Burns : journal of the International Society for Burn Injuries
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Editorial
TG (Tri-Goniometry) technique: Obtaining perfect angles in Z-plasty planning with a simple ruler.
The Z-plasty is used frequently in hand surgery to release post-burn scar contractures. Correct angles and equalization of each limb are the most important parts of the Z-plasty technique. ⋯ These angles are important when elongating a contracture line or decreasing tension. Our method uses only trigonometry coefficients and a simple ruler, which is easily obtained and sterilized, enabling surgeons to perform all types of Z-plasty perfectly without measuring angles using a goniometer.
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A 44 years old male patient had suffered extensive 3rd degree burns on both legs, undergoing thorough surgical debridement, resulting in both tibias being exposed. Approximately 5 months after the incident he was referred to the Department of Plastic and Reconstructive Surgery of the University Hospital Gent, Belgium, to undergo flap reconstruction. Free flap surgery was performed twice on both lower legs but failed on all four occasions. ⋯ One week after the last Glyaderm(®) application both wounds were autografted. The combination of an acellular dermal substitute (Glyaderm(®)) with negative pressure wound therapy and skin grafting proved to be an efficient technique to cover a wider area of exposed tibial bone in a patient who was not a candidate for free flap surgery. An overview is also provided of newer and simpler techniques for coverage of exposed bone that could question the universal plastic surgery paradigm that flap surgery is the only way to cover these defects.
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Acinetobacter baumannii is one of the important causes of nosocomial infection especially in burn patients. So, carbapenemase producing strains can make serious therapeutic problems. Molecular epidemiology studies play key role in decreasing the incidence of carbapenemase producing strains. ⋯ The results of this study were showed the presence of certain clonal groups in two different wards of hospital indicating the spread of carbapenemase producing A. baumannii. On the other hand, the results showed the more discriminating power for PFGE.
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One of the most common and potentially fatal complications in critically ill burns patients is catheter related bloodstream infection (CR-BSI). Lack of in situ diagnostic techniques requires device removal if CR-BSI is suspected with 75-85% of catheters withdrawn unnecessarily. ⋯ Both DTP and SQSC displayed high specificity, NPV and accuracy in a population of adult burns patients. These features may make these tests useful for ruling out CR-BSI in this patient group. This study was limited by a low number of events and further research is required.
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Burns and subsequent contractures are common in developing nations. Contracture release is performed to treat such patients with functional limitations. The aim of this study is to evaluate post-operative functional and psychosocial outcomes following contracture release in a mission setting. ⋯ Patients SF-36 and WPI scores improved following burn contracture release, confirming both functional and psychologic improvement following surgery. During the acute post-operative period, this study suggests that contracture release in a mission setting is of benefit to patients.