• Title/Summary/Keyword: burns

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Operation Room Fire: Caution for Using Electrocautery after Rinsing Operation Field at the End of the Surgery with Alcohol-Based Cleansing Solutions (수술방 화재: 수술 종료 시 알코올 함유 피부 소독액을 이용한 수술부위 세척 이후 전기소작기 사용 주의)

  • Song, Jong Keun;Shin, Hyojeong;Lee, Jun Yong
    • Journal of the Korean Burn Society
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    • v.22 no.2
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    • pp.34-37
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    • 2019
  • Fires in operating rooms rarely occur. However, this type of disaster can complicate almost any surgical procedure. Fuel, heat and oxygen are related with fire outbreak. When ignition sources such as alcohol-based surgical preparation solutions are present, the risk of an operating room fire increases, and burns are more severe in such conditions. Many manufacturers recommend waiting at least three minutes after application to allow complete drying for reduce fire risk. There are a few studies regarding flame burns in the operation room, although most of these studies are related to preoperative skin preparation. However, alcohol containing solutions can be used occasionally for cleansing of the operation field after the surgery, therefore, the surgical team should pay attention to surgical fires, even if they have completed the operation successfully. We present our case of a post-operative flame burn and introduce some precautions that will reduce the risk of alcohol burns.

New techniques for wound management: A systematic review of their role in the management of chronic wounds

  • Bekara, Farid;Vitse, Julian;Fluieraru, Sergiu;Masson, Raphael;De Runz, Antoine;Georgescu, Vera;Bressy, Guillaume;Labbe, Jean Louis;Chaput, Benoit;Herlin, Christian
    • Archives of Plastic Surgery
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    • v.45 no.2
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    • pp.102-110
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    • 2018
  • Debridement is a crucial component of wound management. Recent technologies such as hydrosurgery (Versajet), ultrasound therapy (the MIST therapy device), or plasma-mediated bipolar radio-frequency ablation therapy (Coblation) seem to represent interesting alternatives for wound debridement. The purpose of this systematic review was to describe, evaluate, and compare these three recently developed methods for the management of chronic wounds. In January 2016, an electronic database search was conducted of MEDLINE, PubMed Central, and Embase for articles concerning these three innovative methods for the management of chronic wounds. A total of 389 references were identified by our search strategy, and 15 articles were included. We extracted data regarding the number and age of patients, indications, operating time, number of procedures, costs, wound healing time, decrease in exudation, perioperative blood loss, bacterial load, and the occurrence of complications. The 15 articles included studies that involved 563 patients who underwent hydrosurgery (7 studies), ultrasound therapy (6 studies), or Coblation (2 studies). Six randomized controlled trials were included that compared the use of a scalpel or curette to hydrosurgery (2 studies) or ultrasound therapy (6 studies). Hydrosurgery, in addition to being a very precise and selective tool, allows significantly faster debridement. Ultrasound therapy provides a significant reduction of exudation, and improves the wound healing time. No comparative study dedicated to Coblation was identified. Despite the obvious clinical interest of the topic, our review of the current literature revealed a lack of prospective randomized studies comparing these devices with each other or with standard techniques, particularly for Coblation and hydrosurgery.

Horizontal Consolidation Characteristics of Marine Clay Using Piezocone Test (Piezocone 시험을 이용한 해성점토의 수평압밀 특성 연구)

  • 이강운;윤길림;채영수
    • Journal of the Korean Geotechnical Society
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    • v.19 no.5
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    • pp.133-144
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    • 2003
  • Horizontal consolidation characteristics of Busan marine clay were investigated by computing coefficient of horizontal consolidation from Piezocone data and comparing their results with those of standard consolidation test. It is well known that current prediction models of $c_h$ for high plastic soils have large uncertainties, and show a great difference between the predicted and the measured values. However, the spherical models and expanding cavity theory of Torstensson(1977), and Burns & Mayne(1998) based on modified Cam-Clay model with critical limit state concepts have relative reliability in estimating $c_h$ and good applicability in highly plasticity soils. In this paper, a normalization technique was used to evaluate $c_h$ using the Burns and Mayne's method based on the dissipation test, and their normalized consolidation curves give 0.015 of time factor($T_{50}$) when 50% degree of consolidation is completed. Comparison study using Piezocone data obtained at other similar ground site shows 1.5 times less systematicality than that of standard consolidation test, which indicates considerable approximation with the measured values because standard consolidation test gives the difference of three to few times compared with the measured values. In addition, design chart for estimating $c_h$ based on the chart from Robertson et al.(1992) and using the other method of the direct prediction from the of dissipation test was newly proposed. It is judged that new proposed chart is very applicable to Korean marine soils, especially in very high plastic soils.

Algorithm for Primary Full-thickness Skin Grafting in Pediatric Hand Burns

  • Park, Yang Seo;Lee, Jong Wook;Huh, Gi Yeun;Koh, Jang Hyu;Seo, Dong Kook;Choi, Jai Koo;Jang, Young Chul
    • Archives of Plastic Surgery
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    • v.39 no.5
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    • pp.483-488
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    • 2012
  • Background Pediatric hand burns are a difficult problem because they lead to serious hand deformities with functional impairment due to rapid growth during childhood. Therefore, adequate management is required beginning in the acute stage. Our study aims to establish surgical guidelines for a primary full-thickness skin graft (FTSG) in pediatric hand burns, based on long-term observation periods and existing studies. Methods From January 2000 to May 2011, 210 patients underwent primary FTSG. We retrospectively studied the clinical course and treatment outcomes based on the patients' medical records. The patients' demographics, age, sex, injury site of the fingers, presence of web space involvement, the incidence of postoperative late deformities, and the duration of revision were critically analyzed. Results The mean age of the patients was 24.4 months (range, 8 to 94 months), consisting of 141 males and 69 females. The overall observation period was 6.9 years (range, 1 to 11 years) on average. At the time of the burn, 56 cases were to a single finger, 73 to two fingers, 45 to three fingers, and 22 to more than three. Among these cases, 70 were burns that included a web space (33.3%). During the observation, 25 cases underwent corrective operations with an average period of 40.6 months. Conclusions In the volar area, primary full-thickness skin grafting can be a good indication for an isolated injured finger, excluding the web spaces, and injuries of less than three fingers including the web spaces. Also, in the dorsal area, full-thickness skin grafting can be a good indication. However, if the donor site is insufficient and the wound is large, split-thickness skin grafting can be considered.

Preliminary Study on Developing Test Items of Swallowing & Communication Screening Protocols for Patients with Head and Neck Burns (안면부 및 경부 화상 환자의 삼킴 및 의사소통능력 선별 프로토콜 개발을 위한 예비 연구)

  • Kim, JungWan;Lee, HyoJin;Lee, Hyun-Joung
    • 재활복지
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    • v.21 no.2
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    • pp.217-231
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    • 2017
  • We have to consider two parts of the evaluation and treatment for the patients with head and neck burns. The primary consideration is swallowing function for nutrition supply for them and the next is speech function for efficient communication and aesthetic impression of them. The purpose of this study is to summarize the preliminary questions of Communication Screening Protocols which can help understand comprehensively on swallowing disorder, motor speech disorder and voice disorder of patients with head and neck burns. We divided the evaluation into 4 evaluation areas including 'oral mechanism', 'respiration/voice', 'articulation', and 'swallowing' by referring to overseas studies dealing with various communication disorders caused by burns, and prepared the final questionnaires by conducting the content validity verification by five expert (speech & language pathologist). The range of Content Validity Index was shown relatively appropriate with .50~.84. There was a conflict of opinions in experts whether the items in the areas of respiration/voice and swallowing may be appropriate, whereas there was no different view of the oral mechanism and articulation area. Through the different characteristics of communication difficulties of patients with head and neck burns, we expect it will be modified appropriately according to the patients through evaluation of burn patients by type and severity.

Changes in patterns of plastic surgery emergencies at a level I trauma center in India during the COVID-19 pandemic

  • Singh, Veena;Haq, Ansarul;Sharma, Sarsij;Kumar, Sanjeev;Kumar, Aditya;Kumar, Amarjeet;Kumar, Neeraj;Kumar, Anil
    • Journal of Trauma and Injury
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    • v.35 no.2
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    • pp.108-114
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    • 2022
  • Purpose: The coronavirus disease 2019 (COVID-19) pandemic has had major effects worldwide, including sudden and forceful setbacks to the healthcare system. The COVID-19 pandemic has also led to changes in the plastic and reconstructive management of emergency cases, including those due to road traffic accidents. This study analyzed changes in patterns of plastic surgery emergencies and modifications in consultation policies to minimize the exposure of healthcare workers. Methods: Data on plastic surgery emergency calls received from the trauma and emergency department were collected for a period of 2 months before and during lockdown. The data were then analyzed with respect to the cause, mechanism, and site of the injury, as well as other variables. Results: During lockdown, there was a 40.4% overall decrease in the plastic surgery emergency case volume (168 vs. 100). The average daily number of consultations before lockdown was 2.8 as compared to 1.6 during lockdown. Road traffic accidents remained the most common mechanism of injury in both groups (45.8% vs. 39.0%) but decreased in number during the lockdown (77 vs. 39). Household accidents, including burns, were the second most common cause of injury in both phases (7.7% vs. 20.0%), but their proportion increased significantly from 7.7.% to 20.0% in the lockdown phase (P=0.003). The percentage of minor procedures done in the emergency department increased from 53.5% to 72.0% during lockdown (P=0.002). Procedures in the operating room decreased by 73.1% during lockdown (67 vs. 18, P=0.001). Conclusions: The COVID-19 pandemic and lockdown orders in India greatly influenced trends in traumatic emergencies as observed by the plastic surgery team at our tertiary care center. Amidst all the chaos and limitations of the pandemic period, providing safe and prompt care to the patients presenting to the emergency room was our foremost priority.

Complementary and Alternative Medicine Treatment for Burns and Sequela : A Scoping Review of Randomized Controlled Trials (화상 및 후유증의 보완 대체 의학 치료 : 무작위 대조 시험에 대한 주제범위 문헌고찰)

  • Byung-Soo Kang;Seok-Yeong Yoon;Min-Yeong Jung;Soo-Yeon Park;Jung-Hwa Choi;Jong-Han Kim
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.36 no.3
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    • pp.42-73
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    • 2023
  • Objectives : In order to investigate the current status of recent clinical evidence related to complementary and alternative medicine(CAM) treatment for burns and to inform research and treatment strategies for future, we publish a scoping review(ScR) of randomized controlled trials(RCTs). Methods : The research question of the ScR was "Are there any RCTs of CAM treatment for burn?". RCTs published from 2000 to 2022 were identified in 7 databases(PubMed, Cochrane, CNKI, OASIS, RISS, KCI, KMbase) in March 2023. Data were tabulated and analyzed descriptively with respect to the research questions. Results : 41 RCTs were included. 21(51.2%) were conducted in China, 13(31.7%) in Iran. The main treatment criteria were herbal medicine in 28 cases, acupuncture in 9 cases, chuna therapy in 4 cases, and psychotherapy in 3 cases. Among the herbal medicine, there were 19 topical medications, 5 injections(intravenous pharmacopuncture), 4 aerosol drugs(aromatherapy), and 1 oral drug. Among the acupuncture, there were 4 plum blossom needles(seven-star needles), 2 wrist-ankle acupunctures, 2 press needles, and 1 electroacupuncture. CAM treatments were effective in treating burns. It reduced pain and pruritus at the burn site, helped recovery and management of the donor site, reduced anxiety and pain during dressing change, improved hematological problems and vital signs, and finally lowered the mortality rate. CAM treatments also lowered health care costs. Conclusions : CAM treatments for burns is prospective, and that it deserves to make high-quality studies including additional large-scale RCTs.