Burns : journal of the International Society for Burn Injuries
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Sixty-four patients with electrical burns were admitted to the Department of Plastic Surgery, Ibn Sina Hospital, Kuwait during the past 6 years. There were 1202 admissions during this period, the incidence of electrical burns being 5.3 per cent. Sixty-nine per cent of the patients sustained injury from direct contact with live electrical wire, the remaining 31 per cent sustained flash burns. ⋯ A total of 65 operations was carried out in 39 patients. Twenty of these patients had repeated debridements until the wound was ready for coverage. All 64 patients survived.
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A prospective study of burn wound sepsis was carried out on 31 consecutive patients with fresh burns. Wound swab cultures were assessed at weekly intervals for 5 weeks. The study revealed that while 96.7 per cent of burn wounds were sterile on admission, bacterial colonization reached 80.6 per cent within the first week after admission. ⋯ The antibiotic sensitivity pattern showed resistance of most of the organisms to ampicillin. Only 15 per cent of staphylococci were sensitive to cloxacillin. Most of the organisms cultured (93.5 per cent) were sensitive to ceftazidime.
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Comparative Study
Effect of cerium nitrate-silver sulphadiazine on deep dermal burns: a histological hypothesis.
Although there are excellent clinical results from using cerium nitrate plus silver sulphadiazine in the treatment of deep dermal burns in our burn centre, its mechanism of action remains unexplained. We set up a prospective study to establish a hypothesis which could explain the formation of the typical leathery crust. Burns treated with cerium nitrate plus silver sulphadiazine and silver sulphadiazine alone were compared histologically and metallurgically. ⋯ No calcium was detectable in biopsies from silver sulphadiazine-treated wounds. No major toxicological side-effects were seen during this study. The clinical results were favourable, as have been reported previously.
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The results of microbiological tests performed in a burns unit between January 1989 and December 1990 have been analysed. Burn wound swabs and biopsies, blood cultures, central venous and urinary catheters, bronchial aspirates, pharyngeal swabs and faecal cultures for a total of 7950 examinations were considered. ⋯ The antibiograms have shown a low efficacy rate of cephalosporins, even of the latest generation, while with Gram-positive isolates the highest rates of activity were recorded by vancomycin and teicoplanin (100 per cent sensitivity). The situation seems better with Gram-negative organisms since they appear to be sensitive to a larger number of antimicrobial agents.