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Asian Pacific Journal of Tropical Medicine 2022年第1期15卷 17-25页

作者： Lijuan Guo Hui Xu Zhigang Yue Clinical Laboratory Emergency General HospitalNo.29 Xibahe South RoadChaoyang DistrictBeijing100028China

Objective:To investigate the resistance profiles to antimicrobial agents of wound-isolated Pseudomonas(P.)aeruginosa among Chinese burn patients.Methods:Electronic databases and manual search were used to identify eligible studies published since 2010.The objectives were pooled resistance rates for eleven common antimicrobial agents,estimated by a random-effects model.Subgroup analyses were conducted by stratifying the studies into three four-year periods based on year of isolation.Results:A total of 35 studies were included.Gentamicin had the highest pooled resistance rate(56%,95%CI 48%-64%),while meropenem had the lowest pooled resistance rate(29%,95%CI 20%-40%).There was an increasing trend of resistance to common antimicrobial agents of wound-isolated P.aeruginosa over a span of twelve years(2009-2020).There remained the highest risk of gentamicin resistance over time in China.Subgroup analyses indicated significantly higher resistances to ceftazidime and levofloxacin from 2017 to 2020.Conclusions:Enhanced resistance to common antimicrobial agents in wound-isolated P.aeruginosa presents a challenge in burn wound management in China's Mainland.Effective stewardship programs should be established based on corresponding resistance profiles,thereby optimizing treatment options for hospitalized burn patients.

关键词： Antibiotic resistance burn Nosocomial infection Pseudomonas aeruginosa

Pediatric thermal burn injury:A retrospective analysis from pediatric care institutes,Eastern India

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Journal of Integrative Nursing 2023年第2期5卷 108-114页

作者： Kartik Chandra MANDAL Sourav ROY Pankaj Kumar HALDER Partha CHAKRABORTY L.NEILASANO Debasree GUHA Department of Pediatric Surgery Dr.B.C.Roy Post Graduate Institute of Pediatric SciencesKolkataWest BengalIndia Department of Pediatric Surgery R.G.Kar Medical CollegeKolkataWest BengalIndia Department of General Surgery R.G.Kar Medical CollegeKolkataWest BengalIndia Department of Pediatric Medicine R.G.Kar Medical CollegeKolkataWest BengalIndia

Objective:Pediatric burns pose difficult healthcare issues in underdeveloped nations.Due to the scarcity of pediatric burn care facilities and qualified burn‑care staff,patients are frequently referred from a rural hospital.This study explores the burn‑treatment approach that could be used in rural hospitals in the absence of a dedicated pediatric burn care facility.Materials and Methods:A retrospective analysis of clinical data of 199 children who received treatment for burn‑injury in an isolated general surgical ward.Wound debridement under anesthesia at the earliest was the cornerstone of the treatment plan for this cohort.Until the wounds healed,the treatment was repeated every alternate day.The patient’s demographic data,number of surgical dressings,length of hospital stay,and outcome were analyzed.Results:The mean age of the patients was 51.68±23.79 months.The male‑female ratio was 1.45:1.The survival rate was 99.00%.The disability rate was 4.52%.Univariate logistic regression identified the age group,total body surface area affected,depth of the wound,and time of intervention as statistically significant variables(Pburns can be manageable in an isolated general ward.

关键词： Anesthesia burn cleaning closed debridement dehydration hypothermia paraffin oil pediatric

Evaluation of the wound healing potential of isoquercetin-based cream on scald burn injury in rats

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burns & Trauma 2016年第1期4卷 45-52页

作者： Nitish Bhatia Gursharan Kaur Varinder Soni Juhi Kataria Ravi K Dhawan Pharmacology Research Laboratory Department of PharmacologyKhalsa College of PharmacyAmritsarIndia. Department of PharmaceuticalAnalysis Khalsa College of PharmacyAmritsarIndia. Department ofBiochemistry Khalsa College of Pharmacy and TechnologyAmritsarIndia.

Background:The present study was designed to evaluate the potential of isoquercetin-based cream formulation on scald burn wound injury in rats.Methods:Four isoquercetin-based cream formulations viz.0.01,0.02,0.04,and 0.06%w/w were prepared.Cream base and standard anti-burn cream containing silver sulfadiazine were also used for comparison.Scald burn was given to rats by pouring water at 90℃on a shaved dorsal area of 20 mm2.Deep second-degree burn injury was produced which was evaluated for the next 21 days for the percentage of wound contraction and period of epithelialization.On day 21,the rats were sacrificed and histopathological slides were prepared using hematoxylin-eosin staining.burned tissue was also screened for levels of oxidative stress using thiobarbituric acid reactive species(TBARS)and reduced glutathione(GSH)estimation.Results:There was a significant increase in the percentage of wound contraction and a significant decrease in the period of epithelialization in isoquercetin-based cream-treated groups as compared with the control group.However,most significant results were obtained with isoquercetin 0.06%w/w cream.Histological y,isoquercetin 0.06%w/w cream treatment resulted in almost complete re-epithelialization and re-structuring of the wound tissue.There was a significant rise in TBARS and a decrease in GSH levels in the burn injury group which was reversed to a major extent by the application of isoquercetin-based cream.Conclusions:The results indicate the wound healing potential of isoquercetin-based cream.Tissue biochemical studies indicate towards a possible role of free radical scavenging in the observed effects of isoquercetin in wound healing.

关键词： Isoquercetin Scald burn Free radicals Wound healing

Perforator-based flaps for the treatment of burn scar contractures: a review

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burns & Trauma 2017年第1期5卷 9-16页

作者： C.M.Stekelenburg R.E.Marck P.D.H.M.Verhaegen K.W.Marck P.P.M.van Zuijlen burn Center and Department of Plastic Reconstructiveand Hand SurgeryRed Cross HospitalVondellaan 131942 LE BeverwijkThe Netherlands Department of Plastic Reconstructiveand Hand SurgeryUniversity Medical CenterUtrechtThe Netherlands Department of Plastic Reconstructiveand Hand SurgeryAcademical Medical CenterAmsterdamThe Netherlands Department of Plastic Reconstructiveand Hand SurgeryMOVE Research InstituteVU University Medical CenterAmsterdamThe Netherlands Department of Plastic Reconstructiveand Hand SurgeryIsalaZwolleThe Netherlands Department of Plastic Surgery Medisch Centrum LeeuwardenLeeuwardenThe Netherlands.

Patients with burn scars often experience functional problems because of scar contractures. Surgical treatment may be indicated for those burn scar contractures. If the contractures are small and linear, the contraction bands can be treated with local transposition flaps like the Z-plasty. Broader, diffuse contractures are more challenging and require a different surgical approach, such as the use of local tissue. The use of perforator-based flaps is promising;however, their true clinical significance for this type of burn reconstructions still needs to be determined. Therefore, we performed a review to evaluate the role of perforator-based flaps for burn scar contracture treatment. Electronic databases were searched using a predefined search strategy. Studies evaluating the long-term outcome of perforator-based flaps for the treatment of burn scar contractures were included. The methodological quality was tested and data was summarized. Five hundred and ten papers were identified of which eleven met the inclusion criteria. One study was a randomized controlled trial;ten were cohort studies of a pre-postoperative design. The papers described outcomes of free flaps and local flaps. Most studies had methodological shortcomings and used inappropriate statistical methods. Perforator-based interposition flaps appear to be highly relevant for burn scar contracture treatment. However, due to the paucity and low quality of the studies that were assessed, no definitive conclusions about the true clinical significance could be reached. And therefore, only recommendations could be given for improvement of the quality of further primary research on the effectiveness of perforator-based flaps for burn scar contracture release.

关键词： burn Scar Contracture Perforator flap

The role of antioxidant micronutrients in the rate of recovery of burn patients: a systematic review

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burns & Trauma 2016年第3期4卷 192-198页

作者： Mary Adjepong Pius Agbenorku Patricia Brown Ibok Oduro Department of Biochemistry College of ScienceKwame Nkrumah University of Science and TechnologyKumasiGhana Department of Surgery Reconstructive Plastic Surgery&Burns UnitKomfo Anokye Teaching HospitalSchool of Medical SciencesCollege of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana

burn injury can be detrimental to the health of individuals,meanwhile victims lose proteins and micronutrients in wound exudates.Victims also experience extensive protein catabolism.These make them prone to malnutrition.burn patients also suffer a lot of emotional trauma that reduce nutrient intake.The aim of this paper was to review primary evidence on the effect of antioxidant micronutrients on the recovery rate of burn patients.Electronic databases such as PubMed,BioMed,and Cochrane were systematically searched between January 1,2014,and January 30,2014.Keywords include vitamin A,vitamin C,vitamin E,ascorbic acid,zinc,copper,selenium,tocopherol,carotenoids,dietary intake,supplementation,wound healing,infection,recovery rate,and burn patients.The systematic search was done to retrieve all published data from 1990 to 2013.A total of 518 journal articles were obtained,and after the removal of duplicates,reviews,commentaries,and studies with non-human subjects,11 papers were accepted for review.The review considered only papers that were published,and there might be some unpublished data that may have been omitted.Generally,the wound healing time and infection rates were reduced by the administration of the antioxidant micronutrients.The review revealed that there was no such published work in developing countries and children were excluded from most studies.It was also stated clearly that there was no uniformity in burn management;hence,there is a need for more studies on burn management in various populations.

关键词： burn Micronutrients Recovery Infection Tocopherol Carotenoids Ascorbic acid

Epidemiology of pediatric burns and future prevention strategies—a study of 475 patients from a high-volume burn center in North India

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burns & Trauma 2017年第1期5卷 50-57页

作者： Amol Dhopte V.K.Tiwari Pankaj Patel Rahul Bamal Department of burns Plastic&Maxillofacial SurgeryVMMC&Safdarjung HospitalNew DelhiIndia Present Address:Department of burns&Plastic Surgery PGIMER&RML HospitalNew DelhiIndia

Background: Pediatric burns have a long-term social impact. This is more apparent in a developing country such as India, where their incidence and morbidity are high. The aim of this study was to provide recent prospective epidemiological data on pediatric burns in India and to suggest future preventive strategies. Methods: Children up to 18 years old admitted to the Department of burns, Plastic&Maxillofacial Surgery, VMMC&Safdarjung Hospital, New Delhi, between January and December 2014 were included in the study. Data regarding age, sex, etiology, total body surface area (TBSA), circumstances of injury, and clinical assessment were collected. The Mann-Whitney test or Kruskal-Wallis test or ANOVA was used to compare involved TBSA among various cohort groups accordingly. Univariate and multivariate linear regression analyses were used to determine the predictors of TBSA. Results: There were a total of 475 patients involved in the study, including seven suicidal burns, all of whom were females with a mean age greater than the cohort average. Age, type of burns, mode of injury, presence or absence of inhalation injury, gender, and time of year (quarter) for admission were found to independently affect the TBSA involved. Electrical burns also formed an important number of presenting burn patients, mainly involving teenagers. Several societal issues have come forth, e.g., child marriage, child labor, and likely psychological problems among female children as suggested by a high incidence of suicidal burns. Conclusions: This study also highlights several issues such as overcrowding, lack of awareness, dangerous cooking practices, and improper use of kerosene oil. There is an emergent need to recognize the problems, formulate strategies, spread awareness, and ban or replace hazardous substances responsible for most burn accidents.

关键词： Epidemiology Pediatric burns India Suicidal burns burn prevention

An evaluation of Emergency Management of Severe burn (EMSB) course in Bangladesh: a strategic direction

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burns & Trauma 2017年第2期5卷 127-133页

作者： Animesh Biswas Fazlur Rahman Peter Maitz Kamran Ul Baset Jahangir Hossain Saidur Rahman Mashreky Centre for Injury Prevention and Research Bangladesh (CIPRB) DhakaBangladesh Centre for Injury Prevention and Research Bangladesh (CIPRB) DhakaBangladesh Department of Epidemiology Bangladesh University of Health Sciences (BUHS) Dhaka Bangladesh The University of Sydney SydneyAustralia

Background: burn is one of the major public health problems in Bangladesh. Specialized personnel and technologies are required, however, in many cases they are not readily available. Taking the situation into account,Interplast Australia and New Zealand, Australia & New Zealand burn Association (ANZBA), and Centre for Injury Prevention and Research, Bangladesh (CIPRB) initiated Emergency Management of Severe burn (EMSB) training programme for Bangladeshi physicians in 2008 to help improving their burn management skill. The study was designed to evaluate the effect of EMSB programme in Bangladesh.Methods: Both qualitative and quantitative methods were adopted. A cross-sectional survey was conducted to obtain quantitative information from 38 randomly selected EMSB-trained doctors among 380 trained physicians based on a five year database of EMSB (2008-2012). In-depth interviews (IDIs) and focus group discussion (FGD) were used as data collection techniques to get information.Results: A total of 32 participants completed the interview. It was found that 87.5% (n=28) doctors were using their skill in burn management that they learnt from the EMSB course. About 43.8% (n=14) doctors felt that the course largely helped improve their confidence. Majority (56.2%, n=18) of doctors stated EMSB is essential for the Bangladeshi doctors to learn better management of burns. Qualitative findings show that the courses were organized successfully with an excellent coordination, maintaining same quality and standard as running anywhere in the world. For its effectiveness, the course has been recommended to train graduate nurses and junior doctors from the periphery of the country.Conclusions: EMSB has already created a large doctor community who are able to effectively manage burn patients. It also has proven its indispensability for learning burn management skill. The EMSB established a platform to serve the burn victims and reduce the burden of injuries in Bangladesh.

关键词： burn EMSB Bangladesh Low-income countries

Increased mortality in women: sex differences in burn outcomes

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burns & Trauma 2017年第2期5卷 113-120页

作者： Karen Karimi Iris Faraklas Giavonni Lewis Daniel Ha Bridget Walker Yan Zhai Gareth Graves Sharmila Dissanaike Department of Surgery Texas Tech University Health Sciences Center 36014th Street MS 8312 Lubbock TX 79430 USA Department of Surgery University of Utah Health Sciences Center 30 N 1900 East Salt Lake City UT 84132 USA

Background: There is increasing evidence that sex differences may influence responses after thermal injury and affect clinical outcomes. The objective of this study was to evaluate the relationships between sex, thermal injury,body size, and inpatient mortality in burn patients.Methods: Medical records of adults with >20% total body surface area (TBSA) burn injury admitted to two American burn Association (ABA)-verified burn centers between 2008 and 2014 were retrospectively reviewed.Injury details and baseline characteristics, including body size as estimated by body surface area (BSA) and body mass index (BMI) were recorded, along with details of the hospital course. The primary outcome of inpatient mortality was compared between sexes.Results: Out of 334 subjects, 60 were women (18%). Median TBSA was 33% (IQR 25-49) in this cohort, with 19% full thickness burns and 30% inhalation injury. Despite no significant difference in age, presence of inhalation injury, TBSA,or depth of burn, women had significantly higher rates of inpatient mortality (45 vs. 29%, P = 0.01). BSA was significantly lower in women vs. men (P burn injuries and die sooner than men with similar injuries. Body size does not appear to modulate this effect. burn centers should be aware of the higher mortality risk in women with large burns.

关键词： Mortality Sex Gender burn Survival Outcome

A systematic review of objective burn scar measurements

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burns & Trauma 2016年第2期4卷 90-122页

作者： Kwang Chear Lee Janine Dretzke Liam Grover Ann Logan Naiem Moiemen The Healing Foundation burn Research Centre University Hospital Birmingham Foundation TrustBirmingham B152THUK School of Clinical and Experimental Medicine College of Medical and Dental SciencesUniversity of BirminghamBirmingham B152TTUK Public Health Epidemiology and BiostatisticsInstitute of Applied Health ResearchCollege of Medical and Dental SciencesUniversity of BirminghamBirmingham B152TTUK School of Chemical Engineering University of BirminghamBirmingham B152TTUK School of Clinical and Experimental Medicine College of Medical and Dental SciencesUniversity of BirminghamBirmingham B152TTUK The Healing Foundation burn Research Centre University Hospital Birmingham Foundation TrustBirmingham B152THUK

Background:Problematic scarring remains a challenging aspect to address in the treatment of burns and can significantly affect the quality of life of the burn survivor.At present,there are few treatments available in the clinic to control adverse scarring,but experimental pharmacological anti-scarring strategies are now beginning to emerge.Their comparative success must be based on objective measurements of scarring,yet currently the clinical assessment of scars is not carried out systematically and is mostly based on subjective review of patients.However,several techniques and devices are being introduced that allow objective analysis of the burn scar.The aim of this article is to evaluate various objective measurement tools currently available and recommend a useful panel that is suitable for use in clinical trials of anti-scarring therapies.Methods:A systematic literature search was done using the Web of Science,PubMed and Cochrane databases.The identified devices were then classified and grouped according to the parameters they measured.The tools were then compared and assessed in terms of inter-and intra-rater reproducibility,ease of use and cost.Results:After duplicates were removed,5062 articles were obtained in the search.After further screening,157 articles which utilised objective burn scar measurement systems or tools were obtained.The scar measurement devices can be broadly classified into those measuring colour,metric variables,texture,biomechanical properties and pathophysiological disturbances.Conclusions:Objective scar measurement tools allow the accurate and reproducible evaluation of scars,which is important for both clinical and scientific use.However,studies to evaluate their relative performance and merits of these tools are scarce,and there remain factors,such as itch and pain,which cannot be measured objectively.On reviewing the available evidence,a panel of devices for objective scar measurement is recommended consisting of the 3D cameras(Eykona/Lifeviz/Vectra H1)for surface area and volum

关键词： Scar measurement burn Objective measurement 3D camera Laser imaging High-frequency ultrasound image Colorimeter Cutometer

Effect of artificial colloids on blood coagulation during shock stage of severe burn injury

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Chinese Medical Journal 2013年第17期126卷 3334-3339页

作者： ZHOU Jian-jun XING Nan CHEN Jiong SHI Jian-wu SU Guo-liang Department of burn and Skin Repair Surgery Third Affiliated Hospital Wenzhou Medical College Wenzhou Zhejiang 325200 China

Background There are controversies about the use of artificial colloids. This research was aimed to determine the effect of various artificial colloids on blood coagulation in the shock stage of severe burn injury. Methods Totally, 18 female Ba-Ma mini-pigs were subjected to a 40% total body surface third-degree flame burn under anesthesia. Resuscitation therapy was applied 2 hours after the injury, using the burn shock fluid resuscitation formula commonly accepted in the surgical treatment of bums. The Ba-Ma mini-pigs were randomly assigned to three groups （six pigs in each group）： succinylated gelatin group （the artificial colloid used was succinylated gelatin Injection）, hydroxyethyl starch group （the artificial colloid used was hydroxyethyl starch （130/0.4））, and allogeneic plasma group （the colloid used was allogeneic plasma）. Blood samples were collected from the animals prior to the bum injury and again at intervals of 4, 8, 24 and 48 hours post-injury. The platelet count （PLT）, prothrombin time （PT）, international normalized ratio （INR）, activated partial thromboplastin time （APTT）, and fibrinogen （Fib） were measured, followed by a statistical analysis of all results. Results The PLT of succinylated gelatin group and hydroxyethyl starch group at intervals of 24 and 48 hours were （124.3±52.7）, （78.8±16.4）×10^9/L and （159.0±62.8）, （87.3±32.0）×10^9/L respectively. But in the allogeneic plasma group at intervals of 8, 24, and 48 hours were （234.3±52.6）, （136.0±47.4）, （75.8±31.0）×10^9/L. The decrease were all statistically significant （P 〈0.05, P 〈0.01） when compared to pre-burn （（383.3±77.9）, （382.7±65.7）, （381.0±49.4）×10^9/L）. The PLT among the three groups, at all the time points, had no statistical difference （P 〉0.05）. Compared to pre-burn （（10.8±0.9）, （11.4± 0.8）, （10.6±0.7） seconds）, the PT of succinylated gelatin group and hydroxyethyl starch group at 24 hours were （14.5±1.5） and （16.2±1.3） seconds, whereas in the allogeneic plasma group at 8 and 24 hours the PT were （13.0±0.9） and （14.5±1.5） seconds,

关键词： burn shock colloid hydroxyethyl starch blood coagulation