 % total body surface area (TBSA) vs. 5.8 % TBSA, p < 0.001) and less likely to require operative intervention (29 % vs. 41 %, p < 0.001). Instant noodle burns had a shorter length of stay (4.2 days vs. 6.4 days, p < 0.001), but similar adjusted length of stay (1.7 days/%TBSA vs. 1.5 days/%TBSA, p = 0.18) and experienced similar complication rates (10 % vs. 15 %, p = 0.06). ConclusionInstant noodle burns comprised nearly one-third of all pediatric scald burn admissions at our institution, a higher proportion than previously reported. While less severe than other scald burns in this series, instant noodles injuries still demonstrated a need for hospitalization and operative intervention. Instant noodle burns disproportionately affected Black/African American patients, as well as from neighborhoods with lower socioeconomic status. These findings suggest that focused burn prevention efforts may be successful at reducing the incidence of these common, but serious injuries.

Cost analysis of severe burn victims in Southwest China: A 7-year retrospective study.

Severe burn injury can be a life-threatening experience and can also lead to financial issues for suffers. The purpose of the current study was to analyze the direct hospitalization costs of severe burn inpatients in Southwest China. Data related to all inpatients admitted with severe burns [total body surface area (TBSA) ≥30%] pooled from 2015 to 2021 were reviewed retrospectively at the Institute of Burn Research of Army Medical University. Demographic parameters, medical economics, and clinical data were obtained from medical records. A total of 668 cases were identified. The average age was 37.49 ± 21.00 years, and 72.3% were men. The average TBSA was 51.35 ± 19.49%. The median length of stay of inpatients in the burn intensive care unit was 14 [interquartile range (IQR): 5.0-34.8] days, and the median length of stay (LOS) was 41 (IQR: 22.0-73.8) days. The mortality rate was 1.6%. The median total cost was 212,755.45 CNY (IQR: 83,908.80-551,621.57 CNY) per patient varying from 3,521.30 to 4,822,357.19 CNY. The direct cost of scald burns was dramatically lower compared with that of other types of burns, with 11,213.43 to 2,819,019.14 CNY. Medical consumables presented the largest portion of total costs, with a median cost of 65,942.64 CNY (IQR: 18,771.86-171,197.97 CNY). The crucial risk factors for medical cost in our study were TBSA, surgical frequency, LOS, depth of burn, and outcome. We conclude that an effective burn prevention program, shorter hospital stays, and facilitating the healing of wounds should be focused on with tailored precautionary protocols to reduce the medical costs of inpatients with severe burns.

Admission Pattern of Burn Patients of Various Aetiologies in the Burn Unit of a Tertiary Care Hospital in COVID-19 and Pre-COVID-19 Period: A Retrospective Study

Introduction: Worldwide the Coronavirus Disease-2019 (COVID19) pandemic has brought with it many changes and challenges in the healthcare scenario. While restricted movement during the lockdown period had its effect in the reduction of outdoor burn incident such as industrial burn, overcrowding at residential units led to an increase in domestic burns. Aim: To evaluate various changes in acute burns reflected in the admission pattern in a tertiary care hospital during pre-COVID19 and COVID-19 period. Materials and Methods: The present study was a retrospective observational study conducted in the burn unit of a tertiary care teaching hospital in Kolkata, West Bengal, India, from September 2018 to February 2020 (Pre-COVID-19) and March 2020 to August 2021 (COVID-19). Data of burns patients such as age, sex, aetiology of burn, mode of burn injury, percentage of body surface area involved, duration of hospital stay, number of patients undergoing surgical management, discharge, and death were reviewed and analysed using MS Excel and Z-test. Results: There was a decrease in the admission rates in the COVID-19 period (462 v/s 317). Flame burn 43.51% v/s 48.26% (p=0.67); scald burn 38.10% v/s 41.01% (p=0.19); electric burn 15.8% v/s 4.73% (p=0.00001); chemical burn 2.59% v/s 5.99% (p=0.0173) for pre-COVID-19 v/s COVID-19 periods, respectively. The proportion of accidental burn injuries remained the same because of overcrowding at home (50.22% v/s 47.63%) (p=0.477) which was compensated by a decrease in workplace accidental burns during the lockdown period. The percentage of suicidal injuries had increased during the COVID19 period (35.06% v/s 48.27%) (p=0.00022). The percentage of homicidal burn injuries had significantly reduced during COVID19 time (14.72% v/s 4.1%) (p=0.00001). There was a statistically significant increase in the paediatric population of burn injuries during COVID-19 (35% v/s 62.7%) (p=0.00001). Conclusion: Decrease in admission rates and comparable accidental flame and scald burn injuries and a drop in workplace burn injuries with women and children being the most vulnerable population.

Exploring Limited English Proficiency in the Clinical Outcomes of Pediatric Burn Patients

IntroductionLimited English proficiency (LEP) is linked to lower health care access and worse clinical outcomes. This study aims to explore the potential role of LEP on clinical outcomes of pediatric burn patients. MethodsWe conducted a single-institution retrospective study of burn patients presenting at a tertiary pediatric burn referral program between January 2016 and December 2020. Patient demographics, burn mechanism, severity, interventions, and primary patient language were abstracted from the electronic health record. Clinical outcomes (length of stay [LOS], clinic follow-up, and 30-day readmission) of patients with LEP were compared to patients with English as primary language (EPL). ResultsThirty-five (4.2%) patients with LEP were identified of 840 total patients. On univariate analysis, there was no difference in mean total body surface area (6.5% versus 6.1%), report of physical abuse (2.9% versus 8.9%), or need for grafting (14.3% versus 15.0%) comparing patients with LEP to those with EPL. Patients with LEP were more likely to have a scald burn (68.6% versus 48.9%, P = 0.025) and less likely to have a flame/fire burn (20.0% versus 37.6%, P = 0.047). On multivariate analysis, there was no difference between patients with LEP compared to patients with EPL for LOS (2.9 versus 3.5 d), 30-day readmissions (5.6% versus 5.7%), or clinic follow-up (80.6% versus 75.0%). In patients with >10% total body surface area, patients with LEP had a longer emergency department LOS (277 min versus 145 min, P = 0.06) but no difference in outcome measures. ConclusionsPediatric patients with LEP were not found to have worse burn outcomes compared to EPL patients in our patient sample. However, a true association is difficult to determine given the small sample size of LEP patients and the potential underestimation of language discordancy as recorded in the electronic medical record. Further research is needed to better explore the role of primary language and health communication as a social determinant of health in pediatric burn patients.

737: CLINICAL FEATURES AND OUTCOMES IN SEVERE PEDIATRIC SCALD BURN PATIENTS

Introduction: Young children with scald burns experience severe complications compared to older children. A paucity of data exists to support these observations. This study compares clinical features and complications of younger versus older pediatric patients with scald burns at four children’s hospitals participating in the Pediatric Injury Quality Improvement Collaborative (PIQIC). This collaborative includes five pediatric burn centers that utilize research to improve quality of burn care. Methods: This is a retrospective cohort study of scald burn patients admitted from 2010 to 2020 to four pediatric hospitals participating in PIQIC. Patients with total body surface area (TBSA) < 15% were excluded. Patients were categorized by age into three groups: toddlers (0–3 years), children (3-10 years) and adolescents (>10 years). The adolescent group was excluded with three patients in this group. Demographics, clinical features and adverse events were compared between age groups. For categorical variables, counts and percentages are reported; P-values were determined by Fisher’s Exact test. Continuous variables are reported using median and inter-quartile range; P-values were determined using the Wilcoxon Rank Sum test. Results: Ninety-five patients were identified; 73 (76%) were in the toddler group. Although median burn size was larger in children (24 [21-36] vs 21 [18-30] % TBSA, p< 0.001), toddlers had longer median intensive care unit (ICU) LOS (3 [2-16] vs 3 [2-9], p< 0.001) and more median mechanical ventilator (MV) days (13 [1-137] vs 5 [2-138], p< 0.001) than the child group. There was notable incidence of sepsis, nosocomial infection and abdominal catastrophe in the toddler group. Abdominal catastrophes only occurred in the toddler group, with 5 patients (7%) affected. Mortality was only observed in the child group (n=2, 9%). Conclusions: Scald burns are more prevalent in the toddler group compared to the child group. Mortality risk may not be higher in this group, but they encounter longer ICU LOS, higher MV days, and incidence of sepsis, nosocomial infection, and abdominal catastrophe. This is one of the largest reports of abdominal catastrophe in this patient population to our knowledge. Continued investigation will help better understand this patient population.

650. Cefiderocol use in burn patients admitted to an intensive care unit

Abstract Background Cefiderocol is a novel cephalosporin that binds to ferric acid and is moved across the outer membrane of Gram-negative bacilli via iron transport. Once through the outer membrane, cefiderocol is able to exert typical cephalosporin activity. Because of its ‘Trojan horse’-like mechanism of action, cefiderocol is able to elude typical bacterial resistance mechanisms and has activity against multidrug-resistant organisms (MDROs), including Acinetobacter spp. and Pseudomonas spp. While cefiderocol is considered to be relatively safe, it does have the potential to predispose to secondary infection with Clostridioides difficile. We present a case series where cefiderocol was used to treat infections caused by MDROs in burn patients admitted to our burn intensive care unit (BICU). Methods A clinical review of patients admitted to the BICU who received cefiderocol between September 2019 and April 2022 was performed. Results Five patients received 6 courses of cefiderocol. Three patients (60%) had flame burns, one patient (20%) had a scald burn, and one patient (20%) had blast injury. The median burn size was 47% TBSA (IQR 31, 60 days). The median time from injury to cefiderocol initiation was 73.5 days (IQR 49.5, 108). The median duration of cefiderocol therapy was 7 days (IQR 7, 16). The most common indications for cefiderocol treatment were pneumonia (33.3%) and bacteremia (33.3%), followed by wound infection (16.7%), and discitis/osteomyelitis (16.7%). Organisms isolated included Escherichia coli (n=2), Enterobacter cloacae (n=1), Acinetobacter baumannii (n=1), and Pseudomonas aeruginosa (n=2). All isolates were carbapenem resistant, and only one isolate was susceptible to amikacin (Acinetobacter baumannii). The 2 E. coli isolates carried a New Delhi metallo-beta lactamase. Two thirds of patients (n=4) achieved a clinical cure with cefiderocol treatment. Three of the 5 patients (60%) died during their hospital stay. All patients received appropriate doses of cefiderocol based on the current prescribing recommendations. No patients developed infection with C. difficile as a result of cefiderocol treatment. Conclusion Cefiderocol is a cephalosporin with novel mechanism of action that can be used to treat MDROs in burn patients, with no secondary C. difficile infections observed. Disclosures All Authors: No reported disclosures.

Role of Hybrid Reconstructive Ladder in Adult Scald Burns

The reconstructive ladder discusses progressively more difficult soft tissue coverage methods for wound coverage and healing. Regenerative medicine modalities can be added to conventional reconstructive methods, making it a hybrid reconstruction ladder, which may make it easier to achieve wound coverage at a lower 'rung'. We have used the hybrid reconstruction ladder in an adult patient with scald burns with significant clinical improvement.

Skeletal muscle transcriptome is affected by age in severely burned mice

Severe burn results in muscle wasting affecting quality of life in both children and adults. Biologic metabolic profiles are noticeably distinctive in childhood. We posit that muscle gene expression profiles are differentially regulated in response to severe burns in young animals. Twelve C57BL6 male mice, including young (5 weeks-old) and adults (11 weeks-old), received either scald burn, or sham procedure. Mouse muscle tissue was harvested 24 h later for Next Generation Sequence analysis. Our results showed 662 downregulated and 450 upregulated genes in gastrocnemius of young mice compared to adults without injury. After injury, we found 74/75 downregulated genes and 107/128 upregulated genes in both burned groups compared to respective uninjured age groups. VEGFA-VEGFR2, focal adhesion, and nuclear receptor meta-pathways were the top 3 gene pathways undergoing a differential change in response to age. Of note, the proteasome degradation pathway showed the most similar changes in both adult and young burned animals. This study demonstrates the characteristic profile of gene expression in skeletal muscle in young and adult burned mice. Prominent age effects were revealed in transcriptional levels with increased alterations of genes, miRNAs, pathways, and interactions.

Outcome of burn injury and associated factor among patient visited at Addis Ababa burn, emergency and trauma hospital: a two years hospital-based cross-sectional study

Burn is one of the critical health problems worldwide. Developing countries with sub-Saharan and Asian populations are affected more. Its mortality and non-fatal complications depend on several factors including age, sex, residency, cause, the extent of the burn, and time and level of care given. The purpose of this study was to assess the outcome of burn injury and its associated factor among patients who visited Addis Ababa burn emergency and trauma hospital. The institutional-based, retrospective cross-sectional study design was conducted from April 1, 2019, to March 30, 2021. After checking the data for its consistency the data were entered and analyzed by using SPSS version 25. A total of 241 patients who had visited Addis Ababa burn, emergency and trauma Hospitals after sustained burn injury were recruited through convenience sampling method for final analysis. Model goodness-of-fit was checked by Hosmer and Lemeshow test (0.272). After checking multi-collinearity both the bi-variable and multivariable logistic regression model was fitted and variables having a p-value less than or equal to 0.05 at 95% CI in the multivariable analysis were considered statistically significant. Adults (age 15 to 60 years) are the most affected groups accounting for 55.2% followed by pediatric age groups (age <15 years) (43.6%) and the elderly (age > 60 years) (1.2%). Scald burn was the major cause accounting for 39 % followed by Flame burn (33.6%), Electrical burn (26.6%), and chemical burn (0.8%). The mean TBSA% was 15.49%, ranging from1% to 64%. Adult males are more affected by electrical burns while adult females and the elderly encounter flame burn. 78.4% of patients were discharged without complications, 14.9% were discharged with complications and 6.6% died. The commonest long-term complication is the amputation of the extremity (19, 7.9%). Age greater than 60 years and TBSA% greater than 30% is a strong predictors of mortality with odds of 2.2 at 95% CI of [1.32, 3.69] and 8.7 at 95% CI of [1.33, 57.32] respectively. The mortality rate show decrement from previous studies. Overall scald burn is common in all age groups but electrical burns and flame burns affected more adult and elderly age groups. Extremities were by far, the commonest affected body parts. The extent of burn injury and the age of the patient independently predict mortality. Early intervention will reduce mortality and complications.

Herpes Zoster Manifestation in the Treatment of a Facial Scald Burn: A Case Report

Herpes Zoster Manifestation in the Treatment of a Facial Scald Burn: A Case Report