Burns : journal of the International Society for Burn Injuries
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Review Case Reports
Sarcoma developing in a burn scar: case report and review of the literature.
The development of malignancy in burn scars is a well known entity. However, burn scar sarcomas are rarely seen. This report presents the first case of a leiomyosarcoma arising in a burn scar of scalp in the English literature.
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Review Case Reports
Burn scar carcinoma with longer lag period arising in previously grafted area.
A case of Marjolin's ulcer that arose in previously grafted area of right ankle 55 years after initial burn injury was managed by below knee amputation and right inguinal lymph node dissection. The characteristics of this malignancy were reviewed, and rarely seen features particular to this case, which are a longer lag period and rapid growth in a previously grafted area, were discussed.
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Rhabdomyolysis due to flame burns is not well described. A case of fatal rhabdomyolysis in an epileptic patient who sustained 65 per cent body surface area, very deep, flame burns is described. It appears as if the sustained muscle compression from the restrictive, circumferential eschar was the major factor in the aetiology of the rhabdomyolysis. ⋯ It would seem as if rhabdomyolysis following extensive full thickness burns may be more common than previously suggested. Fluid requirements are in excess of those proposed by traditional protocols. Rhabdomyolysis in flame burn patients indicates a poor prognosis.
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Opiates remain the most common form of analgesic therapy in the burn patient today. Because of increased opiate requirements, optimal relief of burn pain continues to be a problem for these patients. The purpose of this article is to summarize those alternative pain control methods that appear in the literature. ⋯ Ketamine has been extensively used during burn dressing changes but its psychological side-effects have limited its use. Clonidine, however, has shown promise in reducing pain without causing pruritus or respiratory depression. Other forms such as transcutaneous electrical nerve stimulation (TENS), psychological techniques, topical and systemic local anaesthetics are also useful adjuncts.