Burns : journal of the International Society for Burn Injuries
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Low socio-economic status is thought to be associated with increased burn risk, however the significance and generalisability across different populations and cultures has been questioned. ⋯ This study specifically highlights patients under the age of 16 living in poorer socio-economic areas as the most at risk of suffering burns receiving hospital attention. This study demonstrates burns as a significant public health issue, and the results should aid in designing specific burn prevention strategies to target high-risk groups.
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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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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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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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Neutrophil gelatinase-associated lipocalin (NGAL) is a novel biomarker used in acute kidney injury (AKI) diagnostics. Studies on burn patients have highlighted it as a promising biomarker for early detection of AKI. This study was designed to discover whether plasma NGAL is as a biomarker superior to serum creatinine and cystatin C in detecting AKI in severely burned patients. ⋯ This study demonstrated serum creatinine and cystatin C as faster and more reliable biomarkers than plasma NGAL in detecting early AKI within one week of injury in patients with severe burns.