Burns : journal of the International Society for Burn Injuries
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Full skin thickness burns covering 35 per cent of the total body surface of rabbits were followed by measurements of Na-K ATPase and arterial blood gas analyses, before and after the burn injury. Studies of the effects of intravenous fluids with different compositions showed that the active transport of the cell membrane was depressed in vivo immediately after a burn injury, mainly due to acidosis. ⋯ However, an improvement was observed in those groups given the 'Enriched Lactate Solution' (ELS) containing large quantities of lactate as the base source. These results suggest that ELS, which positively corrected acidosis in accordance with its concentration, is very effective and more appropriate than the conventional lactated Ringer's solution for early burn resuscitation.
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Microstomia may be a disfiguring complication of severe burn injuries of the soft tissues of the face. The constriction of the perioral myocutaneous tissues following such trauma poses several problems and usually necessitates major plastic and reconstructive intervention. A novel technique is described which limited the anticipated constriction of perioral tissues in a 21-year-old female who suffered full skin thickness burns to 65 per cent of her body, including her face, following a self-induced petrol burn.
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This is an epidemiological survey of 105 burned patients treated between May 1986 and May 1988 in a modern Burns Unit in Saudi Arabia. Hospitalization time ranged from 1 to 100 days with a mean of 17 days. The mean age of the patients was 9 years. ⋯ Five patients died. The favourable results in this series were attributed mainly to the low severity of burns and partially to the short delay between injury and admission, early surgery and remarkably good facilities. Childhood scalds in this region of the world could possibly be reduced by changing the family habit of having tea at floor level and recommending wide-based tea-pots.
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Silver sulphadiazine 1 per cent (SS), silver sulphadiazine 1 per cent plus chlorhexidine digluconate 0.2 per cent (SS + CD 0.2 per cent) and mafenide acetate 8.5 per cent (MA) were compared to assess the antibacterial effect of once daily application on experimental rat 20 per cent full skin thickness burn wounds seeded 24 h earlier with 10(8) microorganisms originally isolated from infected wounds of burned patients. Separate series evaluated Staph. aureus, Enterococcus faecalis, Enterobacter cloacae and Ps. aeruginosa. The mean concentration of all four organisms recovered after 1 week from full thickness biopsies of eschar and from separate biopsies of subjacent muscle was less in MA and SS + CD 0.2 per cent treated animals compared with those treated with SS alone. The mean concentration in muscle and eschar following treatment with MA was less for wounds seeded with Staph. aureus and Ps. aeruginosa than with SS + CD 0.2 per cent treatment, while the mean concentration in eschar application of SS + CD 0.2 per cent was less than with MA for E. faecalis seeded wounds.
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Between January 1980 and December 1989, a prospective study was carried out on 114 upper limbs in 90 patients, which were electrically burned with the wrist as the current entrance site. Based upon extensive clinical investigations of arterial injury and its adverse effect on hand circulation, a grading system is suggested for electrically injured wrists based on the severity of injury. ⋯ However, in subgroups of Type I to Type IV, the amputation rates were 0, 0, 80 and 100 per cent, respectively. A new method to repair the circumferential wound of an electrically burned wrist as well as to bypass the blood flow to the obstructed hand, using a pedicled greater omentum transfer and vascular anastomosis between gastroepiploic artery and the palmar artery, was successfully used in a Type III case.