1/197. Reliability of inferior pedicle reduction mammaplasty in burned oversized breasts.Heavy pendulous breasts cause physical and psychological trauma. Postburn deformity of breasts results in significant asymmetry, displacement of nipple-areola complex, due to burn scar contracture, and significant scarring; these factors add more psychological discomfort and subsequent behavioral changes. The use of the inferior pedicle procedure in burned breasts can solve many problems. The technique reduces the size of the large breast, eliminates the scar tissue by excising both medial and lateral flaps, and brings the mal-located nipple and areola to a normal position. This study stresses the possibility of harvesting the inferior dermal pedicle flap from within the postburn scar tissue without necrosis of the nipple and areola, because of the excellent flap circulation. Acceptable aesthetic appearance and retainment of nipple viability and sensitivity can be achieved with the inferior pedicle technique even with postburn deformity of the breast. The study was conducted on 11 women, all of whom had sustained deep thermal burns to the breasts and anterior torso and whose breasts were hypertrophied and pendulous.- - - - - - - - - - ranking = 1keywords = discomfort (Clic here for more details about this article) |
2/197. methods for identification of 28 burn victims following a 1996 bus accident in spain.A car collided head-on with a bus containing 56 passengers plus the driver. A few seconds after the crash, the bus caught fire and 28 persons (15 male and 13 female) lost their lives. All the deceased were almost completely incinerated. To establish the identity of the victims, the judge in charge of the case designated a multidisciplinary Identification Commission. Postmortem procedures included a general external examination, routine photographs, dental examination, dental (intraoral and extraoral) and general radiographs (chest, ankle, etc.), and complementary biological methods for identification (e.g., dna analysis). The antemortem information, including dental and medical records available, were transcribed onto the INTERPOL disaster victim identification forms. The detailed ante- and postmortem information were compared manually. In this disaster dental identity could be established in 57% of the victims, whereas dental evidence did not allow by itself the identification of 12 burned victims. Odontological examination and complementary radiographic procedures were found to be accurate, economic and rapid methods of identifying badly burned victims in this bus accident.- - - - - - - - - - ranking = 0.6916938217248keywords = pain, chest (Clic here for more details about this article) |
3/197. Patient-controlled analgesia in burn patients: a critical review of the literature and case report.Although patient-controlled analgesia has been well documented as effective in various types of patients, it has not been adequately studied in burn patients. In this paper, the authors review the literature on PCA in burn patients and present two cases. Flaws in most published studies make it difficult to determine the efficacy of PCA in burn patients. Both the literature and experience indicate that many patients with acute burns are not suitable candidates for PCA. The cases illustrate the different methods patients may use to achieve adequate analgesia with PCA. Both patients and nurses face a steep learning curve in using PCA for management of procedural pain in burn care.- - - - - - - - - - ranking = 0.15970534076233keywords = pain (Clic here for more details about this article) |
4/197. A silver-sulfadiazine-impregnated synthetic wound dressing composed of poly-L-leucine spongy matrix: an evaluation of clinical cases.The management of severe burns requires the suppression of bacterial growth, particularly when eschar and damaged tissue are present. For such cases, silver sulfadiazine (AgSD) cream has been traditionally applied. This antibacterial cream, however, cannot be used in conjunction with a temporary wound dressing that is needed to promote healing. The authors developed a synthetic wound dressing with drug delivery capability for clinical use by impregnating a poly-L-leucine spongy matrix with AgSD, which is released in a controlled, sustained fashion. In general, the dressing adhered firmly to the wound in the case of superficial second-degree burns, and during the healing process it separated spontaneously from the re-epithelialized surface. In the management of deep second-degree burns where eschar and damaged tissue were present, the dressing had to be changed at intervals of 3 to 5 days until it adhered firmly to the wound. Once the dressing had firmly attached to the wound, it was left in place until it separated spontaneously from the re-epithelialized surface. Dressing changes were fewer than with other treatments and the pain was effectively reduced. Cleansed wounds were effectively protected from bacterial contamination. Of 52 cases treated with this wound dressing, 93% (14/15) of superficial second-degree burns, 75% (3/4) of deep second-degree burns, 85% (6/7) of superficial and deep second-degree burns, and 75% (12/16) of split-thickness skin donor sites were evaluated as achieving good or excellent results.- - - - - - - - - - ranking = 0.15970534076233keywords = pain (Clic here for more details about this article) |
5/197. Reduction mammaplasty in postburn breasts.Thermal injury to the anterior chest in the adolescent girl can lead to severe disfigurement of the breasts. Just as in certain non-burn female patients, mammary hyperplasia can occur in patients with previous full-thickness burns of their breasts. Most plastic surgeons have been reluctant to perform reduction mammaplasty in these patients for fear of devascularizing the skin graft or the nipple-areola complex. A series of six patients with full-thickness burns of the breasts and subsequent skin graft coverage before reduction mammaplasty is reported. Four patients had bilaterally burned breasts requiring reduction. Two patients had one burned breast reduced, and one required a balancing procedure on the unburned side. Reduction mammaplasty was performed using the inferior-pedicle technique. The mean amount of tissue removed for the left and right breasts was 454 and 395 g, respectively. There was no nipple loss, hematoma, infection, or major loss of skin flaps. Reduction mammaplasty in this group of patients is safe and carries minimal risk if certain key concepts are followed carefully.- - - - - - - - - - ranking = 0.052872458675463keywords = chest (Clic here for more details about this article) |
6/197. Perianal and gluteal burns as a complication of hot water bottle treatment for anal fissure.Contact with hot objects and surfaces often causes burns. We present a case of burns to the buttock and perineum caused by use of a hot water bottle to relieve the pain caused by an anal fissure.- - - - - - - - - - ranking = 0.15970534076233keywords = pain (Clic here for more details about this article) |
7/197. The ping-pong ball microphone: facilitating speech for a patient with hand burns and a tracheostomy.patients who have sustained thermal injuries may require tracheostomies as a result of facial burns; these operations may also be required after prolonged intubation for smoke inhalation injury or respiratory failure. For a patient with a temporary tracheostomy, speech may be achieved by occluding the opening of the tracheostomy cannula with the tip of a finger, thereby directing airflow through the vocal cords and allowing phonation to be produced. However, some patients who also have hand burns may not be able to cover the opening of the tube because of the injuries to their fingers and the bulky dressings covering them. A simple tracheal occluder can be made out of a ping-pong ball and a syringe casing. The device presented in this article allows for the restoration of speech in the types of patients described above, and it promotes purposeful movement of their upper extremities.- - - - - - - - - - ranking = 0.10919508677787keywords = upper (Clic here for more details about this article) |
8/197. Herpetic tracheitis and brachial plexus neuropathy in a child with burns.Herpetic tracheobronchitis is a well-recognized clinical entity that most commonly occurs in immunocompromised patients, including patients with burns. Although the diagnosis of herpetic tracheobronchitis is usually not made until postmortem examination, the presence of the condition can be established when histologic specimens of a patient with upper airway obstruction are studied. In this article, a case is described in which a child developed herpetic tracheitis after undergoing elective intubation after the grafting of burns of the face, neck, and upper extremity. The tracheitis resulted in severe upper airway obstruction that required tracheal dilatation and sequential bronchoscopic excisions of granulation tissue. The patient also developed a brachial plexus neuropathy that was most likely related to herpetic infection.- - - - - - - - - - ranking = 0.3275852603336keywords = upper (Clic here for more details about this article) |
9/197. Malignant fibrous histiocytoma developing in a burn scar.Malignant fibrous histiocytoma (MFH) which is usually originated from muscles and deep fascia and rarely from the subcutaneous tissue is the most common soft tissue sarcoma; and it frequently invades the extremities. Occurrence of this tumor on a burn scar of scalp is a very rare entity. In the literature, there were only four reported malign fibrous histiocytoma cases that originated from a burn scar but none of them was at the scalp region. A female patient complaining about a painful mass at the scalp region was admitted to our clinic twenty years after burning with hot water when she was 3 years old. Pathological and clinical features of this rapidly growing malignant fibrous histiocytoma were similar with the other cases reported before. After the diagnosis was clear as a pleomorphic storiform type of MFH, a wide tumor excision was done because of the high risk of local recurrence.- - - - - - - - - - ranking = 0.15970534076233keywords = pain (Clic here for more details about this article) |
10/197. Burn injury resulting in mutilation in childhood.We present 3 cases of boys aged 5, 11 and 12 years who sustained very deep burn injury of their extremities. Their future lives were extremely limited. All the 3 boys had a strong emotional reaction to the injury. Two of them sustained amputation of upper extremities as a result from electrical injury, the youngest boy survived without the feet and with mutilated fingers on his hands. To encourage their survival and sense of life we admitted their mothers. Our aim was not only to secure psychological support to the patients but also to prepare the family to accept the sequelae of the injury. This accompaniment in the ward was very useful for both. The mothers were able to watch the progress in the treatment. In this way they were involved in the future care and they coped with the problems from a realistic point of view. The mothers helped the boys with physiotherapy under supervision. All the families were well prepared for discharge of their boys from the hospital without any fear of the following care. The significance of the family member influence upon the patient's resocialization we saw in early acceptance of the child to the society.- - - - - - - - - - ranking = 0.10919508677787keywords = upper (Clic here for more details about this article) |
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