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Annals of Burns and Fire Disasters logoLink to Annals of Burns and Fire Disasters
. 2017 Dec 31;30(4):318–319.

International Abstracts

PMCID: PMC6033489
Ann Burns Fire Disasters. 2017 Dec 31;30(4):318–319.

A comparison of suicidal behaviour by burns five years before and five years after the 2011 Tunisian revolution

Mehdi Ben Khelil

The authors conducted a retrospective review of all cases of self-immolation suicides in Northern Tunisia five years before and five years after the January 2011 Revolution. The aim of the study was to compare the profile of these casualties over a period of 10 years (2006–2015). The study sample was subdivided into two groups according to the Revolution date: before the Revolution (2006–2010) and after the Revolution (2011–2015). For each group they compared data on age, gender, marital status, employment, mental disease history, previous suicide attempts and threats, place of suicide and its motive, the type of fire accelerator, hospitalization and the average body surface area burned. They found that the number of suicides by self-immolation tripled during the post-revolution period (2011–2015) with a stable trend. Fewer cases had a psychiatric history and there had been an increase in self-immolation episodes occurring in public places and in front of public administrations, as well as in suicides due to financial problems. They conclude that specific preventive measures should target young unemployed males.

References

Ann Burns Fire Disasters. 2017 Dec 31;30(4):318–319.

Partial-thickness scalds in children: a comparison of different treatment strategies

E De Graaf

The aim of this study conducted in The Netherlands was to compare the clinical outcomes of different treatment strategies for children with partial-thickness scalds. A two-centre retrospective study was conducted of children admitted between January 2009 and December 2013 for partial-thickness scalds up to 10% TBSA who were treated primarily with a hydrofiber dressing or silver sulfadiazine (Burn Center Rotterdam) vs. cerium nitrate-silver sulfadiazine (Burn Center Groningen). The primary outcome was the time to wound healing. The secondary outcomes were the length of hospital stay, wound infection and surgical treatment. A shorter time to wound healing was observed in the patients treated with CN-SSD. Patients treated with hydrofiber had a shorter clinical period in comparison with the SSD and CN-SSD patients. The authors conclude that a prospective study is needed to gain full insight into the merits and drawbacks of the treatment strategies.

References

Ann Burns Fire Disasters. 2017 Dec 31;30(4):318–319.

A simple mortality prognostic scoring system for burns

P Agarwal

This prospective study was conducted in a plastic surgery unit in a government medical college in Central India. One hundred and eighty-two consecutive patients with burns undergoing treatment in the unit were studied prospectively. Multiple logistic regressions were used to assess the predictive power of each prognostic variable. A simple scoring system was constructed using the four most powerful, but easy to calculate, prognostic factors. This system was then prospectively validated in the next 122 consecutive patients. On multivariate analysis, total body surface area, percentage full thickness burn area, presence of inhalation burn, and serum creatinine were found significant predictors of mortality. The authors conclude that the Jabalpur prognostic scoring system for burns is a simple, accurate system for objectively estimating the probability of death in their burn unit using only four parameters which can be noted simply and objectively; the score can be calculated at the bedside in the smallest hospital in a similar age group of patients and with similar treatment modalities in a developing country, where burn-ICU facilities and sophisticated investigations are lacking.

References

  • 1.Agarwal P. Indian Journal of Burns. 2017;25:26–32. [Google Scholar]
Ann Burns Fire Disasters. 2017 Dec 31;30(4):318–319.

A retrospective study determining the necessity of portable heating devices during transit between theatre and itu for burns surgery in order to prevent hypothermia

O Pujji

The aim of this study conducted at the Queen Elizabeth Hospital in Birmingham, UK, was to determine the need for portable heating devices during transit from theatre to the ITU post burns surgery to prevent hypothermia. The authors compared last recorded core body temperature with first recorded core body temperature in the ITU by examining the anaesthetics charts and critical care notes. Out of a total of 25 transits, 12 showed a temperature increase, 12 showed a temperature decrease, and one showed no change in temperature. The total average temperature change for all 25 patients was a temperature drop of 0.225°C. Three transits resulted in hypothermia. The authors conclude that the need for portable heating devices would not be warranted in their centre as there is adequate prevention of hypothermia both intraoperatively and postoperatively. However, rigorous temperature monitoring is recommended.

References

  • 1.Pujji O. International Journal of Surgery. 2017;47(1):S65. [Google Scholar]
Ann Burns Fire Disasters. 2017 Dec 31;30(4):318–319.

Screening nasal swabs for methicillin resistant staphylococcus aureus: a regional burn center’s experience

S Tejiram

The aim of this study was to examine the utility of admission MRSA screening nasal swabs and determine if being positive for MRSA on admission impacted outcomes. The authors conducted a retrospective review of burn patients who presented to a single regional burn centre between June 2012 and December 2014. Electronic medical records and charts were reviewed for patient demographics and management. MRSA screening swabs were obtained from the anterior nares of burn patients upon admission. Overall length of stay, ICU admission and length of stay, mechanical ventilation, procedure count, time to excision, and wound complications after normalizing to total body surface area burn size (%TBSA) were analyzed. Four percent of the patients who received a MRSA screening nasal swab upon admission screened positive for MRSA. These burn patients had greater lengths of stay, more surgical procedures, and higher wound complications. The authors conclude that early identification of MRSA colonized patients in this patient population might allow for treatment modifications that improve outcomes.

References

Ann Burns Fire Disasters. 2017 Dec 31;30(4):318–319.

MR-proADM: a new biomarker for early diagnosis of sepsis in burned patients

J Gille

The objective of this study was to evaluate burn injury-mediated changes in MR-proADM levels and the diagnostic performance of MR-proADM in comparison to PCT in cases of systemic infection. In a prospective observational study, the authors included 42 patients with a TBSA burn >15% admitted within 24 hours after trauma to a regional burn centre from February 2009 until September 2010. Daily blood specimens collected over the initial 20 days of treatment were submitted for laboratory analysis of MR-proADM and procalcitonin (PCT). In patients without sepsis, an initial increase in MR-proADM and PCT levels was noted post-burn injury, peaking on the second day post-admission and thereafter demonstrated a continued decline in MR-proADM and PCT levels. In those patients who went on to develop sepsis, the levels of MR-proADM and PCT were significantly higher (P < .001) on days categorized as septic, than on days categorized as non-septic. The increase in PCT levels was noted on the first day to be categorized as septic. In contrast, the MR-proADM levels demonstrated an increase one day earlier. The optimal relationship between the specificity and sensitivity of MR-proADM and PCT for the detection of sepsis was an increase of 31% and at least 0.015 nmol/L (area under curve 0.76) or of >39% and at least 0.15 µg/L (area under the curve 0.83), respectively. Burn injury is associated with increased levels of MR-proADM. Subsequent increases may be considered as diagnostic of sepsis onset. In this context, PCT displayed higher specificity and sensitivity, while MR-proADM may be more suitable for the early recognition of sepsis.

References

  • 1.Gille J. Journal of Burn Care & Research. 2017;38(5):290–298. doi: 10.1097/BCR.0000000000000508. [DOI] [PubMed] [Google Scholar]
Ann Burns Fire Disasters. 2017 Dec 31;30(4):318–319.

Basic burns management e-learning: a new teaching tool

FM Egro,

A recent study conducted by the author of this article showed a major lack of burns teaching in the United Kingdom, with only 13% of medical schools providing structured burns teaching. In this article, he presents the steps taken to develop a free purpose-built e-learning tutorial that aims to provide key knowledge to medical students and medical personnel regarding the presentation, diagnosis, and initial management of patients with burns. A 33-webpage e-learning was created, covering topics such as local and general response to burns, assessment of burns, first aid, primary and secondary survey, and referral guidelines. Medical student satisfaction was then evaluated using a 12-question feedback survey based on a Likert scale from 1 (very poor) to 5 (very good). The majority of students (72%) would be interested in having an e-learning module on basic burns management in their medical curriculum. The author’s objective is to encourage and help medical schools and burns consultants in the United Kingdom to incorporate a formal burns teaching session in their curriculum. He concludes that the “Basic Burns Management” e-learning tool can provide an efficient and effective means of information delivery to medical students and junior doctors, allowing easy and fast incorporation of burns teaching within the medical curriculum and in other medical teaching settings.

References

  • 1.Egro, F.M. Journal of Burn Care & Research. 2017;38(4):e715–e721. doi: 10.1097/BCR.0000000000000462. [DOI] [PubMed] [Google Scholar]
Ann Burns Fire Disasters. 2017 Dec 31;30(4):318–319.

Revisiting escharotomy in patients with burns in extremities

ME Pereira Monteiro de Barros

This study aims to present a critical review of the literature on escharotomy to treat patients with burns, and to highlight a different strategy to perform escharotomy in patients with burned extremities. The authors conducted a critical review of articles in Pubmed/MEDLINE using the keywords “escharotomy” and “burns.” A total of 22 articles published from 1955 to 2015 (60 years) were selected. They analyzed the articles for information regarding the indication for escharotomy, the right time to perform it, the professional that should perform it, the anaesthesia protocol, the technique and complications related to escharotomy. With respect to the extremities, they found that most of the publications recommend that medial and lateral longitudinal incisions be performed and that care must be taken to avoid deep structures, particularly nerves. Moreover, the publications mention that escharotomy might result in thick, hypertrophic, retracting and painful scars. The authors advocate that incisions performed only on the lateral and medial borders of the extremities are usually unnecessary, and that they contribute to the creation of misconceptions about burns. In addition, these incisions can somehow trigger complications that can be avoided by using the concept of escharotomy in multiple directions, as highlighted in this review.

References

  • 1.Pereira Monteiro de Barros M.E. Journal of Burn Care & Research. 2017;38(4):e691–e698. doi: 10.1097/BCR.0000000000000476. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Burns and Fire Disasters are provided here courtesy of Euro-Mediterranean Council for Burns and Fire Disasters (MBC)

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