Burns : journal of the International Society for Burn Injuries
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This study assessed the feasibility of performing early tangential excision and skin grafting for burn wounds 'routinely' in a developing country. An analysis of mortality, morbidity and hospital stay was carried out for 90 burns patients with deep partial skin loss burns out of 202 admissions, who underwent 'early' tangential excision and skin grafting. Overall survival rate was 86.5 per cent. ⋯ Morbidity for contractures and hypertrophic scars was nil to minimal. The mean hospital stay for adult patients with major burns was 30 days, with minor burns it was 18.7 days. We conclude that in developing countries, early tangential excision and skin grafting can and should be done routinely for all minor burns and for the major burns who are admitted to a well-equipped burns centre, but not for very 'extensive burns', until biological skin substitutes are more readily available.
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Meningococcal septicaemia is a severe systemic illness which has an overall mortality of 15 per cent. It differs from meningococcal meningitis in clinical presentation, treatment, complications and prognosis. Skin and extremity loss are particular problems seen in meningococcal septicaemia. ⋯ We also discuss some of the pathophysiology behind skin necrosis. A popular view at present is that endotoxin from the cell wall of Neisseria meningiditis initiates the release of vasoactive cytokines by the host. High levels of interleukin-1 and interleukin-6 have been associated with a greater likelihood of fatality.
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A 22-year-old man sustained 35 per cent burns to his skin and an inhalation injury in an industrial accident involving acetic anhydride. Although the skin burns healed following irrigation and conservative treatment, the inhalation injury proved fatal.
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Colonization of burn wounds by beta-haemolytic streptococci can lead to the loss of autografts. The present study investigated the beta-haemolytic streptococcal infections in burned patients treated in the Burns Centre of the Emergency Medical Institute 'N. I. ⋯ The sources of the streptococcal infections were found in 26 (29.2 per cent) of the patients. Epidemiological relationships were established between the strains from one source and the wound swab. For the successful treatment of beta-haemolytic streptococcal infections in burns it is essential to bear in mind the role of non-group A beta-haemolytic streptococci (45.3 per cent according to our study).
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The incidence of non-accidental injury in burned children and the repeat injury rate following non-accidental injury is very high according to some reports. A retrospective follow-up review was undertaken for all patients admitted to the Plymouth Paediatric Burns Unit over a 47-month period. Hospital records, general practitioners' records and the Social Services Department were used to gain follow-up information. ⋯ The repeat injury rate was very low indeed. These figures are very much lower than many of the published figures. This may be due to differences in the definition of non-accidental injury, differences in the population make-up or simply that a burn injury is a relatively uncommon form of non-accidental injury in Devon and Cornwall.