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Journal articles on the topic 'Burn'
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1
Attia, A. F. "Predictive models for mortality and length of hospital stay in an Egyptian burns centre." Eastern Mediterranean Health Journal 6, no. 5-6 (December 15, 2000): 1055–61. http://dx.doi.org/10.26719/2000.6.5-6.1055.
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Our aim was to obtain a statistical profile of survivors and deaths among burn victims and to develop predictive models for mortality and length of hospital stay. All patients admitted to the Burns Unit of Alexandria Main University Hospital over a 1-year period were included. Of 533 cases, mean length of hospital stay was 15.5 +/- 21.6 days and the mortality rate was 33%. Total surface area burnt, inhalation burns, age, sex, depth and degree of burn wounds were the significant independent predictors of mortality in multiple logistic regression analysis. The significant independent predictors of the length of hospital stay were clothing ignition, total surface area burnt, sex, degree and depth of burn and inhalation burns.
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Attia, Ashraf F., Aida A. Sherif, Ahmed Mohamed Amin Mandil, M. Nabil Massoud, Mervat, W. Abu Nazel, and Mostafa A. Arafa. "Epidemiological and sociocultural study of burn patients in Alexandria, Egypt." Eastern Mediterranean Health Journal 3, no. 3 (May 15, 1997): 452–61. http://dx.doi.org/10.26719/1997.3.3.452.
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All burn cases admitted to the burns unit of Alexandria Main University Hospital over a period of one year were investigated. Burns were found to occur in younger age groups. There was an almost equal distribution of cases by sex, but when stratified by age, more females were found in most age groups. Most burns were domestic, with cooking being the most prevalent activity. Flame was the most common agent. Death occurred in about one-third of cases;when using logistic regression analysis, the outcome of the burn injury was significantly associated with age, sex, total surface area burnt and degree and depth of the burn
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Malik1, Anil Kumar, Kunal Khanna, Suresh Kumar Dhattarwal, and Meenu Gill. "Histopathological Evaluation of Burn Injury." INTERNATIONAL JOURNAL OF ETHICS, TRAUMA & VICTIMOLOGY 7, no. 01 (December 25, 2021): 5–10. http://dx.doi.org/10.18099/ijetv.v7i01.2.
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Background: Burns always have posed a threat to the sensitive human body. It is a common catastrophe today as burn injury cases are one of the common emergencies admitted to any hospital. In a medico-legal setting, the main difficulty arises when a burnt body found in unknown circumstances is brought for post-mortem examination. In such a case, a forensic expert has to opine whether the burn injuries sustained are antemortem or post-mortem. It is also of paramount importance to determine the age of burn injuries sustained. Aging of burn injuries by the naked eye is sometimes difficult and unreliable. By histopathological examination of burnt tissue, one can predict whether the victim was alive or dead when the fire was going on and determine the age of burn injuries. Materials and Methods: The present cross-sectional study was carried out in the Department of Forensic Medicine and Toxicology, Pt. B.D.Sharma PGIMS, Rohtak. Total 3033 autopsies were conducted in the mortuary of the Department of Forensic Medicine andToxicology, PGIMS, Rohtak, from November 5, 2011`to November 5, 2013. During that period, out of 486 cases reported burns, randomly 100 cases were selected for this study. Results and Conclusions: In the present study, efforts were made to determine burn wound vitality and age by histopathological evaluation. The study revealed that the inflammatory infiltrate consisted mainly of polymorphonuclear leucocytes in initial stages (up to 3rd-day post-burn) with gradual lymphocytes, macrophages, and fibroblasts forming immature granulation tissue. On the 14th-day post-burn, the burn wound revealed repair by regeneration, increased collagen deposition, fibrosis, and granulation tissue formation. It was infiltrated with fibroblasts, macrophages, and lymphocytes. Our study demonstrated that evaluation of various histopathological changes occurring during the distinctive phases of burn wound healing help in the estimation of its vitality and age.
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Bereda, Gudisa. "Burn Classifications with Its Treatment and Parkland Formula Fluid Resuscitation for Burn Management: Perspectives." Clinical Medicine And Health Research Journal 2, no. 3 (May 12, 2022): 136–41. http://dx.doi.org/10.18535/cmhrj.v2i3.47.
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Burns can be caused by flames, ultraviolet radiation, hot liquids, electricity, lightning and certain chemicals. All burns require immediate first aid treatment. Partial and full thickness burns require urgent medical attention. Full thickness burns often require skin graft surgery. Simple analgesics (such as ibuprofen and acetaminophen) and opioids such as morphine didn’t used in 3rd degree burn because the burnt place is painless. The "Wallace Rule of Nines" is the most common method of determining body surface area. The most commonly used resuscitation formula is the Parkland formula which calculates the amount of fluid required in the first 24 hours.
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Lee, PC, WM Ching, CW Kam, and HH Yau. "A Case Series of Candle Wax Burns during the Lantern Festival in Hong Kong." Hong Kong Journal of Emergency Medicine 9, no. 4 (October 2002): 221–25. http://dx.doi.org/10.1177/102490790200900408.
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Every year there was significant number of burn cases during the Lantern (Mid-Autumn) Festival in Hong Kong because children liked to play with fire on that day. They would either burn the lantern or boil the wax from candles in a pot over a fire. When the wax has melted, they poured cold water into it, causing a small explosion with water vapour and wax droplets. Children and adolescents were more common than adults to be burnt by the hot vapour, fire or hot wax. The majority sustained partial thickness burns involving the face. Such burn injuries should be preventable by education and legislation.
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Dunstan, Evie, Oliver Funnell, Jenny McLelland, Felicity Stoeckeler, Elisa Nishimoto, Dana Mitchell, Sam Mitchell, et al. "An Analysis of Demographic and Triage Assessment Findings in Bushfire-Affected Koalas (Phascolarctos cinereus) on Kangaroo Island, South Australia, 2019–2020." Animals 11, no. 11 (November 12, 2021): 3237. http://dx.doi.org/10.3390/ani11113237.
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In the 2019–2020 Australian bushfires, Kangaroo Island, South Australia, experienced catastrophic bushfires that burnt approximately half the island, with an estimated 80% of the koala population lost. During and after the event, rescued koalas were triaged at a designated facility and a range of initial data were recorded including rescue location and date, sex, estimation of age, body condition and hydration, and assessment of burn severity (n = 304 records available). Koalas were presented to the triage facility over a span of 10 weeks, with 50.2% during the first 14 days of the bushfire response, the majority of which were rescued from regions of lower fire severity. Burns were observed in 67.4% of koalas, with the majority (60.9%) classified as superficial burns, primarily affecting the limbs and face. Poor body condition was recorded in 74.6% of burnt koalas and dehydration in 77.1%. Negative final outcomes (death or euthanasia, at triage or at a later date) occurred in 45.6% of koalas and were significantly associated with higher mean burn score, maximum burn severity, number of body regions burnt, poor body condition score, and dehydration severity. The findings of this retrospective study may assist clinicians in the field with decision making when triaging koalas in future fire rescue efforts.
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KHAN, FIRDOUS, ASIF SHAH, and ABDUL AZIZ JANAN. "BURN PATIENTS;." Professional Medical Journal 20, no. 06 (December 15, 2013): 1042–47. http://dx.doi.org/10.29309/tpmj/2013.20.06.1826.
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Aim: To determine major risk factors of mortality and causes of death in patients presented with burn injury. Study design:Prospective Descriptive Study. Setting and duration: Department of Burns and Plastic Surgery, Khyber Teaching Hospital, Peshawar,Pakistan from April 2008 and June 2012. Methodology: A prospective descriptive study was performed among the patients whoadmitted to the Department of Burns and Plastic Surgery, Khyber Teaching Hospital, Peshawar, Pakistan between April 2008 and June2012. All relative information was collected through a detailed proforma and patient’s treatment files. Patients of any age, any degree ofburns and burns exceeding 10% TBSA were included. Patients presenting after more than one week post burn or patients referred fromother hospitals were excluded. Within this period, demographic data, treatment, and outcomes of treatment were reviewed and analyzed.Survivors and non-survivors among burn patients were compared to define the predictive factors of mortality. Results: Between April2008 and June 2012, 1850 patients were admitted with burn injuries. There were 1150 male patients (62%) and 700 female patients(38%). Mean age was 36 years with range of 1-70 years. Inhalation injuries were present in 45 patients (2.40%). Causes were flameburns (65.0%), electrical burns (15%), scalds (13%) and chemical burns (7.0%). The total body surface area (TBSA) burn ranged from10- 100%, with a mean of 38% TBSA burn. Mean length of hospital stay was 12 days (ranging from 24 hours to 170 days). Mortality ratewas 11.2%. Higher age, larger burn area, wound infection, longer hospital stay and the presence of multi-system organ failuresignificantly predicted increased mortality. Conclusions: Prevention is a key factor in reducing the morbidity and mor tality associatedwith burn injury. A campaign to educate people that burns can be prevented will be important in our community. The prevention of multiorganfailure and septicemia are likely to be more effective than their treatment.
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Horton, Jureta W., David L. Maass, and D. Jean White. "Hypertonic saline dextran after burn injury decreases inflammatory cytokine responses to subsequent pneumonia-related sepsis." American Journal of Physiology-Heart and Circulatory Physiology 290, no. 4 (April 2006): H1642—H1650. http://dx.doi.org/10.1152/ajpheart.00586.2005.
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The present study examined the hypothesis that hypertonic saline dextran (HSD), given after an initial insult, attenuates exaggerated inflammation that occurs with a second insult. Adult rats ( n = 15 per group) were divided into groups 1 (sham burn), 2 [40% total body surface area burn + 4 ml/kg isotonic saline (IS) + 4 ml·kg−1·% burn−1 lactated Ringer solution (LR)], and 3 (burn + 4 ml/kg HSD + LR), all studied 24 h after burns. Groups 4 (sham burn), 5 (burn + IS + LR), and 6 (burns + HSD + LR) received intratracheal (IT) vehicle 7 days after burns; groups 7 (burn + IS + LR) and 8 (burn + HSD + LR) received IT Streptococcus pneumoniae (4 × 106 colony-forming units) 7 days after burn. Groups 4–8 were studied 8 days after burn and 24 h after IT septic challenge. When compared with sham burn, contractile defects occurred 24 h after burn in IS-treated but not HSD-treated burns. Cardiac inflammatory responses (pg/ml TNF-α) were evident with IS (170 ± 10) but not HSD (45 ± 5) treatment vs. sham treatment (80 ± 15). Pneumonia-related sepsis 8 days after IS-treated burns ( group 7) exacerbated TNF-α responses/contractile dysfunction vs. IS-treated burns in the absence of sepsis ( P < 0.05). Sepsis that occurred after HSD-treated burns ( group 8) had less myocyte TNF-α secretion/better contractile function than IS-treated burns given septic challenge ( group 7, P < 0.05). We conclude that an initial burn injury exacerbates myocardial inflammation/dysfunction occurring with a second insult; giving HSD after the initial insult attenuates myocardial inflammation/dysfunction associated with a second hit, suggesting that HSD reduces postinjury risk for infectious complications.
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S, Elankumar, and Chittoria R K. "Epidemiology of Burns: Application of JIPMER Burn Proforma." New Indian Journal of Surgery 10, no. 1 (2019): 103–6. http://dx.doi.org/10.21088/nijs.0976.4747.10119.17.
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Patterson, Kelli N., Kyle Horvath, Amanda Onwuka, Renata Fabia, Sheila Giles, Daniel J. Marx, Pablo Aguayo, et al. "108 Length of Stay per Total Body Surface Area Relative to Burn Mechanism: A Pediatric Injury Quality Improvement Collaborative (PIQIC) Study." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S72—S73. http://dx.doi.org/10.1093/jbcr/irab032.112.
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Abstract Introduction Studies on length of stay (LOS) per total body surface area (TBSA) burn in pediatric patients have been performed at single institutions and based on ranges of TBSA burn. A LOS to TBSA burn ratio of 1:1 has also been widely accepted but not confirmed over time across numerous institutions. The objective of this study was to use multi-institutional pediatric burn data to describe benchmarks associated with LOS per TBSA burn. Methods Data from the Pediatric Injury Quality Improvement Collaborative (PIQIC) were obtained for 1004 patients (n=1004) treated at five pediatric burn centers from July 2018-March 2020. LOS/TBSA burn ratios were calculated for each site. LOS/TBSA burn by institution and mechanism were analyzed. Generalized linear regression models were used to model the effect of hospital and burn mechanism on the LOS/TBSA ratio. Results Among the 1004 injuries, the most common burn mechanism was by scald (64%), followed by contact (16%) and flame (13%). The average LOS/TBSA burn ratio across all cases was 1.3 days (SD 2.2). Flame burns had a higher LOS/TBSA burn ratio than scald burns with a mean LOS/TBSA burn of 1.63 compared to 0.84. In adjusted models, scald burns, and chemical burns had the lowest LOS/TBSA burn ratio and electrical and friction burns had the highest LOS/TBSA burn ratio. The LOS/TBSA burn ratio was comparable across hospitals after adjustment for mechanism, with just Hospital 4 having a lower average LOS/TBSA burn of 0.49 days. Conclusions These data establish a multi-institutional ratio for the overall performance in LOS for pediatric burn patients. A LOS per TBSA ratio of about 1 was observed across PIQIC centers, except for a lower ratio at one center. Additionally, it provides evidence on the variance in LOS per TBSA burn relative to the sustained burn mechanism. Further collaborative data analysis will allow us to recognize specific patterns and outcomes in pediatric burn care, which is essential for the implementation of quality improvement standards.
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Almarghoub, Mohammed A., Ahmed S. Alotaibi, Anas Alyamani, Faisal A. Alfaqeeh, Faisal F. Almehaid, Mohammad M. Al-Qattan, and Abdullah E. Kattan. "The Epidemiology of Burn Injuries in Saudi Arabia: A Systematic Review." Journal of Burn Care & Research 41, no. 5 (June 1, 2020): 1122–27. http://dx.doi.org/10.1093/jbcr/iraa084.
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Abstract Burns are potentially catastrophic injuries that disproportionately affect non-Western countries. We summarize results on the epidemiology of burn injuries in Saudi Arabia of all eligible papers through 2019, specifically evaluating the age and gender of patients, the location and mechanism of injury, burn size and severity, and outcomes. Between July 5 and July 10, 2019, a comprehensive literature review was performed on MEDLINE, EMBASE, Google Scholar, and the Cochrane Library. For this search, “Saudi Arabia,” coupled with the search terms “burn,” “thermal burn,” “flame burn,” “chemical burn,” “electrical burn,” and “contact burn” to identify all abstracts potentially relating to the topic of interest. Eleven studies, encompassing 3308 patients, met eligibility criteria. Younger children (variably defined as ≤10–12) accounted for 52% of all burns. Males outnumbered females by an overall ratio of 1.42:1. About 83% of burns occurred at homes. Scald injuries accounted for 62.4% of injuries, followed by flame-induced burns (28.7%), electrical burns (3.3%), and chemical burns (2.8%). Pertaining to burn extent and severity, 80% to 100% of the burns were limited to <40% total body surface area, while roughly 60% were second-degree burns. Most patients remain in the hospital for 1 to 4 weeks. The overall mortality across studies including patients of all ages was 6.9%, while just 0.76% in the two studies restricted to pediatric patients. Scald injuries involving young children comprise the lion’s share of burn injuries in Saudi Arabia. Increased public awareness is necessary to reduce the incidence and severity of these potentially catastrophic injuries.
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Demir Yiğit, Yasemin, Ebral Yiğit, and Ahmet Çınar Yastı. "A rare type of burn : Nylon burns." Turkish Journal of Surgery 38, no. 2 (June 1, 2022): 202–7. http://dx.doi.org/10.47717/turkjsurg.2022.5373.
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Objective: In this study, it was aimed to examine nylon burns in paediatric patients and compare the results with other causes of hot object contact burns. Material and Methods: A 10-year retrospective study was conducted on 77 paediatric patients hospitalized for hot body burns at Gazi Yaşargil Training and Research Hospital Burn Center. Results: Of those patients with hot body burns, 72.7% (n= 56) were males and 27.3% (n= 21) were females. Male-to-female ratio was 2.67:1. Mean age of the patients was 4.79 (min= 1, max= 16) years. There were 42 patients who applied to our hospital on the day of their burn, while four patients applied one day after the burn, one patient applied two days after the burn, 13 patients applied three days after the burn and 17 patients applied five days after the burn. Most burns (79.3%) were third-degree burns, whereas 19.5% were seconddegree and 1.2% were fourth-degree burns. The most common causes of hot body burns were hot nylon and hot stoves, followed by hot ash and hot irons. The number of nylon burns was the highest in the summer and the highest number of hot stove burns occurred in the winter. Nylon burns were most common in the three to eight age group and then gradually decreased. The highest burn rate was observed in nylon burns. Conclusion: The most common cause of all burns in the Turkish paediatric population is scalding. Although nylon burns are rare, they draw attention due to their higher burn degrees.
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Azzam, Nadin, Ju-Lee Oei, Susan Adams, Barbara Bajuk, Lisa Hilder, Abdel-Latif Mohamed, Ian M. R. Wright, and Andrew J. A. Holland. "Influence of early childhood burns on school performance: an Australian population study." Archives of Disease in Childhood 103, no. 5 (November 29, 2017): 444–51. http://dx.doi.org/10.1136/archdischild-2017-313355.
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ObjectivesTo determine the influence of burn injuries on childhood performance in national standardised curriculum-based school tests.DesignBirth and health records of 977 children who were hospitalised with a burn injury between 2000 and 2006 in the state of New South Wales, Australia, were linked to performance scores in the National Assessment Program: Literacy and Numeracy test, a compulsory nationwide curriculum-based test (CBT) and compared with children who were not hospitalised for burns and who were matched for birth year, gender, gestation and socioeconomic status.Main outcome measuresTest scores in years 3 (ages 8–9), 5 (ages 10–11) and 7 (ages 13–14) in numeracy, writing, reading, spelling, grammar and punctuation.ResultsMean age at first burn injury was 28 months (median: 20, range: 0–140). Children with burns were significantly more likely to have younger mothers (28.5 vs 29.6 years) (P<0.001), be indigenous (OR 2.5 (95% CI 2.1 to 3.1)) (P<0.001) and have siblings (OR 1.2 (95% CI 1.1 to 1.4)) (P<0.001). They were also less likely to meet national minimum standards in most domains of testing until year 5, even after adjustment for parental education levels, parental smoking, maternal age and indigenous status. Each 10% increase in total body surface area burnt was associated with a decrease in year 5 scores by 37.0% in numeracy and 71.9% in writing.ConclusionsMost childhood burn injuries occur before the start of formal schooling. Children who are hospitalised for burns perform more poorly in CBT even after accounting for family and socioeconomic disadvantage. Rehabilitation of children with burn injuries must address school performance to decrease any long-term negative societal impact of burns.
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Singh, Pankaj, Mohd Fahud Khurram, Tushar B. Patil, Kunal Mokhale, and Girish Sharma. "Epidemiology and Outcome in Electrical Burn Injury: Retrospective Study of 282 Patients in a Tertiary Care Hospital of Western Uttar Pradesh, India." Recent Advances in Biology and Medicine 7, no. 3 (August 29, 2021): 1–6. http://dx.doi.org/10.18639/rabm.2021.1495640.
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Electrical burns account for a small percentage of all burn injuries. However, in burn patients, they are a major source of disability. They put socioeconomic burden on the society. This is a retrospective epidemiological study of 282 electrical burn patients admitted in burn unit of a tertiary care hospital of North India. Majority of the electrical burn was due to accidental touching of uncovered wires and occupation-related burns in laborers and industrial workers who were mainly young males in the age group 20 to 40 years. Most of the cases were of high-voltage (≥1000 V) electrical burns. More severe burns, longer hospital stays, and more problems and operations were all linked to high-voltage burns. Amputation rates for high-voltage burns were significantly higher (37.3%) as compared to low-voltage burns (13.6%). Electrical burn injuries can be prevented by awareness programs, proper training, and safety measures both by public and government.
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HAZAR, Erkan, Ali Rıza İNCE, Selim ÇAM, and Naim KARAGÖZ. "HİZMET İŞLETMELERİNDE MALIYET ANALİZİ: SİVAS NUMUNE HASTANESİ YANIK ÜNİTESİNDE YATAN HASTALARIN MALİYET ANALİZİ." Business & Management Studies: An International Journal 1, no. 2 (January 15, 2014): 156. http://dx.doi.org/10.15295/bmij.v1i2.31.
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Aim. The aim of this study is to investigate retrospectively the average cost per patient between the time 1May 2012-15 June 2013 in 68 patients who were hospitalized in the Burn Section of Numune State Hospital. Methods. This investigation includes age, degree of burn, burn percentage, burn type, hospitalization days and bills. Rates were determined according to the burn type of patients and costs were determined according to these types. Results. 80.9% of patients had hot water burn, 7.4% were burned due to burst flames, 4.4% had milk burns, 4.4% had steam burns and 2.9% were identified to have electrical burns. Average costs of burn injury inpatients was reported as TL values. Conclusion. The degree of burn injury, burn ratio and number of days during hospitalization were found to be dependent while age and type of burn injury were found to be independent variable that affect burn costs. The most important paramater that increased cost was number of days of hospitalization. Total cost of 68 patients was 1193,65 TL and average daily cost of a patient was found to be 110,12TL.
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Al Hosni, Ahmed M., Connor McSweeney, Fagun Jain, and Anthony Papp. "571 Ethnicity and Etiology in Burn Patients for the American Burn Association National Burn Repository (NBR)." Journal of Burn Care & Research 43, Supplement_1 (March 23, 2022): S122. http://dx.doi.org/10.1093/jbcr/irac012.199.
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Abstract Introduction The purpose of this study was to analyze data from the American Burn Association National Burn Repository (NBR) with particular focus on patient ethnicity and burn etiology. We hypothesize that burn etiology, severity and other characteristics will be significantly different between differing ethnic groups throughout the database. This information can be used to augment burn prevention strategies by targeting at risk ethnic groups. Methods Data on burn patients was derived from the American Burn Association National Burn Registry including all burn entries for a 10 year period (2009 to 2018) from 46 burn centers. The ethnic categories for this study were White, Black, Hispanic, Indigenous and Asian. The study also involved analysis of patient demographics, burn severity, context of injury, and hospital course. Results White patients were the largest group (64.0%), had the highest proportion of flame injury (53.1%) and shared the highest mortality rate with indigenous patients (3.1% compared with 2.6% for all other ethnicities). Black individuals (22.2%) had higher rates of scald burns (53.2%), the shortest average hospital stay (16.8 days) and along with indigenous patients the highest rates of assault/abuse (2.0% and 1.9% respectively). Hispanic patients (10.0%) had more scald burns (47%), the largest proportion of men (66.5%), the highest incident of work-related injuries (18.0%) and the largest average TBSA at 10.1%. Asian patients (2.7%) had the largest proportion of scald injury (63.1%) and the smallest proportion of male patients (54.5%). Indigenous patients (1.1%) had higher rates of flame burns, suffered full thickness burns at the highest rate (32.8%), had the longest average stays in hospital (21) and the ICU (15) and had the highest rates of blanks for data entry. Conclusions This study found multiple significant differences in burn populations when compared by ethnicity. We have found that the indigenous population suffered full thickness burns at the highest rate and have had the longest average hospital stay as well average ICU stay. We have also had the unexpected finding of higher rates of unknowns in the indigenous population which may reflect racial bias at an institutional level nationally.
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Patterson, Kelli N., Amanda Onwuka, and Rajan K. Thakkar. "549 Length of Stay per Total Body Surface Area Burn: Validation Using the National Burn Repository." Journal of Burn Care & Research 43, Supplement_1 (March 23, 2022): S109—S110. http://dx.doi.org/10.1093/jbcr/irac012.177.
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Abstract Introduction A length of stay (LOS) of one day per percent total body surface area (TBSA) burn has been widely accepted in clinical practice but not validated in current pediatric burn studies. Additionally, TBSA burn data is often presented in ranges, which lacks granular details. The primary objective of this study is to validate our previous Pediatric Injury Quality Improvement Collaboration (PIQIC) findings by using a national burn registry to evaluate LOS per TBSA burn relative to burn mechanism, sociodemographic characteristics, and clinical factors which influence this ratio. Methods We evaluated patients 0-18 years old who sustained a burn injury and whose demographics were submitted to the National Burn Repository (NBR) dataset from July 2008 through June 2018. Patients sustaining inhalation injury and electrical burns were excluded due to LOS being significantly increased unrelated to cutaneous injury. Mixed effects generalized additive regression models were then performed to identify characteristics associated with the LOS per TBSA ratio, a nonparametric variable. Results Among 51,561 pediatric burn patients, 45% were Non-Hispanic White, 58% were male, and the median age was 3 years old (IQR: 1, 9). The most common burn mechanism was scald (55.9%), followed by flame (19.4%), and contact (16.4%), with most burns occurring at home (82.2%). The median LOS per TBSA burn ratio across all cases was 0.9 (IQR: 0.4, 1.8). In adjusted models, scald burns and radiation burns had similar LOS per TBSA burn ratios (mean predicted values: 1.22 vs 1.77), while all other burn mechanisms had a significantly higher LOS per TBSA burn ratio (p< 0.0001). Chemical burns had the highest ratio (predicted mean: 4.8), followed by contact burns (mean predicted value: 2.8; Table 1, Figure 1). Non-Hispanic White patients had lower LOS per TBSA ratios than all other races and ethnicities (p< 0.05) with mean predicted values of 1.6. Native Americans and Hispanics had the highest ratios (2.0 and 1.8 respectively, (Table 1). Conclusions These data substantiate evidence on variance in LOS per TBSA burn relative to burn mechanism, previously demonstrated by PIQIC centers. It also validates differences in LOS per TBSA burn ratios among race/ethnicity.
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Dargan, Dallan, Bismark Adjei, and Kayvan Shokrollahi. "A Rule of Thumb for Hand Burns: Categorization and Mapping of Proportional Surface Area Involvement." Journal of Burn Care & Research 41, no. 5 (March 31, 2020): 1092–96. http://dx.doi.org/10.1093/jbcr/iraa054.
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Abstract Hand burns are common and often complex injuries, requiring referral to specialist centers. The patient’s thumbprint is a rapid means of accurately assessing hand burn surface area. This study aimed to establish categories and evaluate sites of hand burn surface area in order to facilitate comparison of hand burns. Sixteen burns involving the hand and wrist among 14 patients referred to a burns center were retrospectively categorized by burn mechanism, burn thickness, and hand burn surface area. The burn surface area in the clinical record was compared with that calculated by the thumbprint method and the rule of thumb diagram. Burn surface area in the clinical record was either “1%” or “<1%” in 9 of 16 cases. In contrast, the surface area was <1 thumbprint (T) in six burns, two were between 1 and 5T, three were 5 to 10T, two were 10 to 20T, two were 20 to 50T, and one was greater than 50T. The median thumbprint burn surface area was 1.5T (range 0.20–80T), which corresponds to 0.05% TBSA. The hand areas with the highest burn frequency per unit area were the dorsum of the hand and dorsum of the index finger, with relative sparing of the palm and palmar surface of the digits. Hand burns surface area varies widely, and thumbprint evaluation with categories and mapping allows finer distinction between the surface area proportions and specific sites involved, even in a small series of hand burns.
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Baral, Madan Prasad, and Sidarth Timsinha. "Mortality from Burn: An Autopsy Based Study from Nepal." Birat Journal of Health Sciences 6, no. 2 (November 3, 2021): 1496–500. http://dx.doi.org/10.3126/bjhs.v6i2.40333.
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Introduction: In developing countries like Nepal burn deaths are a major public health problem due to their increased mortality, morbidity and long-term disability. A few clinical studies on burns have been reported from Nepal however, autopsy based studies on burns are limited.
Objectives: To study the socio-demographic characteristics of victims of burns and evaluate the cause and magnitude of fatal burn injuries retrospectively.
Methodology: A two years retrospective analysis of burn deaths brought for autopsy was conducted from January 2017 to December 2018 in a central level hospital of Nepal.
Results: Out of 775 total cases autopsied 38 (4.90%) cases were burn related deaths. The majority of the deaths 17(44.70%) occurred in the age group 21-30 years with a preponderance in females 22(57.89%). Majority of the victims were married females 25(65.78%) and most of them were housewives 14(36.84%). Flame burn 23(60.52%) was the most common cause of all burns. The Total Body Surface Area (TBSA) Burn between 50-69% was observed in majority of the cases 27(71.05%).Most of the victims 15(39.47%) survived over 10 days post injury. Burn incidents were mainly accidental 33(86.84%) in nature followed by suicidal burns 5(13.15%). The main cause of burn death was septicemic shock 16(42.10%) followed by neurogenic shock 10(26.31%).
Conclusion: The results of this study show that burns injuries are mostly accidental in nature; therefore, the risks of burn injuries should be rightly addressed and appropriate burn prevention strategies should be developed to reduce the frequency and burn related deaths.
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Nair, C. K. Velayuthan, Vinu Gopinath, and Vishnu G. Ashok. "Demographic and socio-cultural aspects of burns patients admitted in a tertiary care centre." International Surgery Journal 4, no. 7 (June 22, 2017): 2170. http://dx.doi.org/10.18203/2349-2902.isj20172618.
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Background: Burn injury is a serious pathology, potentially leading to severe morbidity and significant mortality, but it also has a considerable health-economic impact. Burn injuries rank among the most severe types of injuries suffered by the human body with an attendant high mortality and morbidity rate. The objective of this study was to identify the demographic and socio-cultural aspects of burn patients attending a tertiary care centre.Methods: A cross sectional study was carried out in the burns unit of a tertiary care centre. All burns cases admitted to the burns unit for the period of one year were included.Results: Out of the 150 burns patient’s majority were females belonging to the age group 21 to 30 years. 80% of the burn injuries occurred at home. Cooking was the main factor for burns in domestic set up. Flames represented the common agent of burn injuries.Conclusions: The current study gives important information about sociocultural factors involved in burn injuries which in turn will help in identifying the high-risk population for preventing future burn injuries.
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Konanur, Anisha, Francesco M. Egro, Caroline E. Kettering, Brandon T. Smith, Alain C. Corcos, Guy M. Stofman, and Jenny A. Ziembicki. "Gender Disparities Among Burn Surgery Leadership." Journal of Burn Care & Research 41, no. 3 (January 30, 2020): 674–80. http://dx.doi.org/10.1093/jbcr/iraa013.
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Abstract Gender disparities have been described in the plastic surgery and general surgery literature, but no data have been reported in burn surgery. The aim of this study is to determine gender disparities among burn surgery leadership. A cross-sectional study was performed. Burn surgeons included were directors of American Burn Association (ABA)-verified burn centers, past presidents of the ABA, and International Society for Burn Injuries (ISBI), and editors of the Journal of Burn Care & Research, Burns, Burns & Trauma, Annals of Burns & Fire Disasters, and the International Journal of Burns and Trauma. Training, age, H-index, and academic level and leadership position were compared among surgeons identified. Among the 69 ABA and ISBI past presidents, 203 burn journals’ editorial board members, and 71 burn unit directors, females represented only 2.9%, 10.5%, and 17%, respectively. Among burn unit directors, females completed fellowship training more recently than males (female = 2006, male = 1999, P < .02), have lower H-indexes (female = 8.6, male = 17.3, P = .03), and are less represented as full professors (female = 8.3%, male = 42.4%, P = .026). There were no differences in age, residency, research fellowship, or number of fellowships. Gender disparities exist in burn surgery and are highlighted at the leadership level, even though female surgeons have a similar age, residency training, and other background factors. However, gender diversity in burn surgery may improve as females in junior faculty positions advance in their careers.
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Kettering, Caroline E., Francesco M. Egro, Anisha Konanur, Brandon T. Smith, Alain C. Corcos, Guy M. Stofman, and Jenny A. Ziembicki. "Racial and Ethnic Disparities Among Burn Surgery Leadership." Journal of Burn Care & Research 41, no. 3 (February 7, 2020): 714–21. http://dx.doi.org/10.1093/jbcr/iraa026.
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Abstract The underrepresentation of racial and ethnic minority groups has been well-documented in general and plastic surgery but not in burn surgery. The aim of this study is to evaluate current minority group disparities among burn surgery leadership. A cross-sectional analysis was performed. Burn surgeons included directors of American Burn Association-verified burn centers in the United States, past and current presidents of the American Burn Association, and editorial board members of five major burn journals (Journal of Burn Care & Research, Burns, Burns & Trauma, Annals of Burns & Fire Disasters, and the International Journal of Burns and Trauma). Surgeons were compared based on factors including age, gender, training, academic rank, and Hirsch index (h-index). Among 71 burn center directors, 50 societal presidents, and 197 journal editors, minority groups represented 18.3, 2.0, and 34.5%, respectively. Among burn center directors, the group classified collectively as nonwhite was significantly younger (49 vs 56; P < .01), graduated more recently (2003 vs 1996; P < .01), and had a lower h-index (9.5 vs 17.4; P < .05). There were no significant differences in gender, type of residency training, advanced degrees obtained, fellowships, academic rank, and academic leadership positions between white and nonwhite groups. When compared with the 2018 U.S. National Census, burn unit directors had a 5.1% decrease in nonwhite representation. Disparities in representation of ethnic and racial minorities exist in burn surgery despite having similar qualifying factors.
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Wardhana, Aditya, and Jessica Halim. "Antioxidants Reduce Tissue Necrosis in The Zone of Stasis: Review of Burn Wound Conversion." Jurnal Plastik Rekonstruksi 7, no. 1 (May 7, 2020): 18–28. http://dx.doi.org/10.14228/jpr.v7i1.292.
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Summary: Severe burns are devastating condition identified by loss of hemodynamic stability and intravascular volume. Adequate fluid replacement, nutritional support, and immediate wound grafting can reduce the risk of infection and mortality. Oxidative stress was shown to have significant role in the burn wound conversion, which happens when the zone of stasis can’t be salvaged and progresses to necrosis. Decreasing the level of oxidative stress early may be fundamental in reducing burn injury progression into deeper tissue. Several animal studies have demonstrated the advance of antioxidant supplementation for burns outcomes. Approach to this salvageable burn tissue is a breakthrough for new directions in burn management. Antioxidant supplementations was proven to prevent burn conversion on the ischemic zone. Administering antioxidant post-burn is linked with less progression of burn depth and inflammatory cytokine release, which alleviates burn-related morbidity and mortality and improves patient’s quality of life. To date, no clinical trials have been done to reproduce similar outcomes of this ROS-scavenging therapy as successfully observed in murine models. Antioxidant supplementation is a promising treatment avenue to halt burn wound conversion following severe burns.
Keywords: Burn wound, wound conversion, burn management, antioxidant
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Vohra, Ekta. "577 The Collaboration of Burn Outreach and Wound Care Nurses." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S140. http://dx.doi.org/10.1093/jbcr/irab032.227.
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Abstract Introduction Certified wound care nurses perform a vital role in skin health and management in the hospital setting. During the certification process, minimal time is spent on burn wound education, despite the fact that wound care nurses are consulted for various wound etiologies; one of those being burns. This construct created a need for collaboration between the burn team and wound care nurses. Although all burns are essentially wounds, the reality is that all wounds are not burns. The management of the burn wound is often different from the management of pressure injuries or surgical wounds. In speaking with the wound care nurses at this large urban academic medical center, a knowledge gap was identified in burn wound care education as well as appropriate and timely consultation of the burn team. Methods This knowledge improvement project focused on educating the wound care nurses in assessment and treatment of burns, and the process for burn service consultation. Burn education was provided through in-person didactic presentations. The lecture included burn wound photos with opportunities to classify the potential depth of burn wounds as well as typical complications. Additionally, it discussed when a burn consult is needed. A basic knowledge retrospective pre-posttest method was utilized. Results An educational plan was tailored to meet the learning needs of the wound care nurses to address the knowledge gap. Post test data results were tracked. Post scores were increased, indicating a successful educational intervention. Also, while providing the education, the burn outreach coordinator identified an opportunity to expand the burn center’s presence among colleagues through collaboration with the wound care nurses. The wound nurses made excellent ambassadors for the mission of the burn service. Conclusions Provision of burn education across disciplines may improve recognition of burn wounds and facilitate definitive treatment.
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Singer, Adam, Evyatar Baer, and Henry Thode. "720 Scalds and Contact Burns: Are They Really Different?" Journal of Burn Care & Research 41, Supplement_1 (March 2020): S191. http://dx.doi.org/10.1093/jbcr/iraa024.304.
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Abstract Introduction Prior studies comparing scalds and contact burns rarely address the affect of burn etiology on burn depth. However, it is commonly believed that scalds tend to heal faster than similarly sized contact and flame burns. As a result, expectant therapy is often preferred after scald injuries. We compared the percentages of full-thickness burns based on burn etiology controlling for burn size, location and patient age. We hypothesized that the percentage of full thickness burns would be lower after scalds compared with contact and flame burns. Methods We performed a retrospective chart review of a prospectively collected burn registry of all patients admitted to a regional burn center between 2000–2010. Data collection included patient and burn characteristics including age, gender, body location, and burn etiology. We compared the percentages of full thickness burns among scald, contact and flame burns using Chi-square tests. Stepwise logistic regression was used to adjust for age, location, and burn size. Results There were 1038 patients in the study with either scald (n=537, 52%), fire/flame (n=434, 42%) or contact (n=67, 6%) burn. Mean (SD) age was 29 (25); 75% were male. Mean (SD) total body surface area (TBSA) was 11 (13)%. Mean (SD) length of stay was 10 (18) days. The percentages of full thickness burns by etiology were scalds 13.1%, fire/flame 34%, and contact burns 45% (P< 0.001). Patients with scalds were younger (22+/-24) than patients with contacts (32+/-28) and fire/flame (38+/-22) burns. Multivariate analysis for predicting full thickness burns found that compared with contact burns, scalds were less likely full thickness (OR 0.23, 95%CI 0.11–0.48) while fire/flame burns were as likely to be full thickness (OR 0.54, 95%CI 0.26–1.15). TBSA and age were also associated with full thickness burns (OR 1.06, 95%CI 1.04–1.09 and OR 1.015, 95%CI 1.007–1.024, respectively). Burns on the head and neck were less likely to be full thickness (OR 0.30, 95%CI, 0.11–0.82). Conclusions Scald burns are significantly less likely to be full thickness than contact or fire/flame burns. Applicability of Research to Practice Based on these results, expectant therapy may be more appropriate for scalds than contact or fire/flame burns.
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Sibbett, Stephen, Jamie Oh, Saman Arbabi, Gretchen J. Carrougher, and Nicole S. Gibran. "556 Hospital Length of Stay for Patients with Small and Medium Burns Impacted by Distance to Burn Center." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S118—S119. http://dx.doi.org/10.1093/jbcr/iraa024.184.
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Abstract Introduction Understanding contributors to patient length of stay is critical for burn center resource management and efficiency. In this study, we analyzed how distance from patient homes to a burn center impacts hospital length of stay. Methods Under IRB approval, we reviewed our trauma registry for burn patients admitted to a regional burn center from 2011 to 2018. Inclusion was limited to patients from the burn center state. Patients were grouped by distance from the home zip code to the burn center (≤100 and >100 miles) according to what might be ground or air transport. Chi-square and Mann-Whitney tests were used to determine differences between groups by race, burn size (TBSA), hospital length of stay (LOS), LOS/TBSA, mortality, and disposition to home. Burn size was categorized by TBSA into small (0–20%), medium (21–50%) and large (51–100%) burns. Results Our study population was predominantly white, non-Hispanic males. Mean burn size was significantly higher in patients who traveled more than the >100 miles to the burn center (Table). Mean LOS/TBSA was not significant between the two groups. However, controlling for burn size, patients with small and medium burns that lived farther from the burn center had significantly longer hospital stays. There was no significant difference in length of stay for patients with large burns, mortality or disposition to home between the two distance groups. Conclusions At a burn center with a large catchment area, patients with burn size < 50%TBSA who lived more than 100 miles from the burn center had significantly longer hospital stays than those who lived closer to the burn center. This may indicate that patients who are referred to a regional burn center for care of smaller burns may require care beyond the level of their local hospitals. It is worth noting that using burn size as an indication of complexity of care may be misleading as body site location of the burn (e.g. hand, face or feet) impacts the recovery. Applicability of Research to Practice For a burn center that serves patients across a vast region, this investigation might be useful in identifying opportunities to provide care for patients who live far from tertiary burn care.
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Liu, Hao, Keqiang Yue, Siyi Cheng, Wenjun Li, and Zhihui Fu. "A Framework for Automatic Burn Image Segmentation and Burn Depth Diagnosis Using Deep Learning." Computational and Mathematical Methods in Medicine 2021 (April 7, 2021): 1–12. http://dx.doi.org/10.1155/2021/5514224.
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Burn is a common traumatic disease with high morbidity and mortality. The treatment of burns requires accurate and reliable diagnosis of burn wounds and burn depth, which can save lives in some cases. However, due to the complexity of burn wounds, the early diagnosis of burns lacks accuracy and difference. Therefore, we use deep learning technology to automate and standardize burn diagnosis to reduce human errors and improve burn diagnosis. First, the burn dataset with detailed burn area segmentation and burn depth labelling is created. Then, an end-to-end framework based on deep learning method for advanced burn area segmentation and burn depth diagnosis is proposed. The framework is firstly used to segment the burn area in the burn images. On this basis, the calculation of the percentage of the burn area in the total body surface area (TBSA) can be realized by extending the network output structure and the labels of the burn dataset. Then, the framework is used to segment multiple burn depth areas. Finally, the network achieves the best result with IOU of 0.8467 for the segmentation of burn and no burn area. And for multiple burn depth areas segmentation, the best average IOU is 0.5144.
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Vega, Jorge, Paul Chestovich, Syed Saquib, and Douglas Fraser. "A 5-Year Review of Pavement Burns From a Desert Burn Center." Journal of Burn Care & Research 40, no. 4 (April 2, 2019): 422–26. http://dx.doi.org/10.1093/jbcr/irz049.
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Abstract Pavement burns account for significant burn-related injuries in the Southwestern United States and other hot climates with nearly continuous sunlight and daily maximum temperatures above 100°F. At peak temperatures, pavement can be hot enough to cause second-degree burns in a matter of seconds. The goal of this study was to review pavement burn injury admissions at a desert burn center compared with maximum ambient temperatures to determine which temperatures correlated to an increase in burn admissions. We obtained ambient temperature data from the National Oceanic and Atmospheric Administration. We reviewed our registry for 5 years retrospectively of all pavement burn injury admissions to our burn center. A total of 173 pavement-related burn cases were identified. We demonstrated an exponential increase in the rate of burn admissions as maximum ambient temperatures increased. More than 88% of pavement-related burn injury admissions occurred when the ambient temperature reached 95°F or higher. The risk per day was extrapolated based on the number of pavement burn injury admissions and the number of days at each of the maximum ambient temperatures recorded. The risk of pavement burns in areas of direct sunlight begins around 95°F and increases exponentially as ambient temperatures rise. This information will be used for burn outreach prevention and public health awareness programs. The benefit of this study relates to the entire community since high ambient temperatures put everyone at risk for hot pavement burns.
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Dalley, Andrew J., Jeffrey Lipman, Renae Deans, Bala Venkatesh, Michael Rudd, Michael S. Roberts, and Sheree E. Cross. "Tissue Accumulation of Cephalothin in Burns: a Comparative Study by Microdialysis of Subcutaneous Interstitial Fluid Cephalothin Concentrations in Burn Patients and Healthy Volunteers." Antimicrobial Agents and Chemotherapy 53, no. 1 (October 27, 2008): 210–15. http://dx.doi.org/10.1128/aac.00718-08.
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ABSTRACT Burn tissue sites are a potential source of bacteremia during debridement surgery. Burn injury is likely to affect the distribution of antibiotics to tissues, but direct evidence of this is lacking. The aim of this study was to directly evaluate the influence of burn trauma on the distribution of cephalothin to peripheral tissues. We used subcutaneous microdialysis techniques to monitor interstitial fluid concentrations of cephalothin in the burnt and nonburnt tissues of adult patients with severe burns following parenteral administration of 1 g cephalothin for surgical prophylaxis. Analogous simultaneous studies conducted with healthy adult volunteers provided reference tissue concentration data. Equivalent tissue exposures were seen for burn and nonburn sites, giving overall median interstitial cephalothin concentrations (from 0 to 240 min) of 2.84 mg/liter and 3.06 mg/liter, respectively. A lower overall median interstitial cephalothin concentration of 0.54 mg/liter was observed for healthy individuals, and the patient nonburnt tissue and volunteer control tissue cephalothin concentrations exhibited significantly different data distributions (P < 0.001; Kolmogorov-Smirnov nonparametric test). The duration of tissue residence for cephalothin was longer for burn patients than for healthy volunteers. The results demonstrate the potential fallibility of using healthy population models to extrapolate tissue pharmacodynamic predictions from plasma data for burn patients.
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Xun, Helen, Laura M. Mafla, Carrie A. Cox, Carisa Cooney, Eliana Duraes, Vidhi Javia, Julie Caffrey, and Charles S. Hultman. "87 Identification of Critical Burn Knowledge Gaps within the USA Population: A Survey and Education on Burn Prevention and Preparedness." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S60—S61. http://dx.doi.org/10.1093/jbcr/irab032.091.
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Abstract Introduction Associations, institutions, and providers have made enormous efforts to educate the United States public on burn injury in the hopes of preventing burns. However, there are no reports to-date describing the level of public burn knowledge in the U.S. This study characterized the public knowledge of burn prevention and preparedness in the US. It also aimed to assess if our interactive quiz is an appropriate educational tool. Methods QualtricsTM surveys designed to test knowledge and educate about burns were crowdsourced to laypersons via Amazon MTurk. Demographics were self-reported. In section 1, respondents were presented six questions asking about causes and care for burns, in a quiz style with explanations provided immediately. In section 2, respondents self-reported personal experiences with burns, burn education, and knowledge of verified burn centers. In section 3, they reported attitudes towards burn care. Survey responses were analyzed using two-tailed Student’s t tests and chi square analyses. Results We received 402 completed survey responses, and 331 total were included for analysis; studies were excluded if they were completed in < 5 minutes or had incorrect attention check questions. The mean age was 39.4 ± 12.08, and 51% male. 1. Knowledge: The average quiz score was 51% ± 8; while 65% of respondents knew to run scald burns under cool water, only 41% knew the optimal time of more than 20 minutes. The majority of respondents (92%) reported the quiz improved their burn knowledge. Also, while majority (63%) of respondents had heard of verified burn centers, only 44% knew where the closest one was. 2. Experiences: 72% of respondents had personally experienced a burn, of which 62% were treated in the emergency room. 57% of respondents had witnessed a burn injury occur, of which 92% applied first aid using cool running water (26%), ice (18%), burn gel (17%), and gauze (11%). Only 61% of respondents have participated in burn precautions at home. 56% of respondents have received formal burn training, such as from CPR class (21.4%) and recent first aid training (32.9%). Informal sources include from friends and family (66%), personal burn experience (63%), or social media (47.4%). 3. Attitudes: The majority of respondents agreed there should be more public education on risks/prevention (85%) and treatment of burns (78.6%). Only 63% believe acute burn care should be covered by insurance. Conclusions Our study demonstrates that despite personal experiences with burns and formalized courses, there remain gaps in public burn knowledge in the US. Further studies are required to characterize more detailed knowledge gaps and intervention strategies.
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Davies, G. M., R. Domènech, A. Gray, and P. C. D. Johnson. "Vegetation structure and fire weather influence variation in burn severity and fuel consumption during peatland wildfires." Biogeosciences 13, no. 2 (January 21, 2016): 389–98. http://dx.doi.org/10.5194/bg-13-389-2016.
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Abstract. Temperate peatland wildfires are of significant environmental concern but information on their environmental effects is lacking. We assessed variation in burn severity and fuel consumption within and between wildfires that burnt British moorlands in 2011 and 2012. We adapted the composite burn index (pCBI) to provide semi-quantitative estimates of burn severity. Pre- and post-fire surface (shrubs and graminoids) and ground (litter, moss, duff) fuel loads associated with large wildfires were assessed using destructive sampling and analysed using a generalised linear mixed model (GLMM). Consumption during wildfires was compared with published estimates of consumption during prescribed burns. Burn severity and fuel consumption were related to fire weather, assessed using the Canadian Fire Weather Index System (FWI System), and pre-fire vegetation type. pCBI varied 1.6 fold between, and up to 1.7 fold within, wildfires. pCBI was higher where moisture codes of the FWI System indicated drier fuels. Spatial variation in pre- and post-fire fuel load accounted for a substantial proportion of the variance in fuel loads. Average surface fuel consumption was a linear function of pre-fire fuel load. Average ground fuel combustion completeness could be predicted by the Buildup Index. Carbon release ranged between 0.36 and 1.00 kg C m−2. The flammability of ground fuel layers may explain the higher C release-rates seen for wildfires in comparison to prescribed burns. Drier moorland community types appear to be at greater risk of severe burns than blanket-bog communities.
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Davies, G. M., R. Domènech, A. Gray, and P. C. D. Johnson. "Vegetation structure and fire weather influence variation in burn severity and fuel consumption during peatland wildfires." Biogeosciences Discussions 12, no. 18 (September 22, 2015): 15737–62. http://dx.doi.org/10.5194/bgd-12-15737-2015.
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Abstract. Temperate peatland wildfires are of significant environmental concern but information on their environmental effects is lacking. We assessed variation in burn severity and fuel consumption within and between wildfires that burnt British moorlands in 2011 and 2012. We adapted the Composite Burn Index (pCBI) to provide semi-quantitative estimates of burn severity. Pre- and post-fire surface (shrubs and graminoids) and ground (litter, moss, duff) fuel loads associated with large wildfires were assessed using destructive sampling and analysed using a Generalised Linear Mixed Model (GLMM). Consumption during wildfires was compared with published estimates of consumption during prescribed burns. Burn severity and fuel consumption were related to fire weather, assessed using the Canadian Fire Weather Index System (FWI System), and pre-fire fuel structure. pCBI varied 1.6 fold between, and up to 1.7 fold within, wildfires. pCBI was higher where moisture codes of the FWI System indicated drier fuels. Spatial variation in pre- and post-fire fuel load accounted for a substantial proportion of the variance in fuel loads. Average surface fuel consumption was a linear function of pre-fire fuel load. Average ground fuel combustion completeness could be predicted by the Buildup Index. Carbon release ranged between 0.36 and 1.00 kg C m−2. The flammability of ground fuel layers may explain the higher C release-rates seen for wildfires in comparison to prescribed burns. Drier moorland community types appear to be at greater risk of severe burns than blanket-bog communities.
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Basaran, Abdulkadir, and Ozer Ozlu. "Inpatient Data of Occupational Burn Injuries Treated at a Tertiary Burn Center." Journal of Burn Care & Research 41, no. 2 (November 25, 2019): 398–401. http://dx.doi.org/10.1093/jbcr/irz193.
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Abstract Occupational burns are among the important causes of work-related injuries. We aimed to investigate the epidemiology and reasons of occupational burns and thereby to emphasize preventive measures. Between January 2017 and December 2018, the data of major occupational burn injury patients admitted to our burn center were evaluated in this cross-sectional retrospective study. During the study period 342 patients older than 16 years were admitted to the burn center. Among them 80 patients with occupational burns (23.4%) were identified. The mean age of the patients was 34.73 ± 12.3 years. Seventy-eight patients (97.5%) were male. Electrical burns and flame burns were the two leading type of occupational burns. The most common occupation of our patients was construction work. Dangerous behavior, carelessness, lack of protective equipment, and failure to follow instructions were causes of injury. Only 14 patients (17.5%) experienced unavoidable accident. Thirty-seven patients (46.3%) worked on temporary basis. Occupational experience was under 5 years in majority of the cases (62.5%). For the occupational burns the percentage of burned TBSA was 17.08 ± 14.5 (1–60) and the length of hospital stay was 23.94 ± 21.9 days (2–106). There were no significant differences between occupational and nonoccupational burn injuries considering TBSA, total length of hospital stay, and complications (P > .05). Occupational burn injuries are common in less experienced and younger workers. Therefore, recognition of the problem and maintaining awareness is important. In order to prevent occupational accidents and burns, occupational health and safety rules must be obeyed.
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Rania, Salsabilla Gina, Lynda Hariani, Helmia Hasan, and Iswinarno Doso Saputro. "A 3-Years Pneumonia Incidence in Burn Cases with Inhalation Injury at the Burn Center of Dr. Soetomo General Hospital Surabaya in 2015-2018." JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga 13, no. 1 (January 5, 2022): 27. http://dx.doi.org/10.20473/juxta.v13i12022.27-30.
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Introduction: Inhalation injury is one of burns impact. Airway burns due to inhalation injury is a non-specific term which refer to all respiratory tract injuries occurred due to irritative chemicals, including heat and smoke during inspiration. Inhalation injury increases the risk of death in burns. Pneumonia is one of burns-related inhalation injury complications.Methods: This was a descriptive retrospective study aiming to determine the incidence of pneumonia in burn patients with inhalation injury using secondary data at Burn Center Dr. Soetomo General Hospital Surabaya in the period of January 2015 - December 2018.Results: There were 5 cases of pneumonia in 14 burn cases with inhalation injury (35.71%). Respectively, 2 and 3 cases were found in 2017 and 2018. There were 2 female (40%) and 3 male (60%) patients, with age varied within 28-73 years old. The burn area of burn patients with inhalation injury and pneumonia were found by 15%, 20%, 24%, 32% and 71%, or within the classification of 11-20% burn area, and most complication found was hypoalbuminemia, as much as 3 cases (60%).\Conclusion: Most pneumonia in burn cases with inhalation injury was occurred in 2018, dominated by male patients. The age of the patient were ranging from early adulthood to elderly. Most burns were in the range of 11-20% burn area with the most complication found was hypoalbuminemia.
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Houschyar, Khosrow S., Christian Tapking, Dominik Duscher, Zeshaan N. Maan, Clifford C. Sheckter, Susanne Rein, Malcolm P. Chelliah, et al. "Optimising management of self-inflicted burns: a retrospective review." Journal of Wound Care 28, no. 6 (June 2, 2019): 317–22. http://dx.doi.org/10.12968/jowc.2019.28.6.317.
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Objective: Self-inflicted burns typically result in extensive injuries requiring intensive care and attention in a specialised burn unit. Burn units should be familiar with the optimal management of self-inflicted burns, including the psychological and psychiatric treatment. This paper describes the experiences of managing these challenging injuries in a German burn centre. Methods: A retrospective review of patients with self-inflicted burns admitted to the burn centre between 2000 and 2017. Demographics, details of injury, presence of psychiatric disorder, clinical course, operative management and patient outcomes were recorded and compared with a control group without self-inflicted burns. Outcome measures included graft take rate, complications and need for further surgery. Results: There were a total of 2055 burn patient admissions, with 17 cases (0.8%) of self-inflicted burns. The mean age was 36±11 years with an mean percentage total body surface area (%TBSA) burned of 43.5±22.5% which was not significantly different from the control group (p=0.184). Schizophrenia and personality disorder were the most common diagnoses in the self-inflicted burns patients (n=11; 65%). Of these, four had sustained previous self-inflicted burns. Length of hospital stay was significantly longer in the self-inflicted burn group than in the control group (49.0±16.7 days, respectively, p=0.002). Conclusion: Attempted suicide by self-inflicted burns represents <1% of burn admissions. This population demonstrates a high incidence of prior psychiatric disorders. Successful treatment includes multidisciplinary management of acute medical, surgical, and psychiatric care.
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Alam, Muhammad Rashedul, Md Saif Ullah, and Prosanto Kumar Biswas. "Pattern of Burn Injury in Children Presented to Dhaka Shishu (Children) Hospital." Dhaka Shishu (Children) Hospital Journal 36, no. 2 (June 29, 2021): 134–37. http://dx.doi.org/10.3329/dshj.v36i2.54392.
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Background: Children are mostly affected in burn injury at our country like other low and middle income countries (LMICs). Approximately 90% of the burns occur in under developed countries, which generally lack the necessary infrastructure to reduce the incidence and severity of burns.
Objectives: This study was done to investigate the pattern of burn cases admitted to Dhaka Shishu (Children) Hospital (DSH).
Methods: This was a retrospective study conducted over the period of one year from January 2019 to December 2019 at Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh. The data was collected from the patients record section of the hospital. Patients characteristics (e.g. age, sex), causes and severity of injury, outcome, hospital stay and seasonal variation were analized in this study.
Results: A total of 91 patients were admitted during study period of one year. This study consisted of 53 male patients (58.24%) and 38 female patients (41.76%) with male to female ratio of 1.3:1. The most frequently hospitalized burn patients were in the age group 3-5 years, which accounted for 30.77% of patients. Burns were more common during winter season followed by autumn season, with 43 cases (47.25%) and 18 cases (19.78%) respectively. The highest number of admissions was during the month of December. Scald burn was the most common cause of burn injury in our study which accounted for 83 cases out of 91 cases (91.2%). Flame burn occured in 3(3.29%) patients. There were 2 cases of electric burn and 2 cases of contact burn during this study period. One patient was with chemical burn. Scald burn was the most common cause of burn injury in this study which accounted for 83 cases out of 91 cases (91.2%). Flame burn occured in 3(3.29%) patients. There were 2 cases of electric burn and 2 cases of contact burn during this study period. One patient was with chemical burn.
Conclusion: The most frequently hospitalized burn patients were in the age group 3-5 years and more common during winter season. Most of the burn occured in children are scald in our country due to accidental fall of worm liquid. Superficial epidermal and dermal burns are treated conservatively, but deep burns may require surgical treatment.
DS (Child) H J 2020; 36(2): 134-137
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Klifto, Kevin M., and C. Scott Hultman. "122 Prevalence and Associated Predictors for Patients Developing Chronic, Neuropathic Pain Following Burns." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S81—S82. http://dx.doi.org/10.1093/jbcr/iraa024.125.
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Abstract Introduction Chronic pain, unrelated to the burn itself, can manifest as a long-term complication in patients sustaining burn injuries. The purpose of this study was to determine the prevalence and compare burn characteristics between burn patients who developed chronic neuropathic pain (CNP) and burn patients without CNP treated at a Burn Center. Methods A single-center, retrospective analysis of 1880 patients admitted to the adult Burn Center was performed from January 1, 2014 through January 1, 2019. Patients included were over the age of fifteen years, sustained a burn injury and were admitted to the Burn Unit. CNP was diagnosed clinically following burn injury. Patients were excluded from the definition of CNP if their pain was due to an underlying medical illness or medication. Comparisons between patients admitted to the Burn Unit with no pain and patients admitted to the Burn Unit who developed CNP were performed. Results One hundred thirteen (n=113) of the 1880 burn patients developed CNP as a direct result of burn injury over five years with a prevalence of 6%. Patients who developed CNP were a significantly older median age [54 vs. 46, p=0.002], abused alcohol [29% vs. 8.5%, p< 0.001], abused substances [31% vs. 9%, p< 0.001], were current everyday smokers [73% vs. 34%, p< 0.001], suffered more full-thickness burns [58% vs. 43%, p< 0.001], greater median %TBSA burns [6 vs. 3.5, p< 0.001], were more often intubated on mechanical ventilation [33% vs. 14%, p< 0.001], greater median number of surgeries [2 vs. 0, p< 0.001] and longer median hospital length of stay (LOS) [10 vs. 3 days, p< 0.001], compared to those who did not develop CNP, respectively. Median patient follow-up was 27 months. Conclusions The prevalence of CNP over five years was 6% in the Burn Center. Older ages, alcohol abuse, substance abuse, current everyday smoking, greater %TBSA burns, third degree burns, being intubated on mechanical ventilation, having more surgeries and longer hospital LOS were associated with developing CNP following burn injury. Applicability of Research to Practice The largest study to date assessing the prevalence of chronic nerve pain following burns. Identified new independent predictors for chronic neuropathic pain following burn injury, not previously assessed in the literature.
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Williams, Felicia N., Kamil Nurczyk, Sanja Sljivic, Lori Chrisco, Catherine Calvert, Rabia Nizamani, Samuel W. Jones, and Bruce Cairns. "553 Work-related Burn Injuries Among Burn Patients in a Tertiary Care Burn Facility, 2013 – 2018." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S116—S117. http://dx.doi.org/10.1093/jbcr/iraa024.181.
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Abstract Introduction The characteristics of work-related (WR) burn injuries compared to non-work-related (non-WR) burns are not well defined in the literature. In an effort to determine the potential impact of commonly accepted prevention efforts, we compared WR and non-WR burn injuries in our facility for the last five years. Methods All patients admitted to the burn center between January 1st, 2013 and December 31st, 2018, of working age were included. Demographics, burn characteristics, and patient outcomes were evaluated using Student’s t-test and chi-squared test where appropriate, significance was accepted at p< 0.05. Results 3,545 patients were included in this study. WR patients were 22% of all patients in this cohort. The majority of patients in both cohorts were white males in their twenties. Compared to non-WR patients, WR patients had fewer comorbidities with 30% smaller total body surface area burns, and shorter lengths of stay (see table). WR patients were more likely to suffer chemical (14.5% vs 2.3%) and electrical burns (11.9% vs 1.2%) compared to non-WR patients, respectively. 67% percent of WR burn fatalities were from electrical injuries, while flame was the leading cause of death in non-WR patients. Conclusions WR burn injured patients are young males with fewer co-morbid conditions. Etiologies of injuries are vastly different between non-lethal and lethal WR and non-WR injuries. Classic burn prevention strategies that target flame burn injuries and fatalities will have little impact on WR burn injuries. Applicability of Research to Practice This study highlights the importance of focusing prevention campaigns to industry as well as schools and homes.
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Egro, Francesco M., Anisha Konanur, Caroline E. Kettering, Alain C. Corcos, Guy M. Stofman, and Jenny A. Ziembicki. "541 Gender Disparities Among Burn Surgery Leadership." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S108—S109. http://dx.doi.org/10.1093/jbcr/iraa024.169.
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Abstract Introduction Gender disparities have been described in the plastic surgery and general surgery literature, but no data has been reported in burn surgery. The aim of this study is to determine gender disparities among burn surgery leadership. Methods A cross-sectional study was performed. Burn surgeons included were directors of American Burn Association (ABA)-verified burn centers, past presidents of the ABA and International Society for Burn Injuries (ISBI), and editors of the Journal of Burn Care & Research, Burns, Burns & Trauma, Annals of Burns & Fire Disasters, and the International Journal of Burns and Trauma. Training, age, H-index, and academic level and leadership position were compared among surgeons identified. Results Among the 69 ABA and ISBI past presidents, 203 burn journals’ editorial board members, and 71 burn unit directors, females represented only2.9 percent, 10.5 percent, and 17 percent, respectively. Among burn unit directors, females completed fellowship training more recently than males (female = 2006, male = 1999, p < 0.02), have lower H-indexes (female = 8.6, male = 17.3, p = 0.03), and are less represented asfull professors (female = 8.3 percent, male = 42.4 percent, p = 0.026). There were no differences in age, residency, research fellowship, or number of fellowships. Conclusions Gender disparities exist in burn surgery and are highlighted at the leadership level, even though female surgeons have a similar age, residency training and other background factors. However, gender diversity in burn surgery may improve as females in junior faculty positions advance in their careers. Applicability of Research to Practice Gender disparities are a significant issue in burn leadership, which needs further discussion at national level and should be addressed more proactively through programs that emphasize leadership opportunities and mentorship for women.
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Kumar, Roshan, Keshamma E, Bhawana Kumari, Ajay Kumar, Vikrant Kumar, Deepika Janjua, and A. Mohathasim Billah. "Burn Injury Management, Pathophysiology and Its Future Prospectives." Journal for Research in Applied Sciences and Biotechnology 1, no. 4 (October 27, 2022): 78–89. http://dx.doi.org/10.55544/jrasb.1.4.10.
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For intensive care physicians, burns are a frequent and challenging patient complication. Specialist facilities prioritise patient stabilisation, infection prevention, and functional rehabilitation to the greatest extent possible. Researchers have been focusing on burns for decades, and thanks to their efforts, the mortality rate for burn patients, especially young patients and those with moderate burns, has been steadily declining. However, the intensivist often faces challenges that make it hard to provide care and stabilise patients. There may be unique complications associated with burn wounds that necessitate either delayed treatment or prolonged rehabilitation. Improvements in patient stabilisation and treatment have resulted from advances made in burn wound care thanks to research. This article discusses recent advances in the treatment of burn patients, focusing on the pathophysiology of burns and the management of burn wounds.
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Burgess, Matthew, Franklin Valdera, David Varon, Esko Kankuri, and Kristo Nuutila. "The Immune and Regenerative Response to Burn Injury." Cells 11, no. 19 (September 29, 2022): 3073. http://dx.doi.org/10.3390/cells11193073.
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Burn are diverse and complex injuries that not only have local effects but also serious systemic consequences through severe and prolonged inflammatory response. They are caused by heat, electricity, friction, chemicals, or radiation and are commonly divided into superficial, superficial partial-, deep partial- and full-thickness injuries. The severity of the burn depends mainly on the size and depth of the injury but also on location, age, and underlying systemic diseases. A prolonged and strong immune response makes major burns even worse by causing multiple systemic effects including damage to the heart, lungs, blood vessels, kidneys, and other organs. Burns that do not require surgical excision, superficial and superficial partial-thickness, follow the known progression of wound healing (inflammation, proliferation, remodeling), whilst deep partial- and full thickness injuries requiring excision and grafting do not. For these burns, intervention is required for optimal coverage, function, and cosmesis. Annually millions of people worldwide suffer from burns associated with high morbidity and mortality. Fortunately, over the past decades, burn care has significantly improved. The improvement in understanding the pathophysiology of burn injury and burn wound progression has led to developments in skin grafting, fluid resuscitation, infection control and nutrition This review article focuses on the immune and regenerative responses following burn injury. In the Introduction, we describe the epidemiology of burns and burn pathophysiology. The focus of the following chapter is on systemic responses to burn injury. Next, we define the immune response to burns introducing all the different cell types involved. Subsequently, we discuss the regenerative cell response to burns as well as some of the emerging novel treatments in the battle against burns.
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Mobayen, Mohammadreza, Reza Zarei, Sanaz Masoumi, Mohsen Shahrousvand, Seyyed Mohammad Hossein Mazloum, Zeinab Ghaed, and Negin Rahimzadeh. "Epidemiology of Childhood Burn: A 5-Year Retrospective Study in the Referral Burn Center of Northern Iran Northern Iran." Caspian Journal of Health Research 6, no. 3 (September 1, 2021): 101–8. http://dx.doi.org/10.32598/cjhr.6.3.8.
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Background: Burns are the second most common etiology of injury death in children under 5 years old and are the most common cause of death in a home accident. Materials & Methods: This study was performed to investigate the epidemiology of childhood burn in children under 16 years old referred to Velayat Burn Center, Rasht City, Iran, from 2013 to 2018. Data were collected from electronic hospital records of burn patients aged under 16 years of age. Results: Out of 717 patients, 44.5% were girls, and 55.5% were boys (sex ratio=1.2). The highest frequency of burns (56.1%) was reported in the 1-5 years age group. The most common cause of burn was scalds (76%), and the most common burn severity was second-degree burns (46.7%). The Mean±SD duration of hospitalization was 3.07±4.15 days, and the hospital stay was significantly associated with the cause of the burn, Burned Body Surface Area (BBSA), and burn severity. The highest frequency was reported on Saturdays, i.e., (the first working day in Iran) (22.7%), between 6 and 12 o’clock (42.8%). Conclusion: This study found that children in 1-5 years old were the most susceptible age group for burn injuries and scalds were the most common cause of the burn. The male to female ratio was 1.2, and the majority of burns occurred in the winter.
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Thakur, Shiwani, Irshad Ahmad, Yaser Hussain Wani, Naseer Awan, Zuneera Banoo, Neha Sharma, Safoora Wani, and Adan Iqbal. "A Retrospective, Facility Based, Analytical Study of Burn Injury, and Correlation of Various Factors with Outcome in a Tertiary Care Hospital of Kashmir." Journal of Evidence Based Medicine and Healthcare 8, no. 20 (May 17, 2021): 1544–48. http://dx.doi.org/10.18410/jebmh/2021/292.
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BACKGROUND The skin is the largest organ of our body with a complex function. Burn injuries result in damage to the skin by electrical, chemical, thermal or radiation energies or a combination of them, by far the most common being the thermal injuries. However, most burn injuries are preventable and hence need preventive strategies. Outcome is dependent on various factors. The focus of this study is to provide an overview of various factors and clinical presentation of burn injury and their correlation of these various factors with outcome of burn injury. METHODS A retrospective facility-based document review analytical study was conducted on 215 patients admitted in the emergency (burn ward) department of Government Medical College and Hospital, Srinagar, Kashmir from September 2019 to September 2020. RESULTS In our study, out of total 215 hospitalized burn patients, 101 (47 %) were female and 114 (53 %) were males. In 103 (47.9 %) patients, burn injury was caused by scald burn, kangri burn was present in 3 (1.4 %) patients; 207 (96.3 %) patients had accidental burns and 8 (3.7 %) patients had suicidal burn injuries; 181 (84.2 %) had received good pre-hospital intervention; 165 (76.7 %) patients were discharged without complications. Various parameters – degree of burn, cause of burn, nature of burn, nutritional status and antibiotic coverage show statistical significance with P-value < 0.05. CONCLUSIONS Kashmir is a valley surrounded by mountains, has cold weather for about threequarters of year. People here are more prone to burn injuries especially thermal injuries. Outcome of burn injuries is better for lesser degree of burns and mortality increases with severe degree of burns. Patients without complications, patients with good nutritional status at presentation and patients with proper antibiotic coverage had good outcome. KEYWORDS Burn Injury, Kangri, Outcome of Burn
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Tiwari, V. K. "Burn wound: How it differs from other wounds?" Indian Journal of Plastic Surgery 45, no. 02 (May 2012): 364–73. http://dx.doi.org/10.4103/0970-0358.101319.
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ABSTRACTManagement of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock while whole blood loss is the cause of shock in other acute wounds. Even though the burn wounds are sterile in the beginning in comparison to most of other wounds, yet, the death in extensive burns is mainly because of wound infection and septicemia, because of the immunocompromised status of the burn patients. Eschar and blister are specific for burn wounds requiring a specific treatment protocol. Antimicrobial creams and other dressing agents used for traumatic wounds are ineffective in deep burns with eschar. The subeschar plane harbours the micro-organisms and many of these agents are not able to penetrate the eschar. Even after complete epithelisation of burn wound, remodelling phase is prolonged. It may take years for scar maturation in burns. This article emphasizes on how the pathophysiology, healing and management of a burn wound is different from that of other wounds.
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GROSU-BULARDA, Andreea, Andra-Luana LAZARESCU, Mihaela-Cristina ANDREI, Dan Aurel IONESCU, Adrian FRUNZA, Sabina GRAMA, Alexandru STOIAN, et al. "Infectious Complications in Severely Burned Adult Patients-Diagnostic and Therapeutic Algorithm." Medicina Moderna - Modern Medicine 28, no. 1 (March 29, 2021): 25–40. http://dx.doi.org/10.31689/rmm.2021.28.1.25.
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Severe burn injuries represent a major challenge to the entire healthcare system in developing countries and even for states with a high standard of care. A clear understanding of the physiopathology of burn injuries is essential for providing an adequate prompt treatment to ensure an optimal patient outcome. Early recognition and treatment of burns complications, especially severe infections represent an important prevention strategy, improving survival after these severe injuries. Specific treatment must be conducted according to the characteristics of the patients in order to reduce morbidity and mortality and avoid the development of antimicrobial resistance. A diagnostic and therapeutic algorithm is presented, centered on infectious source prevention and control with early surgical excision and skin grafting together with culture-guided antimicrobial therapy. It is a known fact that, indifferent of the involved germ, the best intervention for both prophylaxis and treatment of infections in the burn patient is the early excision of the devitalized tissue and subsequent closure of burn wounds with skin grafts, measures that diminish local and systemic mediator releasing effects in burnt tissue, attenuating the progressive inflammatory
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Chan, Rayleigh, Aaron C. Van Slyke, Marija Bucevska, and Cynthia Verchere. "A 3-Year Review of an Outpatient Burn Sedation Program in a Tertiary Burn Care Centre: Is It Safe and Does It Work?" Plastic Surgery 27, no. 4 (September 22, 2019): 305–10. http://dx.doi.org/10.1177/2292550319876663.
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Introduction: The burn treatment room at our tertiary-care centre is run by a multidisciplinary team, providing care to primarily burn patients who require moderate to deep sedation to undergo dressing changes in a monitored setting outside the operating room. There is little literature on the safety, efficacy, and logistics of treating outpatient pediatric burn patients in this manner. This study reviews the safety of deep sedation in the burn treatment room. Methods: A retrospective chart review of patients with burns treated in the burn treatment room from 2013 to 2015 was conducted. Patient demographics, diagnosis, procedure details, sedation, and adverse events were recorded. Data were analyzed descriptively. Results: Sevety-four patients with burns had a total of 308 visits in the burn treatment room for burn bath and/or dressing changes. Scald burns were the most common mechanism of injury (n = 56). Most burns were superficial and mid-dermal (54%), initially estimated at 5% to 10% TBSA (50%). Of the 308 visits, 304 required sedation. Adverse events were recorded in 11 (3.6%) of 304 sedated procedures. None of these events were critical: 7 patients required intravenous conversion due to inadequate oral sedation, 2 experienced brief apnea episodes but recovered spontaneously, and 2 had delayed discharge of more than 2 hours due to residual sedation. Conclusion: The burn treatment room is a safe and effective setting for treating pediatric burn patients, bypassing what might historically require operating suite inpatient management.
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Beaulieu, Emilie, Alex Zheng, Fahra Rajabali, Frances J. MacDougall, and Ian Pike. "548 The Economics of Burn Injuries Among Children Aged 0–4 Years." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S114. http://dx.doi.org/10.1093/jbcr/iraa024.176.
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Abstract Introduction Children under the age of five years are particularly vulnerable to scalds and contact burns and have the highest rate of hospitalization and mortality from burns. Studies of costs associated with pediatric burns have included a limited number of patients and focused on inpatient and complication costs, limiting our understanding of the full economic burden of pediatric burns, including costs incurred through outpatient care and caregivers’ productivity loss. This study aimed to develop a societal costing model for burn injuries among children aged 0 to 4 years. Methods Children aged 0 to 4 years identified through the local Burn Registry with a burn injury between January 1, 2014 and March 15, 2018 were included in this study. Patients with inhalation injury, electrical, chemical and friction burns were excluded. An incidence-based cost-of-illness analysis with a human capital approach was used to quantify the cost of partial and full-thickness burns according to the percentage of total body surface area (%TBSA) involved. The cost of a burn injury was assessed from a societal perspective through the following cost categories: emergency department visits, inpatient, outpatient dressing changes, outpatient burnbaths, day surgeries, clinic visits and caregiver productivity losses. A list of resource items for each category were extracted from patient chart review, the local Burn Registry, and the local Hospital Finance Database, and assigned unit prices. Costs were discounted to a present value in 2017 dollars at 1.5% per annum. Results Burn injuries were observed for 342 children, of which 249 (73%) had their burn severity classified (%TBSA and partial/full thickness) and were included in this study. Burn severity categories (1–5%, 6–10%, 11–20%, and >20%) were developed based on the differential distribution of the costs allocated to each burn incident. The majority of children (60.8%) suffered from a 1–5% burn. A 1–5%, 6–10%, 11–20%, and >20% burn respectively cost an average of $2,229, $8,653, $13,663, and $98,634 to society. Costs incurred by the 1–5% burns were related mostly to emergency department visits and dressing changes, while costs incurred by the >20% were related mostly to inpatient and clinic visits (garments) costs. Conclusions This costing approach raises awareness about the important, yet preventable economic burden that pediatric burn injuries place on society. Applicability of Research to Practice This evidence may persuade policymakers and clinicians to invest in pediatric burns prevention programs in order to decrease pediatric burns costs allowing for the allocation of funds towards other clinical initiatives. This costing model may also facilitate cost-effectiveness analyses of burn prevention programs in the coming years.
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Chakera, Hawwa, Jennifer Zuccaro, Charis Kelly, and Joel Fish. "564 The Impact of COVID-19 on the Provision of Pediatric Burn Care." Journal of Burn Care & Research 43, Supplement_1 (March 23, 2022): S118. http://dx.doi.org/10.1093/jbcr/irac012.192.
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Abstract Introduction The WHO declared the outbreak of COVID-19 a pandemic in the spring of 2020 which led to widespread restrictions on daily life activities as people were instructed to isolate at home. Given that 75 – 85% of pediatric burns occur in the home, it is likely that these measures had an impact on pediatric burn care. Thus, the aim of this study was to investigate the impact of the COVID-19 pandemic on the provision of pediatric burn care at an American Burn Association-verified pediatric burn center. Methods Data was retrospectively extracted from all new burn patients aged 0-18 years during a pre-pandemic period (April 2019 – August 2019) and a pandemic period (April 2020 – August 2020). Continuous data was examined using 2 tailed t-tests (p < 0.05), while non-continuous data was examined using Pearson chi-squared tests (p < 0.05). These analyses were used to analyze burn demographics and examine changes in the delivery of acute and follow-up burn care before and during the pandemic. Results During the pre-pandemic period, 213 new burns were identified, compared to 172 new burns during the pandemic period. No clinically significant changes were observed in patient age at presentation (p = 0.54), total body surface area of burn (p = 0.85), and time to presentation following the injury (p = 0.24). Interestingly, a significant increase in friction burns (p = 0.023) was observed, which mainly consisted of treadmill burns. During the pandemic, burn operating room utilization remained high and represented approximately 25% of the hospital's total surgical capacity. In addition, there were no significant changes to inpatient and outpatient encounters (p = 0.56 and p = 1.00) between the two periods thereby highlighting the need for these essential services during the pandemic. Conclusions Burn-related service needs remained consistent across the pre-pandemic and pandemic cohorts as demonstrated by the number of new burns as well as the continued provision of burn care. Overall, no clinically significant changes to patient demographics, aside from the increase in friction burns, were observed. Furthermore, the ability to provide all aspects of pediatric burn care at this tertiary pediatric hospital remained consistent across the pre-pandemic and pandemic cohorts. Although this study presents data from the first five months on the pandemic, further analysis of the entire year will be carried out in order to identify additional trends.
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Çomçalı, Bülent, Cengiz Ceylan, Buket Altun Özdemir, Serhat Ocaklı, Hikmet Pehlevan Özel, and Ahmet Çınar Yastı. "Seasonal effects on the mechanisms of burn injuries." Turkish Journal of Surgery 38, no. 1 (March 1, 2022): 5–10. http://dx.doi.org/10.47717/turkjsurg.2022.5377.
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Objective: This study aimed to evaluate seasonal effects on the mechanisms of burn injuries in patients requiring hospitalization. Material and Methods: A retrospective evaluation was made using the information of 419 hospitalized burns patients, including demographic data, degree and percentage of burn injury, cause and mechanism of burn injury, morbidity and mortality. Burn mechanisms were grouped as thermal burns (flame, boiling liquid, contact), chemical burns and electrical burns. When calculating the percentage of body surface area burned, the rule of nines was applied. Seasonal classification was made appropriate to the northern hemisphere. Results: According to the seasons, the most burns were seen in spring months (n= 130, 31.0%). In the examination of the mechanism of burn injury, the most common type of injury was boiling liquid in 159 patients followed by flame injury in 146 patients. There was an increase in electrical and chemical burns in spring and summer. A statistically significant difference was determined between the types of burns according to the seasons (p= 0.024). The burn injury occurred as a result of a workplace accident in 82 cases, the majority of which were in autumn, and summer, and the difference in the seasons was determined to be statistically significant (p= 0.045). There was a statistically significant increase in the exposure of individuals aged >65 years to boiling liquid burns in winter and summer months (p= 0.014). Conclusion: The results of this study showed a seasonal effect on the types of burn injuries. A higher rate of thermal burns was expected to be found in winter, but this was not the case in patients with indications for hospitalization, as chemical and electrical burns in workplace accidents were seen more frequently in warmer seasons of spring and summer. In this context, burns units should be prepared for patient profiles to vary according to the season.
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Galo, Amenah, Mohammed Farid, and Riyadh Almasharqah. "The conservative management of self-inflicted chemical burns: Case report and literature review." Scars, Burns & Healing 8 (January 2022): 205951312210805. http://dx.doi.org/10.1177/20595131221080545.
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Introduction Chemical burns, particularly injuries related to psychiatric illnesses, are underreported in the literature. We present two cases of self-inflicted alkali chemical burns managed conservatively. Frequent clinical review of the burn was aimed to ensure appropriate healing and compliance with the treatment plan based on regular dressing changes. Case 1 A 24-year-old woman presented during the first day of the initial injury with a minor self-inflicted chemical burn to the right forearm. The causative agent was an oven cleaner containing sodium hydroxide triggering an alkali-based burn. The surface area of the injury was 0.5% total body surface area (TBSA) full-thickness burn. The patient had a complex psychiatric history diagnosed with personality disorder, anxiety and depression. Case 2 A 55-year-old woman presented with a self-inflicted left forearm full-thickness burn (0.5% TBSA). This was five days after the initial injury from an oven cleaner containing sodium hydroxide. The patient had a psychiatric history of anxiety and depressive disorder. The mainstay of burn management was conservative with regular dressing changes and a topical agent. Telemedicine via a designated email address was given to the patient for virtual clinical burn review and any urgent issues. Photograph of the initial burn was taken, and clinic visits were scheduled to determine healing progress. Conclusion Self-inflicted chemical burns are to be managed within a multidisciplinary setting including early psychiatric involvement. We advocate a holistic approach to determine conservative or operative management, taking into account patient factors, burn complexity and clinician's judgement to streamline the treatment plan. Lay Summary Chemical burns due to self-harm are rare to see in clinical practice. A review of two cases secondary to intentional burns sustained using an oven cleaning material. Patients had psychiatric issues and were on medications to control symptoms. Close observation with regular dressings and topical cream would allow burns to heal without the need for an operation. Our recommendation would be to treat these burns with dressings and regular follow up in the clinic or virtually till healed.