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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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Prokopenko, Max, Alistair J. M. Reed, Maria Chicco, and Fadi Issa. "Preventable Burns from Domestic Tap Water." European Burn Journal 3, no. 2 (May 9, 2022): 362–69. http://dx.doi.org/10.3390/ebj3020031.
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Tap water scalds from domestic outlets can afflict large body surface areas. Such injuries are preventable and carry significant associated morbidity, mortality, and economic burden. Previously identified risk factors include age (<5 or >65 years old) and the presence of physical or mental disabilities. Education campaigns and advances in legislation mandating the restriction of tap water temperature at user outlets have been employed in an attempt to prevent such injuries. Nonetheless, the incidence of these injuries persists, and further mitigating measures must be implemented to minimize their occurrence. The purpose of this study was to determine the groups at risk for such injuries and whether this has recently changed. A retrospective observational study was carried out to include patients admitted with tap water scalds to a regional burn’s unit from October 2016 to September 2020. Twenty-three patients were included, and their incidence was 5.75 cases per year, equating to 5.1% of all scalds requiring inpatient treatment. The very young (<5 years old) and elderly (>65 years old) accounted for the majority of admissions (65.2%), 26.1% had a mental disability, and 30.4% had a physical disability. Tap water scalds continue to cause preventable injuries affecting all ages, and in particular, the elderly and patients with pre-existing disabilities.
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Battle, Ceri Elisabeth, Vanessa Evans, Karen James, Katherine Guy, Janet Whitley, and Phillip Adrian Evans. "Epidemiology of burns and scalds in children presenting to the emergency department of a regional burns unit: a 7-year retrospective study." Burns & Trauma 4 (June 21, 2016): 1–6. http://dx.doi.org/10.1186/s41038-016-0047-7.
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Abstract Background Variation in the incidence and mechanism of thermal injury has been reported in different age groups in children. The aim of this study was to report the incidence, mechanisms, and environmental factors of all burns presentations to the emergency department (ED) of a regional burns centre over a 7-year period. Methods A retrospective, chart review study of all burns presentations to the ED of a regional burns centre in South Wales was conducted. All children recorded as having sustained a burn or scald, aged less than 16 years were included in the analysis. Subjects’ demographics were analysed using descriptive statistics, and comparisons were made between patients aged less than 5 and patients aged 5–16 using chi-square test and Mann–Whitney U test. Results A total of 1387 cases were included in the final analysis. Scalds were the most common thermal injury with 569 (41.0 %) reported, followed by contact burns in 563 (40.6 %) patients. The patients requiring hospitalisation were significantly younger (2 vs 3 years; p < 0.001) and had a higher rate of non-accidental injury (10 vs 4; p < 0.001). The most commonly injured site in both age groups was a hand or digit. Conclusions Scalds and contact burns were the most commonly reported thermal injury in children aged less than 16. Common mechanisms were hot beverages, hobs and hair straighteners, highlighting further burn prevention strategies are needed and good-quality prospective studies that investigate the effectiveness of such strategies.
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Lee, Christina, and Palmer Q. Bessey. "61 Tap Water: Still Burning After All These Years." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S40. http://dx.doi.org/10.1093/jbcr/iraa024.065.
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Abstract Introduction Hot tap water has long been recognized as a cause of burns, especially for children. Standards for appliance manufacture and building codes were established several decades ago to avoid excessively high hot water temperature at the tap in order to reduce the incidence of these injuries. The purpose of this study was to determine the prevalence and impact of tap water scalds (TWS) seen at burn centers in a recent time period. Methods We reviewed the National Burn Repository (NBR) for the years 2015–2017. We identified all scald burn injuries from the primary ICD10 code (former ECodes in ICD9, now External Cause Codes in ICD10). The codes for the cause of burns include X00 – X19. The X11 series identifies TWS. The data fields were analyzed using SAS 9.4 (Cary, NC). Data are expressed as Mean ± SEM or Mean (95% CI). Differences in continuous variable means were tested with TTest and categorical variables with Chi square and Fisher’s Exact Test. Logistic regression analysis was used to test differences between groups and identify risk factors for death. Results There were 16,318 patients included in the two-year data set. Of those, 5,014 (30.7 ± 0.4 %) had scald burns identified by the Primary ICD10 code, and 1,029 (20.5 ± 0.6 %) of those were due to hot tap water. The prevalence of TWS among children < 5 with scald injuries was 21.8% (15.9–23.8); among children 5–14, 19.4% (15.9–22.8); among young adults 15–44, 14.7% (12.8–16.5); those 45-64 24.1% (21.3–26.8); and those 65 and older 27.9% (23.7–32.2). Burn size for those 45–64 tended to be larger with TWS than other scald injuries (3.3 ± 0.7 % TBSA vs 2.0 ± 0.2, p=0.08), and was significantly larger in those 65 and older (3.8 ± 0.9 % vs 1.2 ± 0.3, p< 0.01). Case fatality for all TWS was greater than that for all other scalds (1.4 ± 0.4 % vs 0.3 ± 0.1, p< 0.01). No patient less than 45 died following TWS. Case fatality for those 45–64 tended to be greater for TWS than other scalds (0.9 ± 0.6 % vs 0, p=0.06.), and it was substantially higher for 65 and older (10.0 ± 2.8 % vs 2.3 ± 0.8, p< 0.01). Among patients 65 and older, those with TWS were slightly older than those with other scalds (76.3 ± 0.7 years vs 74.6 ± 0.4, p< 0.05). Conclusions TWS burns still account for a substantial proportion of scald burns across the country, despite the wide application of building codes and manufacturing standards designed to prevent these injuries. They are most prevalent among children and older adults. In older patients they are more extensive than other scalds and result in an appreciable case fatality. Hot tap water continues to be a clear and potentially deadly hazard, especially for the elderly. Additional strategies to prevent these injuries should be sought. Applicability of Research to Practice Directly Applicable.
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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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Bednarz, Bartlomiej, Mehul Thakkar, and Sankhya Sen. "744 Shrove Tuesday Related Injuries in Children, 8 Years’ Experience of Single Paediatric Burns Centre." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S205. http://dx.doi.org/10.1093/jbcr/iraa024.326.
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Abstract Introduction Shrove Tuesday, also known as Pancake Day is one of the Christian traditions in many countries and marks the beginning of Lent. Many families cook pancakes together by frying batter. It is considered to be a fun and simple activity. Children often get heavily involved. This creates a danger of pancake related burn injuries. We have noticed a significant number of burns around Pancake Day and herein report our observed epidemiology of these injuries. Methods Burns admissions/assessments during the period around Shrove Tuesday were identified from our burns database over an eight year period (2011–2019). Pancake related injuries were identified and then reviewed to look for commonalities. Results 52 patients were identified. The age ranged from 20 months to 15 years (average 5.94 years, median 6, mode 3). 50 (96.1%) of these injuries were contact burns with pan/hob. The remaining 2 (3.9%) were minor scalds form hot oil. 47 patients (90.3%) had burns localised to the hands. 16 (30.7%) patients had burns involving the index finger, which was usually an isolated injury. 14 (26.9%) patients were burnt whilst trying to toss the pancake. The average age of the patient differed depending on the causative mechanism: 3.63 years for touching hob, 5.71 years from touching the frying pan, 7.21 years for burns associated with pancake tossing. The average burn size was 0.2% TBSA. None required admission, excision or grafting. Conclusions This research consolidates the knowledge about Shrove Tuesday related injuries in children: the need for close supervision of children in kitchen is highlighted. The causative mechanism changes as children grow up. Applicability of Research to Practice This knowledge can be used in targeting prevention strategies and campaigns, particularly at the beginning of Lent.
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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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Hepburn, Kirsty, Verity Bennett, Alison Mary Kemp, Linda Irene Hollen, Diane Nuttall, Zoe Roberts, David Farrell, and Stephen Mullen. "Burns and Scalds Assessment Template: standardising clinical assessment of childhood burns in the emergency department." Emergency Medicine Journal 37, no. 6 (April 22, 2020): 351–54. http://dx.doi.org/10.1136/emermed-2019-208595.
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ObjectivesThe Burns and Scalds Assessment Template (BaSAT) is an evidence-based proforma coproduced by researchers and ED staff with the aim of (1) standardising the assessment of children attending ED with a burn, (2) improving documentation and (3) screening for child maltreatment. This study aimed to test whether the BaSAT improved documentation of clinical, contributory and causal factors of children’s burns.MethodsA retrospective before-and-after study compared the extent to which information was recorded for 37 data fields after the BaSAT was introduced in one paediatric ED. Pre-BaSAT, a convenience sample of 50 patient records of children who had a burn was obtained from the hospital electronic database of 2007. The post-BaSAT sample included 50 randomly selected case notes from 2016/2017 that were part of another research project. Fisher's exact test and Mann-Whitney U tests were conducted to test for statistical significance.ResultsPre-BaSAT, documentation of key data fields was poor. Post-BaSAT, this varied less between patients, and median completeness significantly (p<0.001) increased from 44% (IQR 4%–94%) to 96% (IQR 94%–100%). Information on ‘screening for maltreatment, referrals to social care and outcome’ was poorly recorded pre-BaSAT (median of 4% completed fields) and showed the greatest overall improvement (to 95%, p<0.001). Documentation of domestic violence at home and child’s ethnicity improved significantly (p<0.001) post-BaSAT; however, these were still not recorded in 36% and 56% of cases, respectively.ConclusionIntroduction of the BaSAT significantly improved and standardised the key clinical data routinely recorded for children attending ED with a burn.
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Budkevich, Liudmila I., and Vera V. Soshkina. "Algorithm of local conservative treatment of children with burns." Pediatrics. Consilium Medicum, no. 4 (January 18, 2023): 268–76. http://dx.doi.org/10.26442/26586630.2022.4.201815.
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Background. This article presents the results of using atraumatic wound dressings Branolind N and sorbing bandage Zetuvit. In research there were 10 children with superficial scalds (III degree) and parcial deep (IIIII degree) burns. Children were treated at the Burn Center of Speransky Pediatric City Hospital №9 in Moscow in June November 2021. The analysis of the conducted research testifies to the effectiveness and safety of the medical products listed above. The absence of local complications during treatment was revealed. The possibility of their simultaneous use in patients with exudating wounds has been established. Branolind N and Zetuvit bandage can be recommended for use both in a on- and outpatient cases in children with local burns. The results of treatment of children with burn injury depend on adequate diagnosis of the severity of the burn trauma, reliable determination of the depth of scald and local treatment of burn wounds. Tactics of local treatment depends on the phase of wound process, the age of the child and the presence of concomitant diseases.
Aim. To assess the effectiveness and safety of using wound dressings ointment dressing Branolind N with Peruvian balsam and Zetuvit sorbent dressing in treatment children with burns.
Materials and methods. Analysis of the using of Branolind N ointment dressing with Peruvian balsam and Zetuvit sorbent dressing in 10 children with burn injury was carried out. The study was completed in June November 2021. Inclusion and exclusion criteria were determined by the physicians participating in the study. The studies were carried out in accordance with Helsinki Declaration. The age of the patients ranged from 3 years 2 months up to 17 years 1 month. The depth of burn wounds in the studied patients was assessed according to the classification of the damage degree of European Burn Association: patients with superficial scalds (III degree) and partial deep burns (IIIII degree).
Results. The absence of local skin complications during the application of the Branolind N ointment dressing with Peruvian balsam and Zetuvit sorbent dressing was revealed. The possibility of using. These wound dressings in patients with exuding wounds was established.
Conclusion. The analysis of the conducted study testifies to the effectiveness and safety of the above medical products. Ointment bandage Branolind N with Peruvian balsam and sorbent bandage Zetuvit can be recommended for use both in out- and inpatients practice of treatment children with local skin burns.
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Ramli, Rianto Noviady, Almas Prawoto, Nyoman Putu Riasa, Iswinarno Doso Saputro, and Ahmad Fawzy Mas'ud. "Epidemiology and Knowledge of First Aid Treatment Related to Burn Injury in the Rural Region of Kulon Progo, Indonesia." Open Access Macedonian Journal of Medical Sciences 9, E (February 12, 2021): 101–8. http://dx.doi.org/10.3889/oamjms.2021.5649.
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BACKGROUND: We investigated the epidemiology and the knowledge of first aid regarding to burns in the rural area of Kulon Progo, located in Indonesia. Although 44% of Indonesia’s population resides in rural areas, data of burn in Indonesia are very limited to national referral centers located in Indonesia’s largest cities. We also surveyed the patients and families of these burn patients to try to understand their knowledge on the first aid of burns.
AIM: We wanted to explore and discover what myths and misperceptions existed in rural communities.
MATERIALS AND METHODS: A retrospective study analyzing the medical records of patients with burns admitted to two of Kulon Progo’s largest referral hospitals between January 2018 and December 2019. A survey was distributed to the patients and their families regarding their knowledge on the first aid of burns. We wanted to analyze if certain groups of the population were more at risk for specific types of burn etiologies, the correlation between burn etiology and length of stay, the correlation between total body surface area (TBSA) of burns and length of stay in the hospital, and the correlation between education level of survey participants’ and their knowledge of first aid of burns.
RESULTS: A total of 115 patients were reviewed in this study. The highest proportion of total burn injuries occurred in the age group of 1–14 years old (38%). The major etiology of all burn cases were caused by scald (54%). Housewives and children were at a higher risk for scalds and laborers were at a higher risk for electrical and chemical burns (p = 0.001). There was no significant correlation between etiology and length of stay (p = 0.29). There was a statistically significant correlation between the TBSA and the length of hospital stay (p = 0.0001). The majority of survey respondents (66%) had poor knowledge on the first aid of burns. There was no significant correlation between education level and knowledge of first aid of burns (p = 0.07547).
CONCLUSIONS: Children, laborers, and housewives have a significant risk of suffering from a burn injury. A majority of people still have poor knowledge on the first aid of burns. There was no correlation between education levels and knowledge of first aid burns.
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Tracy, Lincoln M., Yvonne Singer, Rebecca Schrale, Jennifer Gong, Anne Darton, Fiona Wood, Rochelle Kurmis, Dale Edgar, Heather Cleland, and Belinda J. Gabbe. "Epidemiology of burn injury in older adults: An Australian and New Zealand perspective." Scars, Burns & Healing 6 (January 2020): 205951312095233. http://dx.doi.org/10.1177/2059513120952336.
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Introduction: The ageing global population presents a novel set of challenges for trauma systems. Less research has focused on the older adult population with burns and how they differ compared to younger patients. This study aimed to describe, and compare with younger peers, the number, causes and surgical management of older adults with burn injuries in Australia and New Zealand. Methods: The Burns Registry of Australia and New Zealand was used to identify patients with burn injuries between 1 July 2009 and 31 December 2018. Temporal trends in incidence rates were evaluated and categorised by age at injury. Patient demographics, injury severity and event characteristics, surgical intervention and in-hospital outcomes were investigated. Results: There were 2394 burn-injured older adults admitted during the study period, accounting for 13.4% of adult admissions. Scalds were the most common cause of burn injury in older adults. The incidence of older adult burns increased by 2.96% each year (incidence rate ratio = 1.030, 95% confidence interval = 1.013–1.046, P < 0.001). Compared to their younger peers, a smaller proportion of older adult patients were taken to theatre for a surgical procedure, though a larger proportion of older adults received a skin graft. Discussion: Differences in patient and injury characteristics, surgical management and in-hospital outcomes were observed for older adults. These findings provide the Australian and New Zealand burn care community with a greater understanding of burn injury and their treatments in a unique group of patients who are at risk of poorer outcomes than younger people. Lay Summary The number and proportion of older persons in every country of the world is growing. This may create challenges for healthcare systems. While burn injuries are a unique subset of trauma that affect individuals of all ages, less is known about burns in older adults and how they differ from younger patients. We wanted to look at the number, type, management, and outcomes of burns in older adults in Australia and New Zealand. To do this, we used data from the Burns Registry of Australia and New Zealand, or BRANZ. The BRANZ is a database that collects information on patients that present to Australian and New Zealand hospitals that have a specialist burns unit. Our research found that one in eight adult burns patients was over the age of 65, and that the rate of burn injuries in older adults has increased over the last decade. Older adult burns patients were most commonly affected by scalds after coming in contact with wet heat such as boiling liquids or steam. Fewer older adults went to theatre for an operation or surgical procedure compared to their younger counterparts. However, a larger proportion of older adults that went to theatre had a skin graft (where skin is removed from an uninjured part of the body and placed over the injured part). This research provides important information about a unique and growing group of patients to the local burn care community. It also highlights potential avenues for injury prevention initiatives.
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Mullen, Stephen, Roisin Begley, Zoe Roberts, and Alison Mary Kemp. "Fifteen-minute consultation: Childhood burns: inflicted, neglect or accidental." Archives of disease in childhood - Education & practice edition 104, no. 2 (June 22, 2018): 74–78. http://dx.doi.org/10.1136/archdischild-2018-315167.
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Burns are a relatively common injury in children accounting for over 50 000 emergency department attendances each year. An estimated 1 in 10 of these are due to maltreatment. These may present in the form of physical abuse or neglect with a reported ratio of 1:9. A burn associated with maltreatment may be a marker for future abuse or neglect and it is paramount that concerns are identified and addressed at the initial visit. Paediatricians need to be confident to identify safeguarding concerns specific to childhood burns and investigate accordingly. In this review, key variables that may aid in differentiating maltreatment from accidental burns are discussed in a case-based format, utilising up-to-date evidence to support the recommendations. Despite a proportion of burns resulting from physical abuse, the rate of child protection investigations in these patients are significantly lower than for children who present with other forms of physical injuries despite a similar proportion of positive findings. Our objective is to review the available evidence to support the safe assessment and management of children presenting with scalds or contact burns.
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Ajitsingh .P. Chadha, Nehadeepkaur A Chadha, and Kshirsagar A Y. "Burns Management In Tertiary Health Care Centre." International Journal of Research in Pharmaceutical Sciences 12, no. 1 (January 20, 2021): 544–50. http://dx.doi.org/10.26452/ijrps.v12i1.4188.
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In rural places of our country, burns have become frequent accidents due to the use of floor-based stoves & kerosene lamps. Suicides due to burns are also quite usual in our country. The objective of this study is to evaluate the necessity of early excision of the burn wound and skin grafting to decrease the morbidity, mortality, complications of burns and stay at the hospital. Calculate pressure garment efficacy in preventing burn scar and contracture formation. To lay out cost-effective management for patients at rural hospitals. 50 patients were included in this study presenting with burn injuries, admitted in the department of plastic surgery from June 2019 to December 2020. In a recent study, Females (52%) suffered more as compared to males. Scalds were the prime root cause of the burns constituting the 52% of the cases. Infections of Burn wound was seen in 20 patients (40%). Pseudomonas was prime organism isolated. Wound excision was required in 19 patients (38%). Around 6 to 12 days, elapsed between the injury to the surgical excision. 19 patients required (38%) covering of wound permanently with STSG. The mean admission period in hospital for burns of 41-60% was 62 days, 33.4 days for 21-40% burns and 19.6 days for <20%. Amongst 50 patients, 3 died accounting to 6% of overall cases. This study concluded that initiation of resuscitation with untimely wound excision and permanent coverage with grafting can bring significant fall in mortality, painful debridements, limiting complications, decreasing the duration of stay at a hospital, curtailing the cost of health care and time apart from work.
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Cohen-Manheim, Irit, Moti Harats, Sharon Goldman, Dmitry Beylin, Josef Haik, Moran Bodas, Adi Givon, et al. "Burns in Israel: Etiologic, Demographic, and Clinical trends—A 9-Year Updated Comprehensive Study, 2004–2010 versus 2011–2019." Seminars in Plastic Surgery 36, no. 02 (May 2022): 066–74. http://dx.doi.org/10.1055/s-0042-1749094.
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AbstractBased on the Israeli National Trauma Registry (INTR) data, this study reports etiological, demographic, and clinical trends and includes all admissions to burn and trauma centers across Israel from 2011 to 2019 and compares these with 2004 to 2010 rates. From 2011 to 2019, 5,710 patients were admitted to burn centers across Israel. Children aged 0 to 1 years (25.9%), non-Jews (40.7%), and males (67.2%) remain the main groups of the burn casualties. Most of the casualties sustained 1 to 9% total body surface area (TBSA) burns with various depths. Scalds were less fatal than fire/flame-related casualties (<1 vs. 11.5%). Fewer surgical procedures were conducted for burns under 9% TBSA compared with greater TBSA. The percentage of TBSA and burn depth were found to be the most significant predictor of mortality among all age groups (>200 times increased risk with full-thickness burns >30% TBSA burn) and correlated with prolonged length of stay (>7 days).
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D. G. Dissanayaka, Udukubhura, Amal N. Vadysinghe, Yapa M. G. I. Banda, and Thenuwara H. I. Gayathree. "The Magnitude, Clinical Presentation and Consequences of Patients with Burn Injuries Admitted to Tertiary Care Hospital, Kurunegala, Sri Lanka: A Prospective Analysis." Arab Journal of Forensic Sciences & Forensic Medicine 2, no. 2 (October 29, 2020): 153–63. http://dx.doi.org/10.26735/gjme7901.
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This prospective analysis is based on clinical forensic examinations and clinical case records of the victims who sustained burns and were admitted during a one-year period since 2017. Of the 90 patients (34 children and 56 adults), 54 % were male with ages ranging from 1 month to 80 years. Males below the age of 20 years (48 %) were highly vulnerable. Education status revealed that most of the patients have an education level below O/L representing 52 % (Ordinary Level/ O/L is similar to the General Certificate of Secondary Education/ GCSE in Cambridge Education System in United Kingdom) and the majority were married (52%). Scalds were seen in 52 %, while flame burns in 28 % cases. Most of the incidents had taken place at home (92%). Burn injuries were most frequently observed on upper extremities (47 %) and the majority were of first degree in nature. Furthermore, this study revealed that 57 % recovered without any complications, while 34 % resulted in scarring or disfigurement. It was highlighted that children are the most vulnerable to in sustaining burns, especially with hot water in domestic settings. The study recommends increasing awareness among parents/guardians regarding safe handling of hot water to minimize such incidents.
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Hong, Rebecca, Monica Perkins, Belinda J. Gabbe, and Lincoln M. Tracy. "Comparing Peak Burn Injury Times and Characteristics in Australia and New Zealand." International Journal of Environmental Research and Public Health 19, no. 15 (August 4, 2022): 9578. http://dx.doi.org/10.3390/ijerph19159578.
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Burns are a leading cause of morbidity and mortality worldwide. Understanding when and how burns occur, as well as the differences between countries, would aid prevention efforts. A review of burn injuries occurring between July 2009 and June 2021 was undertaken using data from the Burns Registry of Australia and New Zealand. Peak injury times were identified on a country-by-country basis. Variations in demographic and injury event profiles between countries were compared using descriptive statistics. There were 26,925 admissions recorded across the two countries (23,323 for Australia; 3602 for New Zealand). The greatest number of injuries occurred between 6 PM to 7 PM in Australia (1871, 8.0%) and between 5 PM to 6 PM in New Zealand (280, 7.8%). In both countries, scalds accounted for the greatest proportion of injuries during peak times (988, 45.8%), but a greater proportion of young children (under three years) sustained burns during New Zealand’s peak times. The number of burn injuries associated with the preparation and/or consumption of food offers an opportunity for a targeted prevention program that may yield benefits across the two countries. Age- and mechanism-related differences in the profile of burn-injured patients need to be considered when developing and implementing such a program.
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Sachkov, A. V., T. G. Spiridonova, E. A. Zhirkova, P. A. Brygin, and K. S. Smirnov. "Etiology, Pathogenesis and Outcomes of Patients Treated at the Burn Center of N.V. Sklifosovsky Research Institute for Emergency Medicine." Russian Sklifosovsky Journal "Emergency Medical Care" 11, no. 2 (September 4, 2022): 232–37. http://dx.doi.org/10.23934/2223-9022-2022-11-2-232-237.
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Background We identified patients treated at our Burn Center over a 14-year period.Material and methods The following data were studied: the annual and total number of patients, the number of patients admitted to the Intensive Care Unit (ICU) and the Burn Unit (BU), gender and age of the patients, the epidemiology of burn injury, percentage of total body surface area (TBSA) burned, percentage of inhalation injury, percentage of full thickness burns, mortality.Results It was revealed that the annual number of patients averaged 730 (692; 747). The proportion of those hospitalized to the ICU was 35–49%, and 51–65% to the BU. These figures did not differ significantly (all p>0.05; Fisher exact test [FET]). The male to female ratio was 2.3-1.6:1. The age of the patients increased from 44 (31; 59) to 48 (33; 62) years (p=0.003; M–W test). The percentage of the etiological factors changed: flame burns accounted for 60% of cases in 2006 and 34% of cases in 2019 (p<0.001; FET). The number of patients with scalds increased from 18% in 2006 to 33% in 2019 (p=0.023; FET). The proportion of patients with inhalation injury without burns did not exceed 15% for the entire study period. Median burn area among all hospitalized decreased by almost twice from 2006 to 2019: total area from 12% to 7% TBSA (p<0.001; M–W test); superficial, from 10 to 6% TBSA (p<0.001; M–W); deep burns, from 9 to 3% TBSA (p<0.001; M–W). In patients in the ICU, the median of the total burned area was 20–25% TBSA, the area of superficial burns prevailed without a statistically significant difference between 2006 and 2019. (p=0.285; M–W test). The median area of deep burns gradually decreased by more than twice: from 15% TBSA in 2006 to 7% TBSA in 2019 (p<0.001; M–W test). For the period from 2006 to 2019 overall mortality in the burn center decreased from 16.7% to 7.4% due to a 2.4-fold decrease of mortality from 16.3% to 6.9% in the ICU (p<0.001; FET). In the BU, for the entire period it was 0.4-1.6%. In 2019, the highest mortality of 27% was observed in combined burns and inhalation injury (InI) followed by InI without burns (13.6%), and then came electrical injury (11.8%).Conclusion For 14 years, mortality has decreased by more than twice. The highest number of deaths was observed among patients with skin burns and InI, InI without burns and electrical injury. Annual number of admissions in ICU and BU, gender ratio remained steady. The median area of total burns decreased by 2-3 times, the median area of deep burns in patients in the ICU decreased by 2 times. The median age of burn patients increased by 4 years and began to refer to the middle age group according to the WHO classification.
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Abali, Ayse Ebru, Cem Aydogan, Nigar Turkmen, and Mehmet Haberal. "565 Pandemia Experience in Pediatric Minor to Moderate Burns and the Role of Telemedicine in Treatment." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S132—S133. http://dx.doi.org/10.1093/jbcr/irab032.215.
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Abstract Introduction A huge number of pediatric burn injuries are minor to moderate burns. During covid-19 pandemia, these cases have continued to require medical attention. Aim of the present study was to share our burn center’s pandemia experience in minor to moderate burns in children. Methods Records of 117 victims (age:0 to 17yrs) were documented {study period: 3/11/2020(pandemia decleration by WHO)-9/11/2020}. Data were classified according to treatment modalities (outpatient/inpatient/telemedicine). Age; sex; extent of burns; burn cause; environment in which injury occured; referral history (time interval between injury and referral; other hospitals before arriving at our center) were noted for each case. Thereafter, subjects were divided into two subgroups according to pandemia calender: GroupIconsisted of referrals in march+april+may (national ‘lock-down’ period for children n=60) and GroupIIconsisted of referrals in june+july+august+september (‘new normal’ period with limited social life n=57) (mean±SE,p˂.05). Results: Outpatients comprised 82,1% of all referrals(n=96) with 361 in-person visits. Mean age was 4,2yrs±0,4(min:0 max:17); male/female ratio was 1,04/1. Mean total body surface area(TBSA) burned was 2,6%±0,6(min:0,2 max:20). The most common burn causes were scalds(n=79; 82,3%) and contact burns (n=11;11,5%). Number of referrals on the same day with injury was 41 (42,7%) and 65 referrals were unmediated(67,7%). Inpatients comprised of 11,1% of all referrals (n=13). Mean age was 3,9yrs ± 1,7 (min:1 max: 16). Male/female ratio was 0,9/1. Mean TBSA burned was 9,3%±1,8 (min:1 max:18). The most common burn cause was scalds(92,3%;n=12). Nine patients were hospitalized on the same day with injury (69,2%). Ten patients were referred from other hospitals (76,9%). Mean lenght of hospital stay was 6,77days±1,4 (min:1 max:14). Telemedicine visits (n=33) which were carried out for 23 children via e-mail and phone/video calls included photographic follow up visits for scars, treatment of contact dermatitis and controls of wound-dressings. Comparison of ‘lock-down’ period (groupI) with ‘new normal’ period (groupII) revealed that almost whole telemedicine service was carried out in groupI except two interurban visits in groupII. Findings were similar in both groups except the significant increase of outdoor burns and remarkable presence of sun burns in groupII(p< .05). Conclusions Covid pandemia has created extraordinary conditions; however present data suggests that minor to moderate burns in childhood continue to occur anyway. Telemedicine is an advantageous method under pandemia conditions. Therefore, attempts for basic burn-care guidelines including telemedicine facilities should be supported.
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Moser, William J., Kristen R. Bilka, Sebastian Q. Vrouwe, Jill Glick, and Veena Ramaiah. "60 Running Water While Bathing Is a Risk Factor for Pediatric Scald Burns." Journal of Burn Care & Research 43, Supplement_1 (March 23, 2022): S42. http://dx.doi.org/10.1093/jbcr/irac012.063.
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Abstract Introduction Scalds are the most common mechanism of burn in children, and a significant proportion of these injuries are associated with bathing. Burns sustained while bathing present a unique opportunity for injury prevention; previous studies have examined lowering water heater temperatures, however reputable infant bathing educational resources do not explicitly recommend avoiding running water and the risks that it could pose. In an effort to inform prevention programs, this study seeks to determine the incidence and circumstances of running water in bathing scald burns at our institution. Methods A retrospective review was performed of records from an American Burn Association verified center over a ten year period (1/1/2010 to 12/31/2019). This center treats both children and adults and is affiliated with an academic hospital in a major urban center. The burn database was queried for scald injuries in children less than three years involving bathing. The Child Advocacy and Protective Services team provides inpatient consultation for all children less than three years old with burn injuries allowing us to analyze the specific events surrounding the bathing scald burns in this cohort. Results A total of 123 patients met inclusion criteria. Three bathing safety risk factors were specifically noted in the chart review: (1) running water, (2) lack of caregiver presence for duration of bathing, and (3) failure of caregiver to check water temperature before bathing. Of the cases identified, 107 (87%) had clear documentation of running water as part of the history of injury, 66 (54%) cases involved failure of caregiver to check the water temperature before bathing and 53 (43%) cases did not have a caretaker present for the duration of the bath. In cases with only one risk factor, running water was identified in 34 (94%) out of 36 cases, and in cases with one or two risk factors, running water remained the primary risk factor with 38 (90%) out of 42 cases. When looking at the combination of risk factors, only three (2%) cases had no risk factors while 77 (63%) involved two or more risk factors. Conclusions The vast majority of bathing burn injuries in this series involved running water. In addition, a significant number of scald burns occurred from running water alone, even without the other identified risk factors. Conversely, only 2% of scald burns associated with bathing featured none of these three risk factors, suggesting that these injuries could be greatly impacted by safe bathing education.
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Verma, S. S., S. Srinivasan, and A. M. Vartak. "An epidemiological study of 500 paediatric burn patients in Mumbai, India." Indian Journal of Plastic Surgery 40, no. 02 (July 2007): 153–57. http://dx.doi.org/10.1055/s-0039-1699194.
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ABSTRACT Aim: To study the epidemiological data of paediatric burn patients to determine the role of demographic distribution and epidemiological parameters for assessment of mortality rate and development of burn prevention strategy.Materials and methods : epidemiological data of 500 patients admitted to the burns and plastic surgery unit of b.j. wadia hospital, mumbai over a period of six years (2000-2005) was reviewed from medical records. age, sex, demographic distribution, seasonal variation, total body surface area (tbsa) involved, type and place of burn injury, parental occupation, family size, first aid and mortality rate were studied.Result: Median age group for patient was 3.44 years (range one month to 14 years). the majority (24%) of burns occurred in children between the one to two years age group. male to female sex ratio was 1.38:1. most of the patients were from the defined demographic region served by the hospital. a significant number of patients however were from outside this region. burn injury occurred predominantly during winter. most common type of burn was scalds which occurred mainly in domestic circumstances. in the majority of patients, less than 10% tbsa was involved. all patients were managed as per the unit protocol. mortality rate was 10.4%. mortality rate was high in patients having more than 40% tbsa involvement. seventy-three per cent of the total deaths occurred in the patients coming from regions outside the demographic region served by the hospital. parental occupation, family size and the first aid did not affect the mortality rate.Conclusion: Availability of a burn care unit in the vicinity can decrease the mortality rates in the paediatric burn patients. an intense and focused burn prevention campaign to educate the general population about dangerous aetiological factors will decrease the incidence of paediatric burns.
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Riaz-ul-Haq, Muhammad, Shafiq-ur Rehman, Muhammad Amir Hanif Khan, and Yasir Makki. "Comparative Analysis of the Risk Factors among Survivors and Non-Survivors Burned Children." Pakistan Journal of Medical and Health Sciences 16, no. 6 (June 29, 2022): 349–52. http://dx.doi.org/10.53350/pjmhs22166349.
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Background: Burn trauma in children results into high mortality and morbidity with lifelong consequences. Lack of health care facilities, equipped burn centers, illiteracy, poor infra structure and involvement of girls in cooking activities at early age are potentiating factors towards high mortality. Objectives: To determine key factors resulting into high mortality in children Study Design: Cross-sectional study Place and Duration of Study: Department of Paediatric Surgery Sahiwal Teaching Hospital & Sahiwal Medical College Sahiwal from 1st May 2019 to 28th February 2022. Methodology: One hundred and eighty four patients upto the age of 12 years with more than 10% partial thickness burn and less than 10% full thickness burn and any percent electric burn were included. Age, sex, presence of inhalation injury, total burn area, development of wound infection, sepsis, mode of burn, surgical intervention and length of hospitalization were all used to predict mortality. Resuscitation was done according to ATLS guide lines on admission. Topical treatment and intravenous antibiotics were given. Fasciotomy was done wherever needed. Wound swab was taken culture sensitivity on 5th day. Results: Overall mortality was 18.47%. Eighteen (53%) of non-survivors were 3-7 years. Mortality was high in females (61.67%). With regards to cause of burn, flame burns remained at the top in survivors (48%) while scalds in non-survivors (61.76%). 50% of patients presented with partial thickness burn (75/150) in survivors while 50% (17/34) with mixed burns in non-survivors. Mean total body surface area burn was 14.9% in survivors and 40.6% in non-survivors. Non-survivors presented late as compared to survivors. Hospital stay for survivors ranged from 1-28 days while non-survivors stayed 3-18 days before death (Mean 5.9 and 7.4 days) respectively. Conclusion: Age less than 7 years, females, scald burn, delayed presentation, full thickness or mixed burns with burn surface area more than 40% are significant risk factors for high mortality in burned children. Keywords: Burn, Children, Mortality, Sepsis, Scald
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Wang, Xiaodong, Xuehong Pan, Nana Zhao, and Defang Chen. "Study on the Effect and Mechanism of Antibacterial Adhesive Hydrogel on Wound Healing." Computational and Mathematical Methods in Medicine 2021 (November 30, 2021): 1–7. http://dx.doi.org/10.1155/2021/8212518.
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Bleeding and infection can cause significant increases in mortalities. Hydrogel sealants have attracted extensive attention for their ability to control bleeding. In this study, the adjuvant treatment with antibacterial adhesive hydrogel dressings was applied to patients with deep second-degree burns/scalds. The traditional medical dressing was regarded as control adjuvant treatment. The results indicated that the total positive rate of bacteria in wound secretions and the pain during dressing change in patients who used antibacterial adhesive hydrogel dressings were significantly reduced. The number of fibroblasts and new capillaries in the granulation tissue of the wound increased, and the patient’s wound healing is accelerated. The overall clinical effectiveness has been significantly improved. It is proven that the antibacterial adhesive hydrogel dressing has a significant effect on wound healing.
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Aslam, Muhammad Rizwan, Taokeer Ahmed Rizvi, Muhammad Tariq Munawar, Asad Maqbool, and Shahid Naqvi. "A GHASTLY RISING RATE OF PREVENTABLE PEDIATRIC BURNS: WE NEED TO ACT." Pakistan Armed Forces Medical Journal 70, no. 6 (December 15, 2020): 1622–28. http://dx.doi.org/10.51253/pafmj.v70i6.4308.
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ABSTRACT
Objective: To ascertain the increase in paediatric burn admissions in our tertiary care facility. Find various causes of this trend and assess the morbidity and mortality in paediatric population, and suggest remedies.
Study Design: This is a “descriptive case series study”
Place of Study: This Study was conducted during September 2017 to August 2019 at Department of Burns & Plastic surgery.
Materials and Methods: Total number of acute burn admissions under 12 years were recorded. Subdivided this group into 0 to 2 years and 2 to 12 years. We assessed epidemiology, sex, cause of burn, mode of admission, location of incident, type of first aid given, mortality, and compared results during two equal halves of this period. We used SPSS 20 for data analysis.
Results: 504 (49.85%) were pediatric acute burn admissions. Their age ranged from 25 days to 12 years (mean 5 ±1.2 years). 152 were infants/toddlers aged 0-2 years. 270 male and 234 females. 316 were direct admissions. There were 72.43% more pediatric burn admissions. 381 were scalds, 91 flame burns, 21 electric burns and 11 chemical burns. There was 11.94% improved survival among burn patients. Two temporal peaks, largest in summer from May to Jul and second in Dec to Feb.
Conclusion: There is an increasing trend in acute pediatric burn admissions. Majority of victims did not receive proper first aid. We need to start a very aggressive campaign on print and electronic media for public education.
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Duggan, Robert P., Kimberley C. Brondeel, William L. Mahony, Grant Torres, Alen Palackic, and Ludwik K. Branski. "546 Health Disparities Among Rural Burn Patients." Journal of Burn Care & Research 43, Supplement_1 (March 23, 2022): S108. http://dx.doi.org/10.1093/jbcr/irac012.174.
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Abstract Introduction Socioeconomic status is a risk factor for sustaining a burn and for burn mortality. Patients from rural areas make up a minority of the population but are frequently more isolated from life-saving care and burn centers. Lower socioeconomic status patients may delay seeking treatment of their burns for concern over medical costs, time away from work, and overall distance from accredited burn centers. We aim to explore disparities in burn outcomes at our institution based on patient socioeconomic status. Methods Between January 2020 and January 2021, patients presenting for management of acute burns were reviewed. Patient demographics and outcomes were collected, including time to presentation, total body surface area burned, presence of inhalational injury, and mortality. Patient socioeconomic status and rural designations were assigned based on a validated metric derived from Census endpoints, with higher scores reflecting lower socioeconomic status. Results A total of 524 patients were identified. Overall, 30% of our patients were from areas defined as being small towns or rural by the Census. Racial demographics did not differ between rural and urban areas (p = 0.099), but Hispanic ethnicity was less common (16% vs. 29%, p = 0.002). Rates of alcohol, tobacco, and illicit drug use did not differ between groups. Compared to the urban/suburban cohort, rural patients were from less affluent areas (63.6 vs. 58.5, p = 0.001) and traveled farther to our center (112 miles vs. 70 miles, p = 0.029). Despite these distances, rural patients did not have a higher rate of delayed presentation (35.7% vs. 43.3%, p = 0.105), or longer average time to presentation (3.4 days vs 4.4 days, p = 0.222). Flame burns were the most common mechanism overall (44.3%) and were significantly more common in the rural population (59.2% vs. 37.8%, p < 0.001), Scalds, the second most common burn mechanism (25.9%), occurred less frequently in rural patients (18.5% vs. 29.2%, p = 0.011). Controlling for age, TBSA, inhalational injury, and ventilator requirement, patients from rural areas were at a significantly higher risk of mortality (OR 24, p = 0.024). Conclusions Rural burn patients face many challenges receiving appropriate care following a burn. They frequently come from less affluent backgrounds, limiting their ability to access care, and they must travel greater distances to a qualified burn surgeon. Despite these barriers, our rural patient population did not present any later following a burn compared to our more urban patients. Rural patients sustained more extensive burns but were not hospitalized at a greater rate. Even when controlling for numerous factors associated with burn mortality, rural patients were still at an increased risk. Burn prevention strategies targeting rural communities should address the unique challenges facing these areas.
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Cohen, Arnon D., R. Gurfinkel, R. Glezinger, Y. Kriger, N. Yancolevich, and L. Rosenberg. "Pediatric Burns in the Bedouin Population in Southern Israel." Scientific World JOURNAL 7 (2007): 1842–47. http://dx.doi.org/10.1100/tsw.2007.239.
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Burn trauma is an important public health concern, with increased risk for burns in children. A cross-sectional study was performed to describe the epidemiological characteristics and risk factors for burns in hospitalized Bedouin children in Soroka University Medical Center during the years 2001–2002. In a population of 558 hospitalized burn-injured patients, 282 Bedouin children were identified. Two hundred and sixty five patients (94.0%) had burns involving less than 20% of the body surface area. Cause of the burns was scald in 190 patients (67.4%), fire in 80 patients (28.4%), chemical in 8 patients (2.8%), and explosion in 2 patients (0.7%). Two female patients (0.7%) aged 11 and 17 years died of their burns that were caused by fire. The mean length of hospitalization was 9.8 days. Pediatric burn injury has become a significant public health problem in the Bedouin population of the Negev. To reduce the burden of burn injury, it is necessary to increase current efforts in prevention of burns.
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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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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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V. R., Krishnamurthy, Ishwaraprasad G. D., Sumana M., and Samudyatha U. C. "Pattern of burn injury admissions at a teaching hospital of Karnataka, India: a three year retrospective study." International Surgery Journal 5, no. 12 (November 28, 2018): 3930. http://dx.doi.org/10.18203/2349-2902.isj20185021.
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Background: The study aims to review current trends in epidemiology, demographics and pattern of burn injury over three year period.Methods: A retrospective study was done using the records of all burn patients admitted from January 2013 to December 2015 at Teaching Hospital, HIMS Hassan. The records were analysed for socio demographic profile, pattern of injuries and outcome.Results: 390 patients were enrolled in the study. Woman patients marginally outnumbered men (52.6% vs. 47.4%). Accidental burns were 92.8%. 84.6% of the patients sustained burns at their home. Flame burn constituted 62.6 % and scald burns 31% of the total burns.Conclusions: Burns is still an issue of concern. Our study highlights the need for a burns data- base to know the reasons and what measures could prevent the occurrence. Number of patients referred is high indicating the need for specialist services at the District level.
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Hilt, T., DF Graves, JM Chernin, CA Angel, DN Herndon, and JB Zwischenberger. "Successful use of extracorporeal membrane oxygenation to treat severe respiratory failure in a pediatric patient with a scald injury." Critical Care Nurse 18, no. 6 (December 30, 1998): 63–72. http://dx.doi.org/10.4037/ccn1998.18.6.63.
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If ECMO is to be used effectively in pediatric patients, specifically in those with burns, the candidates must be chosen with care. Unlike the situation in neonates, when ECMO is being considered for use in a pediatric patient, no clear set of inclusion or exclusion criteria exists. Evaluation of a pediatric patient for ECMO support is largely based on an assessment of the patient's condition and a center's previous experience with pediatric ECMO. The data that are available through ELSO indicate that survival decreases as the number of days a patient receives mechanical ventilation before the initiation of ECMO increases. The effect of burns on patients' outcomes is unknown. Age, duration of mechanical ventilation, and excision with allografting or homografting of the burns should all be considered before the patient is offered ECMO support. The remaining prognostic signs--duration of ECMO support, frequency of complications, and blood product requirements--are available only after the ECMO course is under way or completed. The success of our center and others in using ECMO to treat respiratory failure associated with burns shows that some patients with burns may benefit from ECMO. Unfortunately, no specific set of criteria exists that would enable ECMO centers to differentiate good candidates from poor ones and thus be able to offer ECMO support with confidence in its benefit for the patient.
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Thapa, Bijay, Ram Hari Chapagain, and Anju Kayastha. "Epidemiology, Clinical Pattern and Management Outcome of Paediatric Burn Injuries in Nepal." Journal of Nepal Paediatric Society 41, no. 3 (December 31, 2021): 387–94. http://dx.doi.org/10.3126/jnps.v41i3.30828.
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Introduction: Burn injuries are third commonest type of injury in Nepal and 61% of burn victims are children. This represents a significant morbidity and mortality burden for patients and families. This study was carried out to describe epidemiology, clinical pattern and therapeutic outcome of children with burn. Methods: It is a retrospective observational study of routinely collected data of children up to 14 years admitted to the Burns Ward at Kanti Children’s Hospital, Kathmandu, Nepal, from July 2016 to July 2019. Statistical analysis was done on the collected data. Results: Total 935 patients were admitted with an average of 311.7 per year, among which 63% were males and 83.0% were aged five years or under. Patients travelled from all over Nepal for treatment at this hospital. 50.6% of patients presented with fresh burns < 24 hours after injury. Scald burn was the commonest (82.6%). Children under five were more likely to have scald burns, whereas older children more likely to have flame or electric burns. Majority of cases (70%) were of mild burns < 10% TBSA and only 3.2% TBSA > 30%. 68.5% were managed conservatively and 18.4% required debridement and skin grafting. Mean length of stay was 15 days. Overall mortality was 1.0%. In children with > 30% burns mortality was 12.9%. Conclusions: Scald burn was the commonest while proportion of flame burn increases with age. Majority of burns occur in male under five years of age. Most cases presented with < 10% TBSA and were managed conservatively.
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Yaacobi, Dafna (Shilo), Yehiel Hayun, Lior Har-Shai, Arik Litwin, and Dean D. Ad-El. "Epidemiology of Burn Wounds Arriving to a Level 1 Trauma Center in Israel." Journal of Burn Care & Research 41, no. 2 (August 29, 2019): 317–21. http://dx.doi.org/10.1093/jbcr/irz160.
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Abstract Burn injuries have grave consequences for patients and impose a heavy economic burden on healthcare services. Studies on the epidemiology of burn injury in Israel are sparse and outdated, and improved understanding of current trends can help experts plan prevention campaigns and design effective treatment paradigms. This study sought to assess the background, clinical, and treatment characteristics of adult patients admitted with burn injury to a level 1 trauma center in Israel in 2005 to 2017. Data were retrospectively retrieved from the hard copy and electronic files as follows: patient sex and age; burn type, degree, and etiology; percentage total BSA (%TBSA) affected; and type of treatment and length of hospital stay (LOS). The cohort included 734 patients of mean age 41.79 years and a male-to-female ratio of 1.8:1. Thermal factors, particularly hot liquids, were the most common cause; second-degree burns were the most common. Mean %TBSA was 5.39%; mean LOS was 11.81 days; and mean LOS/%TBSA was 4.65. Advanced dressings alone yielded satisfactory outcome in 74.2% of patients. The relatively younger patient age and male predominance of our cohort were in line with published findings. The LOS was similar to previous studies in Israel but lower than in Europe. The LOS/%TBSA was higher than in the literature, with a decrease over time suggesting an increased effectiveness of treatment. There appears to be a decline in the rate of surgery for burn injury and increased expertise in the use of advanced dressings. National prevention campaigns should focus on scalds rather than flame-induced burns.
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Pelizzo, Gloria, Giulia Lanfranchi, Marcello Pantaloni, Anna Camporesi, Paola Tommasi, Eleonora Durante, Sara Costanzo, et al. "Epidemiological and Clinical Profile of Pediatric Burns in the COVID-19 Era: The Experience of a Reference Center." Children 9, no. 11 (November 11, 2022): 1735. http://dx.doi.org/10.3390/children9111735.
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Pediatric burns represent a significant public health problem. We analyzed the characteristics of pediatric burns in a reference center, in order to identify better strategies for prevention and care. Burn patients admitted to the pediatric departments of our hospital from January 2020 to June 2022 were retrospectively evaluated. Age, gender, the etiology of injuries, the total burn surface area (TBSA), the degree of burns, the length of hospital stay (LOS), concomitant SARS-CoV-2 infection, and burn surface microbial colonization were analyzed. Forty-seven patients were included in the analysis (M:F = 1:0.67). Most of the cases involved patients between 0 and 4 years of age (83%). Hot liquid burns accounted for 79% of cases, flame burns for 9%, thermal burns for 6%, scald burns for 4% and chemical burns for 2%. Mean TBSA was 14 ± 11%. A second-degree lesion was detected in 79% of patients and third-degree in 21%. Mean LOS was 17 days. No additional infection risks or major sequelae were reported in patients with SARS-CoV-2 infection. Fifteen different species of bacteria plus C. parapsilosis were isolated, while no anaerobic microorganisms were detected. In the light of our experience, we recommend a carefully planned and proactive management strategy, always multidisciplinary, to ensure the best care for the burned child.
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Gravante, Gianpiero, and Antonio Montone. "A retrospective analysis of ambulatory burn patients: focus on wound dressings and healing times." Annals of The Royal College of Surgeons of England 92, no. 2 (March 2010): 118–23. http://dx.doi.org/10.1308/003588410x12518836439001.
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INTRODUCTION In this study, we retrospectively analysed healing times of ambulatory burn patients after silver-based dressings were introduced in late December 2005, and compared the results with those obtained before. PATIENTS AND METHODS Data were collected in November–December 2005 and in January–February 2006. We excluded from the study: (i) admitted patients; (ii) patients with mixed superficial partial thickness and deep partial thickness burns; (iii) patients with full-thickness burns; and (iv) operated patients that came for follow-up. We recorded the age, sex, cause (flame vs scald), burn depth, dressings used and healing times. RESULTS We selected 347 patients corresponding to 455 burned areas (64.4% superficial and 35.6% deep; 47.7% treated in 2005 and 52.3% in 2006). During the years 2005 and 2006, there was an increase in the use of silver-based dressings (2005, 9.7%; 2006, 38.7%; chi-squared test, P < 0.001) and a decrease in the use of paraffin gauzes (2005, 66.4%; 2006, 40.3%; chi-squared test, P < 0.001). The healing time of overall burns and of superficial burns showed no significant differences between 2005 and 2006. However, in deep partial thickness burns, a significant reduction was present (2006, 19; 2005, 29 days; Student's t-test, P < 0.01). Among all dressings, paraffin gauzes had the shortest healing times in superficial burns (5 days); with silver-based dressings in deep burns, the healing times were nanocrystalline silver (16 days) and silver carboxymethylcellulose (21 days). CONCLUSIONS Results of our retrospective study would suggest that paraffin gauzes are a valuable option in superficial burns, while silver-based dressings are preferable in deep burns.
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Shen, Chuanan, and Dawei Li. "843 A Study on Changes of Pancreatic Structure and Function After Severe Burns and Its Mechanism." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S260—S261. http://dx.doi.org/10.1093/jbcr/iraa024.415.
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Abstract Introduction This research was to explore the changes of pancreatic structure and function after severe burns and its mechanism. Methods A scald model of rats with a 50% total body surface area was established. Rats were injected with bpv (hopic, 0.6 mg/kg) subcutaneously once daily post scald creation. Rats’ fasting blood glucose (FBG) and serum insulin concentration were measured to calculate the insulin resistance index at 72 h post injury. Western blot assay was used to measure the content of p-Akt and t-Akt in pancreatic tissue and observe Akt phosphorylation levels. Paraffin sections and electron microscopic sections of pancreatic tissue were prepared for observation under light and transmission electron microscopy. The number of insulin particles and insulin vacuoles attached to per 10 μm of the cell membrane in β cells were calculated. Results Scalds increased FBG and impaired glucose tolerance significantly in the rats. Bpv could reduce blood glucose and improve glucose tolerance remarkably. Western blot assay revealed that the activity of PI3k/Akt pathway in rats’ pancreas decreased after scalding, and bpv could up-regulate its activity. The number of insulin particles attached to to per 10 μm of the cell membrane in β cells was reduced, and the proportion of insulin vacuoles was increased, indicating that rats’ insulin secretion function was impaired. After treatment with bpv, rats’ insulin secretion function was improved. Conclusions The activity of PI3k/Akt pathway in scalded rats’ pancreas is reduced and the insulin secretion function is decreased. Improving the activity of PI3k/Akt pathway in rats’ pancreas may improve the insulin secretion function and restore physiological blood glucose levels during the early stage after scalding. Applicability of Research to Practice This research may be applicable in practice in the future to regulate the metabolism of burn patients.
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Tanuwijaya, Lucretya Yeniwati. "Burn Case Prevalence In Dr Kariadi General Hospital Semarang From 2012 to 2014." Jurnal Plastik Rekonstruksi 7, no. 2 (September 30, 2020): 77–82. http://dx.doi.org/10.14228/jprjournal.v7i2.286.
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Background: Burns is a type of trauma that requires treatment and rehabilitation, which is still difficult and requires perseverance, a high amount of costs, and trained and skilled personnel. Morbidity and mortality of burns are relatively high, especially in developing countries where burn prevention and treatment systems are inadequate. The prevalence of burns is expected to be an advantage for the development of science in further research and could help clinicians prevent and curative burn care efforts. Method: The study subjects were burned patients examined and hospitalized at Dr. Kariadi General Hospital, Semarang. Data from each sample's clinical examination results were then collected to be described based on gender, age, burns degree criteria, and etiology of burns. Results: The total sample obtained was 72 samples, including 61 patients (85.53%) with new burns and 11 non-emergency patients (14.47%). From a total of 61 new burn patients, eight female patients (13.11%) and 53 male patients (86.89%) were obtained; 10 patients (16.40%) were children (0-18 years), 50 (81.96%)were adults (18-65), and one patient (1.64%) belonged to geriatric (> 65 years) ); based on the degree of the burns, seven patients (11.48%) had a moderate degree and 54 patients (88.52%) had a severe degree; there were 28 patients (45.90%) who suffered burns caused by fire, 20 patients (32.79%) due to electricity, six patients (9.84%) caused by scald, and seven patients (11.47 %) with an unknown cause. Of the 61 new burn patients, there were five patients (8.20%) who died. Conclusion: Burn prevalence in Dr. Kariadi General Hospital, Semarang in 2012-2014 are mostly experienced by men, adults, with severe burn criteria, with the most common etiology is fire.
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Tyagi, Arnav, Manu Rajan, Sanjay Dvivedi, and Kinnari A. V. Rawat. "Clinical profile of patients with post burn contracture." International Surgery Journal 6, no. 1 (December 27, 2018): 126. http://dx.doi.org/10.18203/2349-2902.isj20185459.
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Background: Burns are a major, global public health problem, resulting in an estimated 195,000 deaths annually. Most burns occur in low-and middle-income countries, with almost half occurring in the south-east Asia region. The reasons for the high incidence include widespread ignorance of fire prevention, the rapid increase of poor socio-economic conditions, and the persistence of old traditions and customs.Methods: The study was carried out in Department of Surgery, Himalayan Institute of Medical Sciences, SRH University, Swami Ram Nagar, Dehradun over a period of 12months. Cases of the post burn contractures attended in the O.P.D were included in the study.Results: A total of 45 patients were included in the study. Of these, 22 (48.8%) were males and 23 (51.2%) were females. Ages ranged from 1 to 55year. Flame burn (20 cases = 44.4%) was the most common type of initial burn insult followed by scald burns (14 cases=31.1%).Conclusions: The pitfalls in initial burn care that lead to contractures in the patients include the failure to institute adequate surgical management of deep burns, the lack of physiotherapy/ROM exercises, and failure to provide proper anti-deformity splint age. There is need to revisit the prevalent acute burn care practices and establish focused preventive strategies.
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Vostrugina, Kristina, Daiva Gudavičienė, and Rytis Rimdeika. "Nudegimų gydymas pasireiškus bakteriemijai." Lietuvos chirurgija 3, no. 1 (January 1, 2005): 0. http://dx.doi.org/10.15388/lietchirur.2005.1.2328.
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Kristina Vostrugina, Daiva Gudavičienė, Rytis RimdeikaKauno medicinos universiteto klinikųPlastinės chirurgijos ir nudegimų skyrius,Eivenių g. 2, LT-50009 KaunasEl paštas: kristinavostr@mail.lt Tikslas Ištirti 1999–2003 m. Kauno medicinos universiteto klinikų Plastinės chirurgijos ir nudegimų skyriaus ligonių, kuriems patvirtinta bakteriemija, gydymo aspektus. Ligoniai ir metodai Atlikta retrospektyvi 82 nudegusių ligonių, kuriems patvirtinta bakteriemija, ligos istorijų analizė. Vertintas pacientų amžius, nudegimą sukėlę veiksniai, nudegimo plotas, kvėpavimo takų nudegimas. Analizuota, kokiam skaičiui pacientų reikėjo kateterizuoti centrines venas, prireikė dirbtinės plaučių ventiliacijos, enterinio ar parenterinio maitinimo, kokių radosi komplikacijų, kokie mikroorganizmai išaugo žaizdų pasėliuose ir toks jų sutapimas su kraujo pasėlių duomenimis, nagrinėti antibiotikų terapijos aspektai. Rezultatai Pacientų, kuriems patvirtinta bakteriemija, vidutinis amžius buvo 50 metų, standartinis nuokrypis – 16. Vyravo nudegimai liepsna (82%) ir skysčiais (8,5%). Vidutinis nudegusio kūno paviršiaus plotas buvo 29%, standartinis nuokrypis – 19. Centrines venas reikėjo kateterizuoti 78% pacientų. Dirbtinės plaučių ventiliacijos prireikė 13% pacientų. Enterinis maitinimas skirtas 48% pacientų, parenteriniu būdu maitinta 90% ligonių. Pneumonija nustatyta 29% pacientų, kardiovaskulinis nepakankamumas – 15%, dauginis organų funkcijos nepakankamumas – 13%, inkstų funkcijos nepakankamumas – 7% ligonių. Visais atvejais sutapo žaizdos ir kraujo pasėlių duomenys, kai iš kraujo išaugo Pseudomonas aeruginosa, 87% – kai išaugo meticilinui atsparus Staphylococcus aureus ir 74% – kai išaugo meticilinui jautrus S. aureus. Antibiotikais gydyta 80 ligonių, dažniausiai penicilinu, gentamicinu ir vankomicinu. Išvados Bakteriemija dažnai nustatoma didelius plotus nudegusiems ligoniams, kuriems tenka kateterizuoti centrines venas, skirti parenterinį maitinimą. Dažniausiai iš kraujo mėginių išauga tie mikroorganizmai, kurie auga žaizdų pasėliuose. Reikšminiai žodžiai: nudegimai, bakteriemija, antibiotikų terapija Treatment of burned patients with diagnosed bacteremia Kristina Vostrugina, Daiva Gudavičienė, Rytis RimdeikaKaunas University of Medicine Hospital,Department of Plastic Surgery and Burns,Eivenių str. 2, LT-50009 Kaunas, LithuaniaE-mail: kristinavostr@mail.lt Objective The aim of the study was to investigate the aspects of treatment of burned patients with confirmed bacteremia treated at Kaunas University of Medicine Hospital Department of Plastic Surgery and Burns during 1999–2003. Patients and methods A retrospective analysis of case histories of 82 burned patients with confirmed bacteremia was performed. The evaluated factors included the patients’ age, factors that caused the burns, the burned area, and burns of the airways. We also analyzed how many patients required catheterization of the central veins, artificial pulmonary ventilation, enteral or parenteral feeding, and complications, as well as what microorganisms grew in wound crops, how many cases corresponded to the blood crop findings, and the aspects of antibiotic therapy. Results Mean age of patients with confirmed bacteremia was 50 years, standard deviation (SD) – 16. Flame burns (82%) and scalds (8.5%) predominated. Mean burned body surface area was 29%, SD – 19. 78% of patients required catheterization of central veins, and 13% – artificial pulmonary ventilation. 48% of patients were fed enterally, and 90% – parenterally. 29% of patients had pneumonia, 15% – cardiovascular insufficiency, 13% – multiple organ failure, and 7% – renal failure. The coincidence of the findings of wound and blood crops was 100% in cases of Pseudomonas aueruginosa growth, 87% – in cases of methicillin-resistant Staphylococcus aureus growth, and 74% – in cases of methicillin-sensitive Staphylococcus aureus growth. 80 patients received antibiotics, mostly penicillin, gentamicin, and vancomycin. Conclusions Bacteremia was very common among extensively burned patients requiring catheterization of the central veins and parenteral feeding. In most cases, microorganisms that grew in wound crops also grew in blood samples. Key words: burns, bacteremia, antibiotic therapy
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Campbell, Stephanie, and Trina Andres. "98 A 10-year Retrospective Review of Older Adult Admissions at a Regional Burn Center." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S64—S65. http://dx.doi.org/10.1093/jbcr/iraa024.101.
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Abstract Introduction A verified regional burn center conducted a 10-year retrospective review of older adult patients admitted to the burn service. The primary goal of the review was to examine trends in mechanisms of injury, demographics, and outcomes to inform burn prevention programming. Methods Admission data from 2009–2018 was retrieved from burn center databases and combined into a Microsoft Excel spreadsheet. Older adults were defined as age 65 years and older. Patients admitted to the burn service for skin disorders or soft tissue infections were excluded. Patients with cutaneous burn injuries or inhalation only injuries were included. Results The total number of patients included was 697. Nearly a third of the patients were 65 to 69 years old, with incidence declining with each subsequent 5-year age group. Males accounted for 61.3% of admissions. Two thirds of the patients were White (67.6%). The other third consisted of Black (18.4%) and Hispanic (9.8%), Asian (1.9%) and Native American (0.14%) patients. Overall mortality was 14%. Mortality generally increased per 5-year age group: 65–69 (7.8%), 70–74 (10.6%), 75–79 (13.7%), 80–84 (20.6%), 85–89 (29.8%), 90–94 (24.2%), and 95–99 (42.9%). Baux scores ranged from 65 to 180. The highest Baux score that lived to discharge was 119. The average Baux score of the mortality group was 114 and the average of the lived group was 82. No patients with a Total Body Surface Area (TBSA) above 43% lived. Fire/flame burns accounted for 72.7%. Scald burns made up 19.9%, contact burns 3%, chemical burns 2.3% and electrical burns < 1%. Nearly a quarter (24.6%) of fire/flame burns were related to smoking on home oxygen therapy (HOT), which was also the overall most common mechanism at 17.8%. Other fire/flame mechanisms included housefires (21.2%), clothing catching on fire (16.9%), and gasoline-related injuries (11.7%). More than 70% of scald burns came from the three mechanisms: hot tap water, boiling water, and hot grease. For the mortality group, a third of patients had been injured in housefires (32.7%), followed by clothing catching on fire (17.4%) and HOT burns (12.2%). Conclusions Incidence rates decline with increasing age but mortality rates climb. Burn injuries with a TBSA greater than 40% are generally fatal in the older adult. Flame burns account for the majority of injuries with HOT and house fire injuries as the leading mechanisms. Scald burns were most often caused by hot tap water or boiling water. White older adults accounted for more than double the number of patients identified in all other races combined. Applicability of Research to Practice The demographics and mechanism of injury insight gained from this review can be utilized to inform prevention programming design in this region. Trends in mortality can help emphasize the seriousness of preventing older adult burn injuries and anticipate the mortality risk for older adults admitted to the burn center.
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Smith, Hannah, Scott R. Echternacht, and Derek Bell. "554 Severity of Gasoline Burns: A Retrospective Review." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S117—S118. http://dx.doi.org/10.1093/jbcr/iraa024.182.
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Abstract Introduction Gasoline burns represent a significant source of preventable morbidity each year. Often used inappropriately as an accelerant, gasoline is substantially more volatile than other commonly used accelerants due to its low flash point and vapor pressure. We sought to review the clinical outcomes for patients presenting with burns caused by gasoline accelerated flame. Methods An IRB exempt retrospective study of consecutive patients presenting from 2010–2017 to a single ABA verified institution was performed. Exclusion criteria included ultraviolet burns, allergic reactions and Stevens-Johnson Syndrome. Collected patient demographics included age and gender. The primary clinical endpoint was percent total body surface area (%TBSA) burned, delineated into second or third degree burn. Secondary endpoints included length of stay (LOS), days admitted to the intensive care unit (ICU), and mortality. Kruskal-Wallis Test and Wilcoxon Rank Sum Test were used for statistical comparison between the etiologies of burns. Fisher’s Exact test was used for comparison of mortality rates using a Bonferroni correction accounting for nine pairwise comparisons. Results A total of 5,994 patients were included; 256 with burns from gasoline fueled flame and 5,738 from other etiologies including flame with other accelerants, flame, scald, contact, electrical, chemical, friction, radiation, and frostbite. Gasoline burns resulted in a higher %TBSA of second degree burns (x̅=4.37%: 95% CI 3.62–5.12; p < 0.001; Table 1) and higher overall %TBSA (x̅=4.94%: 95% CI 3.99–5.88; p < 0.001; Table 2) than burns of all other etiologies except radiation burns where no statistically significant difference was found. Gasoline burns had a lower percent mortality (0.39%) than flame burns (4.98%; p< 0.05) and showed no statistically significant difference in mortality rate compared to other etiologies of burns. Comparison of second degree measures of LOS and number of ICU days yielded mixed results and lacked statistical significance. Conclusions Patients with burns caused by gasoline accelerated flame sustain a higher %TBSA of second degree burns and overall %TBSA than all other etiologies of burns except radiation burns. Applicability of Research to Practice Our results highlight the extent of burns caused by gasoline accelerated flame and underscore the importance of public education to reduce the inappropriate use of gasoline as an accelerant with the ultimate goal of reducing the significant morbidity associated with these burns.
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Alegbeleye, Bamidele Johnson. "Childhood burns in Shisong, Northwestern Cameroon." Iberoamerican Journal of Medicine 2, no. 2 (March 9, 2020): 49–54. http://dx.doi.org/10.53986/ibjm.2020.0011.
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Objective: The study aimed to highlight the pattern and treatment outcome of childhood burn injuries in northwestern Cameroon. Such reports are expected to provide preventive and improvement guidelines in our settings in the long run. Methods: Forty-two consecutive patients under fifteen with burns injuries managed at our facility were prospectively enrolled in the study. Results: The study population was 42 patients, which consisted of 23 (54%) male and 19 (46%) female, with the median 2.40±3.05 years, interquartile range of 1-14 years. The most frequent timing of burns was about mid-day (median 11:50 am). The majority of injuries were right at the patient's homes (70% cases). Interestingly, 4%, 15%, and 20% applied raw-egg, ice, and nothing as the first intervention for their children burns, respectively. Scald burns were the leading category of wounds (p<0.012). The majority of the cases were minor burns injuries with TBSA of 1-12% (p=0.002), with a mortality rate of 4%. Conclusion: Burns is still a significant health problem among children in northwestern Cameroon. Considering the application of raw egg and others like local herbs, therefore pre-hospital interventions may be harmful in our settings. Early and prompt response may be desirable, with strong advocacy for aggressive and urgent public health enlightenment campaigns on the prevention of childhood.
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Nathan, Shelby, Autumn D. Nanassy, Brooke A. Burkey, Wellington J. Davis, and Paul M. Glat. "The management of paediatric burns with Burns and Wounds ointment and burdock leaves: a case series." Journal of Wound Care 29, Sup5a (May 1, 2020): S30—S35. http://dx.doi.org/10.12968/jowc.2020.29.sup5a.s30.
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Objective: In the Amish community, natural therapies, such as Burns and Wounds (B&W) ointment and burdock leaves, are preferred over modern medicine when treating burn wounds. The primary aim of this case series is to highlight the use and clinical outcomes of this treatment for paediatric Amish patients. Method: At the a paediatric burn centre, two patients were treated with B&W ointment and burdock leaves. The first patient was 11 months old with 17% total body surface area (TBSA) partial and full-thickness scald burns to her lower extremities. The second patient was 24 months old with 20% TBSA partial-thickness scald burns to the torso, bilateral upper extremities, neck and chin. Results: Soon after presentation to the hospital, both patients developed positive wound cultures and required cessation of ointment and burdock leaf therapy. Both patients ultimately underwent surgical interventions. Conclusion: Managing burn wounds with B&W ointment and burdock leaves should be considered as an additional option for wound care in select cases. However, the efficacy of this therapy is limited and standard-of-care modern medical burn treatments should remain an option for these patients. It is critically important to build a mutually respectful relationship with Amish patients' community leaders, as this allows open communication and collaboration in patient care and increases the likelihood that Amish guardians will bring their children to a hospital when necessary.
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Mehta, Kajal, Nikitha Thrikutam, Kiran K. Nakarmi, Paa Ekow Hoyte-Williams, Michael Peck, and Barclay T. Stewart. "74 Epidemiology and Outcomes of Cooking and Cookstove-related Burn Injuries: A World Health Organization (WHO) Global Burn Registry (GBR) Report." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S51—S52. http://dx.doi.org/10.1093/jbcr/irab032.078.
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Abstract Introduction Cooking- and cookstove-related burns (CSBs) comprise a large proportion of burn injuries globally. A cookstove is any apparatus that provides heat and is used for cooking (e.g., three-stone fire, traditional or improved cookstove). There are limited data on patterns of cooking behaviors and CSBs to inform prevention initiatives and advocacy. We aimed to describe the epidemiology, risk factors and outcomes of cooking-related burns and CSBs, specifically. Methods Patients with cooking and non-cooking related burns from 2018 to 2020 were identified in the World Health Organization (WHO) Global Burn Registry (GBR). Patient demographics, cooking arrangement, injury characteristics [mechanism, total body surface area (TBSA), revised Baux score] and outcomes were described. Differences in proportions and medians were compared. Bivariate regression was performed to identify risk factors associated with occurrence of CSB. Results GBR contained data of 6,965 burn-injured patients from 17 countries; 88% were from middle-income countries. One quarter of burn injuries (1,723 burns) were cooking-related. More than half of cooking-related burns (55%) occurred in females. Median age for cooking-related burns was 11 years (IQR 2–35). Of cooking-related burns, 22% were cookstove-related burns (CSBs; 311 burns). The most common mechanism in CSB was flame (87%), whereas the most common mechanism in other cooking burns was scald (62%). Patients with CSBs were more often female (65% vs 53%; p< 0.001) and much older than patients with other cooking burns (32 years, IQR 22–47 vs 5 years, IQR 2–30). CSBs were significantly larger in TBSA size (30%, IQR 15–45% vs 15%, IQR 10–25%; p< 0.001), had higher revised Baux scores (70, IQR 46–95 vs 28, IQR 10–25; p< 0.001) and more often resulted in death (41 vs 11%; p< 0.001) than other cooking burns (Table1). Patients with CSBs were more likely to be burned by fires (OR 4.74; 95% CI 2.99–7.54) and explosions (OR 2.91, 95% CI 2.03–4.18) than other cooking injuries. Kerosene had the highest odds of CSB than all other cooking fuels (OR 2.37, 95% CI 1.52–3.69). Conclusions Cooking-related burns are common and have different epidemiology than CSBs, specifically (e.g., more often female, older, larger burn size, higher mortality). CSBs were more likely caused by structural factors (e.g., explosion, fire) than behavioral factors (e.g., accidental movements) when compared to other cooking burns.
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Sándor, George Kb, Howard M. Clarke, Hugh G. Thomson, and Ronald M. Zuker. "Pediatric Burns: A Decade Later." Canadian Journal of Plastic Surgery 5, no. 4 (December 1997): 210–12. http://dx.doi.org/10.1177/229255039700500404.
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The Hospital for Sick Children, Toronto, Ontario serves as a regional pediatric burn centre for metropolitan Toronto and the province of Ontario. The demographics and outcomes of the admissions of burn patients are reviewed periodically to help in future planning of resources and preventive strategies. This study was designed to review recent admissions and detect trends of the past decade by comparing admission and outcome data from two cohorts: one from 1986 to 1988 and one from 1977 to 1979. The number of admissions increased during the past decade. There was a lower proportion of patients with flame burns and a higher proportion with scald burns. This may be due to a combination of preventive measures and changing demographics. The overall mortality rate decreased from 2.2% in the previous decade to 0.78% in the past decade.
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Choi, Katherine J., Christopher H. Pham, Clifford C. Sheckter, Zachary J. Collier, Haig A. Yenikomshian, Warren L. Garner, and Justin Gillenwater. "806 Foot burns in diabetic patients: A systematic review." Journal of Burn Care & Research 43, Supplement_1 (March 23, 2022): S209. http://dx.doi.org/10.1093/jbcr/irac012.355.
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Abstract Introduction Patients with diabetes are prone to foot injuries and burns. Managing burned feet in patients with diabetes can be difficult due to multiple concomitant patient comorbidities that delay wound healing. Burn surgeons tasked with treating these complex foot burns understand that these patients are at risk of developing significant complications, such as infections and non-healing diabetic foot ulcers, which may ultimately lead to amputation. Although there are many studies that examine the causes and outcomes of diabetic foot ulcers and their management, there is a lack of consensus on how to best manage lower extremity burns in patients with diabetes. Methods A systematic review was performed according to PRISMA criteria and identified 18 articles addressing the management of burned feet in patients with diabetes. Means and standard deviations of scale variables and frequencies derived from nominal and ordinal variables abstracted from the literature were compared between each group. A meta-analysis was attempted but existing data was not of sufficient quality for meaningful analysis, and data aggregation was done where applicable. Results The three-database search identified 726 articles, which yielded 18 full text articles that met inclusion criteria. mean age of patients was 54 years (SD 7), and 80% (n=203) were male. Most (90%, n=179) had type II diabetes, and 10% (n=20) had Type I diabetes. Mean duration of diabetic disease was 11 years (SD 4), and mean A1c at admission was 9% (SD 1). Peripheral neuropathy (64%, n=123) was the most common comorbidity. Median TBSA burned was 2% (IQR 2), and scald (56%, n=155) was the most common mechanism of injury. Full thickness burns (70%, n=102) were most common, followed by partial thickness (28%, n=41), and superficial thickness (2%, n=2). A majority (55%, n=88) had burn wound infection identified at admission. Patients had a median delay in presentation from time of injury to hospital admission of 4 days (IQR 4.5). Sixty percent of patients received surgical treatment via excision and grafting, had a median length-of-stay of 20.5 days despite a median total body surface area involvement of 2%, and experienced sequelae of impaired wound healing such as infections, graft loss, and need for further surgery. Ultimately, 23% of patients had significant wound healing issues that resulted in amputation. Conclusions Excision and grafting may not be the optimal approach for managing foot burns in patients with diabetes, many of whom are at high risk of amputation. Non-operative management of foot burns in patients with diabetes should be explored as a method to decrease amputations in patients with foot burns.
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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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Macedo, Jefferson Lessa S. de, Simone C. Rosa, and Cleudson Castro. "Sepsis in burned patients." Revista da Sociedade Brasileira de Medicina Tropical 36, no. 6 (December 2003): 647–52. http://dx.doi.org/10.1590/s0037-86822003000600001.
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A prospective study was conducted from June 2001 to May 2002 at the Burns Unit of Hospital Regional da Asa Norte, Brasília, Brazil. During the period of the study, 252 patients were treated at the Burns Unit, 49 (19.4%) developed clinically and microbiologically proven sepsis. Twenty-six (53.1%) were males and 23 (46.9%) females with a mean age of 22 years (range one to 89 years) and mean burned body surface area of 37.7 ± 18.4% (range 7 to 84%). Forty-three patients had flame burns, five a scald and one an electric burn. These 49 patients had a total of 62 septic episodes. Forty (81.6%) patients had only one and nine (18.4%) had up to three episodes of sepsis. Thirty (61.2%) patients had their first septicemic episode either earlier or by one week postburn. Out of 62 septic episodes, 58 were due to bacteria and four due to Candida sp. The most common bacteria isolated from blood culture were Staphylococcus aureus, coagulase-negative Staphylococcus, Acinetobacter baumannii, Enterobacter cloacae and Klebsiella pneumoniae. Eleven (18.9%) episodes were due to oxacillin resistant Staphylococcus aureus. Acinetobacter baumannii was sensitive to ampicillin/sulbactam in 71.4% and to imipenem in 85.7% of the cases. The primary foci of sepsis were the burn wound in 15 ( 24.2% ) episodes. The most common clinical findings of sepsis in these patients were fever, dyspnea, hypotension and oliguria. The most common laboratory findings of these patients were anemia, leukocytosis, hypoalbuminemia and thrombocytopenia. Twelve (24.5%) patients died. The appropriate knowledge of clinical, epidemiological, laboratorial and microbiological aspects of sepsis in burned patients permits an adequate diagnosis and treatment of this complication.
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Satish Gadade and Monali Sonawane. "Duration of stay and outcome in different types of burn cases in paediatric age group." World Journal of Advanced Research and Reviews 8, no. 3 (December 30, 2020): 104–7. http://dx.doi.org/10.30574/wjarr.2020.8.3.0467.
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The incidence of burns, their treatment and rehabilitation have considerably marked effect on children both physically and psychologically. The hospital stay and the outcome also important in the cases of burns patients because the socio economic status and chances of life long disability. Aim of the study is to analyze the duration of stay and outcome in different types of burn cases in paediatric age group. The Data was collected from 83 paediatric patients less than 15 years admitted in GMC, Miraj, Maharashtra during the period from September 2014 to September 2016. The overall length of stay at hospital, factors influencing length of stay and outcome of patients were analyzed. Out of 83 patients 50 percent was cured over the period of time. The death rate was 10.8%.Lower the percentage of burns had good outcome and higher percentage of burns had poor outcome (66.7% had mortality when burns was >60%). In the study 30% patients were cured with duration of stay 6 to 10 days. Out of subjects who died 44.4% stayed for less than 5 days in hospital, as they were having more % of burn area. Also 72.7% patients who improved was stayed < 5 days. Subjects cured in scald and flame burn were 60.66% and 59.1% respectively with no significant difference, while subjects died in scald and flame burn 6.56% and 22.72% respectively more in flame burn. In our study 8.4% of subjects underwent Escharotomy. It is concluded that surgical intervention increases the hospital stay and outcome of the mean duration of stay was high among subjects who deteriorated, followed by cured subjects. Lowest duration of hospital stay was observed among improved subjects, as they were having lower percent total body surface area (TBSA) burn. More hospital stay increase the chance of infections and vice versa.
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Allen, Courtney E., Janet Figueroa, Maneesha Agarwal, and Wendalyn K. Little. "Pediatric Scald Injuries Sustained From Instant Soup and Noodle Products." Clinical Pediatrics 60, no. 1 (July 25, 2020): 16–19. http://dx.doi.org/10.1177/0009922820944394.
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Background and Objective. Scald burns are a major cause of pediatric burn injuries. Instant soups have been identified as one source of these injuries. This study aims to quantify and characterize these injuries in pediatric patients. Methods. Ten-year query of National Electronic Injury Surveillance System (NEISS) database identified instant soup- and noodle-related scald burns in children aged 4 to 12 years. Data included patient demographics, injured body part, case narratives, and emergency department disposition. Results. A total of 4518 cases were identified, yielding an estimate of 9521 cases/year in the United States. Younger children were affected more than the older. Trunk was the most commonly burned body area. Approximately 10% of injuries required admission or transfer for further care. Conclusion. Instant soup and noodle products are a common cause of pediatric scald burns, potentially injuring 25 children per day in the United States and leading to high rates of health care utilization.
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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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U. Nnadozie, Ugochukwu, Charles C Maduba, Gabriel M. Okorie, Lucky O. Lawani, Anikwe C Chidebe, Obiora G. K Asiegbu, and Amaechi Ugbala. "Burns in pregnancy: Five-year experience in a tertiary hospital in southeastern Nigeria." Malawi Medical Journal 33, no. 3 (September 27, 2021): 204–9. http://dx.doi.org/10.4314/mmj.v33i3.8.
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BackgroundBurns in pregnancy is often associated with high maternal and fetal morbidity and mortality especially when the total burn surface area (TBSA) involved is high. This study aims to review management outcome of cases of burns in pregnancy at Alex Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA).MethodsA five year retrospective study of all pregnant women that presented at AE-FUTHA with burn injury between April 2014 and March 2019. Information was collected from the medical records using a proforma and analyzed with IBM SPSS Statistics version 20.0 (IBM Corp., Armonk, NY, USA) using descriptive statistics.ResultsA total of 222 cases of burns were managed but only 8 were pregnant, giving an incidence of 3.6%. The commonest causes were flame (62.5%), scald (25%) and friction (12.5%) occurring mostly during the harmattan season. The median age of participants was 25-34 years. The burns affected 12.5% of the patients in the first trimester and 62.5% and 25% in the 2nd and 3rd trimesters respectively. Most patients (62.5%) had superficial burns while 25% had other associated injuries in addition to burns. About 87.5% had term spontaneous vaginal delivery. There was no maternal death but, there was an early neonatal death.ConclusionThe good outcome observed in this study with a 100% survival, could be explained by inter-disciplinary management approach given, even as most cases were minor degrees of burns. Early involvement of obstetricians in all burns affecting pregnant women is advised especially in burn centres where obstetricians are hardly in the employ.