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Dargan D, Himmi G, Anwar U, Jivan S, Muthayya P. A comparison of the epidemiology of isolated and non-isolated hand burns. Burns 2023; 49:951-960. [PMID: 35760611 DOI: 10.1016/j.burns.2022.05.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/21/2022] [Accepted: 05/17/2022] [Indexed: 11/02/2022]
Abstract
Hand burns are common and treatment individualized, however given large volumes in some centers, pattern recognition may help optimize service provision. We performed a single center retrospective review from 2014 to 2018 of hand burns in patients aged 16 and over. Burns confined to the hands were considered isolated. We found 1163 patients (790 male, 68%), with 853 isolated (9% bilateral) and 310 non-isolated (35% bilateral) hand burns, and 12% were sustained in industrial workplaces. Most isolated burns received first aid (72%) and were scalds (41%) or contact (23%). Many presented to hospital by car (73%) and most were treated as outpatients (92%). Non-isolated burns were mainly flash (38%) or flame burns (25%, p < 0.01), with 66% given first aid, 49% used ambulances (p < 0.01) and 54% underwent hospital admission (p < 0.01). Non-isolated injuries had more full thickness involvement (p < 0.01), 13% were resuscitation burns and 10% received intensive care. Isolated and non-isolated burns are distinct clinical entities, as are unilateral and bilateral injuries. Isolated burns are usually unilateral scalds or contact burns, suited to outpatient treatment. Non-isolated burns are often flash or flame, bilateral, often needing ambulances, admission, and interventions. First aid can be improved, and consideration given to inpatient rehabilitation of bilateral hand burns.
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Affiliation(s)
- Dallan Dargan
- Regional Burns Centre, Pinderfields General Hospital, Aberford Road, Wakefield WF1 4DG, United Kingdom.
| | - Ghita Himmi
- Hull York Medical School, University of York, Heslington, York YO10 5DD, United Kingdom
| | - Umair Anwar
- Regional Burns Centre, Pinderfields General Hospital, Aberford Road, Wakefield WF1 4DG, United Kingdom
| | - Sharmila Jivan
- Regional Burns Centre, Pinderfields General Hospital, Aberford Road, Wakefield WF1 4DG, United Kingdom
| | - Preetha Muthayya
- Regional Burns Centre, Pinderfields General Hospital, Aberford Road, Wakefield WF1 4DG, United Kingdom
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Kong W, Xiao Y, Wang B, Zhu Z, Hu L, Tang H, Wang K, Fang H, Shi Y, Long J, Gan L, Wang H, Sun Y, Xia Z. Comorbidities of scars in China: a national study based on hospitalized cases. BURNS & TRAUMA 2021; 9:tkab012. [PMID: 34212062 PMCID: PMC8240520 DOI: 10.1093/burnst/tkab012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 12/09/2020] [Indexed: 12/13/2022]
Abstract
Background Scar comorbidities seriously affect the physical and mental health of patients, but few studies have reported the exact epidemiological characteristics of scar comorbidities in China. This study aimed to investigate the prevalence of scar comorbidities in China. Methods The data of 177,586 scar cases between 2013 and 2018 were obtained from the Hospital Quality Monitoring System based on the 10th edition of the International Classification of Diseases coding system. The total distribution of scar comorbidities and their relationship with age, aetiology and body regions were analysed. Results Six comorbidities (contracture, malformation, ocular complications, adhesion, infection and others) were the main focus. In general, male patients outnumbered females and urban areas outnumbered rural areas. The proportion of contractures was the highest at 59,028 (33.24%). Students, workers and farmers made up the majority of the occupation. Han Chinese accounted for the majority of the ethnic. The highest proportion of scar contracture occurred at 1-1.9 years of age (58.97%), after which a significant downward trend was observed. However, starting from 50 years of age, ocular complications increased gradually and significantly, eventually reaching a peak of 34.49% in those aged >80 years. Scar contracture was the most common comorbidity according to aetiology, and the highest proportion was observed in patients who were scalded (29.33%). Contractures were also the most frequent comorbidity in hands (10.30%), lower limbs (6.97%), feet (6.80%) and upper limbs (6.02%). The mean and median hospitalization durations were 12.85 and 8 days, respectively. Conclusions Contractures were the most common comorbidities, and different comorbidities tended to occur at different ages and with different causative factors.
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Affiliation(s)
- Weishi Kong
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, P.R.China.,Burn Institute of PLA, Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, Shanghai 200433, P.R.China
| | - Yongqiang Xiao
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, P.R.China.,Department of Burn and Plastic Surgery, The 970th Hospital of People's Liberation Army, Yantai, Shandong, 264000, China
| | - Baoli Wang
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, P.R.China
| | - Zhe Zhu
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, P.R.China
| | - Lunyang Hu
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, P.R.China
| | - Hongtai Tang
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, P.R.China
| | - Kangan Wang
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, P.R.China
| | - He Fang
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, P.R.China
| | - Ying Shi
- China Standard Medical Information Research Centre, Shenzhen 518000, P.R.China
| | - Jianyan Long
- China Standard Medical Information Research Centre, Shenzhen 518000, P.R.China
| | - Lanxia Gan
- China Standard Medical Information Research Centre, Shenzhen 518000, P.R.China
| | - Haibo Wang
- China Standard Medical Information Research Centre, Shenzhen 518000, P.R.China
| | - Yu Sun
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, P.R.China.,Burn Institute of PLA, Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, Shanghai 200433, P.R.China
| | - Zhaofan Xia
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, P.R.China.,Burn Institute of PLA, Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, Shanghai 200433, P.R.China
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Dargan D, Kazzazi D, Limnatitou D, Cochrane E, Stubbington Y, Shokrollahi K, Ralston D. Acute Management of Thermal Hand Burns in Adults: A 10-Year Review of the Literature. Ann Plast Surg 2021; 86:517-531. [PMID: 33675628 DOI: 10.1097/sap.0000000000002755] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Advances in the evidence base of acute thermal hand burns help to guide the management of these common injuries. The aim of this literature review was to evaluate recent evidence in the field over 10 years. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols methodology was used as a guide for this literature review. PubMed, MEDLINE, EMBASE, CINAHL, and Google Scholar were searched for English language articles related to hand burns published between 2009 and 2018 inclusive, and the Cochrane Library was reviewed. Exclusion criteria were as follows: participants younger than 18 years, scar or contracture management, rehabilitation, outcomes assessment, late reconstruction, and electrical or chemical burns. RESULTS An initial search retrieved 6493 articles, which was narrowed to 403 full-text articles that were reviewed independently by 3 of the authors and categorized. Of 202 included articles, there were 8 randomized controlled trials and 2 systematic reviews. Six evidence-based guidelines were reviewed. Referral of hand burns to specialist centers, use of telemedicine, early excision and grafting, and immediate static splintage have been recommended. Enzymatic debridement results in earlier intervention, more accurate burn assessment, preservation of vital tissue, and fewer skin grafts, and ideally requires regional anesthesia. Guidance on escharotomy emphasizes indication, technique and adequate intervention, and potential for enzymatic debridement. Inclusion of topical negative pressure, dermal regenerative templates, acellular dermal matrices, and noncellular skin substitutes in management has helped improve scar and functional outcomes. DISCUSSION The results of this literature review demonstrate that multiple national and international societies have published burns guidelines during the decade studied, with aspects directly relevant to hand burns, including the International Society for Burn Injuries guidelines. There are opportunities for evidence-based quality improvement across the field of hand burns in many centers. CONCLUSIONS More than 200 articles globally in 10 years outline advances in the understanding of acute management of thermal hand burns. Incorporating the evidence base into practice may facilitate optimization of triage referral pathways and acute management for hand burns.
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Affiliation(s)
| | - Diana Kazzazi
- From the Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital
| | | | - Elliott Cochrane
- From the Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital
| | | | - Kayvan Shokrollahi
- Mersey Regional Burns Centre, St Helens and Knowsley Teaching Hospitals NHS Trust, Whiston Hospital, Merseyside, Prescot, United Kingdom
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Klifto KM, Yesantharao PS, Dellon AL, Hultman CS, Lifchez SD. Chronic Neuropathic Pain Following Hand Burns: Etiology, Treatment, and Long-Term Outcomes. J Hand Surg Am 2021; 46:67.e1-67.e9. [PMID: 32855013 DOI: 10.1016/j.jhsa.2020.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 05/16/2020] [Accepted: 07/13/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE Chronic neuropathic pain (CNP) after burn injury to the hand/upper extremity is relatively common, but not well described in the literature. This study characterizes patients with CNP after hand/upper extremity burns to help guide risk stratification and treatment strategies. We hypothesize that multiple risk factors contribute to the development of CNP and refractory responses to treatment. METHODS Patients older than 15 years admitted to the burn center after hand/upper extremity burns, from January 1, 2014, through January 1, 2019, were included. Chronic neuropathic pain was defined as self-described pain for longer than 6 months after burn injury, not including pain due to preexisting illness/medications. Two analyses were undertaken: (1) determining risk factors for developing CNP among patients with hand/upper extremity burns, and (2) determining risk factors for developing refractory pain (ie, nonresponsive to treatment) among hand/upper extremity burn patients with CNP. RESULTS Of the 914 patients who met the inclusion criteria, 55 (6%) developed CNP after hand/upper extremity burns. Twenty-nine of these patients (53%) had refractory CNP. Significant risk factors for developing CNP after hand/upper extremity burns included history of substance abuse and tobacco use. Among CNP patients, significant risk factors for developing refractory pain included symptoms of burning sensations. In all CNP patients, gabapentin and ascorbic acid were associated with significant decreases in pain scores on follow-up. CONCLUSIONS Substance abuse and tobacco use may contribute to the development of CNP after hand/upper extremity burns. Those who developed refractory CNP were more likely to use the pain descriptor, burning sensations. Pharmacological pain management with gabapentin or pregabalin and ascorbic acid may provide the most relief of CNP symptoms. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic IV.
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Affiliation(s)
- Kevin M Klifto
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Pooja S Yesantharao
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - A Lee Dellon
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - C Scott Hultman
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Scott D Lifchez
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD; Department of Orthopedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.
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Shi JJ, Sun Y, Pan SS, Xu TT, Hua JJ. Manufacture and clinical application of the forearm pronation's assistant tableware in the severely burned. Burns 2020; 47:684-691. [PMID: 32917474 DOI: 10.1016/j.burns.2020.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 08/04/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Even after reconstructive surgery, it is still difficult for patients with severe burns to achieve independent eating activity. In this project, we customized the forearm pronation's assistant tableware to assist in improvement with eating activities. METHODS From January 2017 to December 2018, 28 patients with severe burns including the hands were recruited. For the patient's independent eating activities, we customized forearm pronation's tableware (forks and spoons). We compared modified Barthel index (MBI) and Visual analogue scale (VAS) of satisfaction under three conditions: no auxiliary tableware, ADL universal cuff, or forearm pronation tableware; to compare the duration and the weight of food spilled during lunch when the patients wore the ADL universal cuff or the forearm pronation's tableware. Differences in MBI (rank data) were tested by the Friedman test, differences in VAS (normal distribution) were tested with One-way ANOVA (Bonferroni), differences in the duration and the weight (normal distribution data) were tested by paired sample t test. RESULTS After wearing the forearm pronation's assistant tableware, MBI VAS both increased more than when the patients did not wear the auxiliary tableware (all p<0.05). When the subjects wore forearm pronation tableware, the duration of lunch significantly decreased and the quality of eating activity significantly improved compared to the ADL universal cuff in eating activity (all p<0.05). CONCLUSION After wearing the forearm pronation's assistant tableware, the patients with severe burns completely or almost completely accomplished independent eating, the duration was decreased, and during eating activity the quality and the satisfaction were improved. CLINICAL TRIAL REGISTRATION Chinese Clinical trial registry, ChiCTR1800019963.
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Affiliation(s)
- Jia-Jia Shi
- Department of Physical Medicine and Rehabilitation Medicine, Kunshan Rehabilitation Hospital, Suzhou, Jiangsu, PR China
| | - Ying Sun
- Department of Physical Medicine and Rehabilitation Medicine, Kunshan Rehabilitation Hospital, Suzhou, Jiangsu, PR China
| | - Shan-Shan Pan
- Department of Burn Medicine, Kunshan Rehabilitation Hospital, Suzhou, Jiangsu, PR China
| | - Ting-Ting Xu
- Research Laboratory, Kunshan Rehabilitation Hospital, Suzhou, Jiangsu, PR China
| | - Jia-Jia Hua
- Department of Rehabilitation Medicine, The Sixth People's Hospital of Nantong, Nantong, Jiangsu, PR China.
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Mc Kittrick A, Gustafsson L, Marshall K. A systematic review to investigate outcome tools currently in use for those with hand burns, and mapping psychometric properties of outcome measures. Burns 2020; 47:295-314. [PMID: 32826095 DOI: 10.1016/j.burns.2020.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/18/2020] [Accepted: 07/10/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Severe burn injuries to the hand impact multiple domains of function and participation. Measurement of outcomes after hand burn injuries is multifaceted and is influenced by several variables. OBJECTIVE The aim of this systematic review was to review outcome measures reported in studies used to measure outcomes after severe hand burn injuries; and to critically evaluate the reliability, validity and clinical utility of each hand assessment tool identified from the literature to determine suitability for use with the burn's population. DATA SOURCES A search of the published literature using electronic data bases MEDLINE, CINAHL, PEDro, OT seeker and PubMed was undertaken. Studies were included if they reported assessment tools and outcome measures used to determine hand function after severe burn injuries; were published in English and available in their full-length. Studies were excluded if they were related to a group under 18 years of age. RESULTS Thirty-four papers were included in this systematic review. A total of 25 outcome measures were confirmed for inclusion in this paper and each underwent further evaluation to identify their psychometric properties. LIMITATIONS A factor which could cause bias in this systematic review was the search was restricted to English language journals therefore excluding any primary papers in other languages. Mapping of the outcome measures to the ICF was conducted by the primary author which may give rise to bias however a member checking was conducted in order to remove this bias. CONCLUSIONS This review established that no one outcome measure meets all the psychometric properties of validity, reliability and responsiveness SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO: CRD42018085059.
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Affiliation(s)
- Andrea Mc Kittrick
- Department of Occupational Therapy, Royal Brisbane and Women's Hospital, Herston, 4029, QLD, Australia; School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, 4072, QLD Australia.
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Allied Health Sciences, Griffith University, Nathan, QLD, 4111, Australia; Honorary Associate Professor School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, 4072, QLD Australia
| | - Kathryn Marshall
- Department of Occupational Therapy, Princess Alexandra Hospital, Woolloongabba, 4102, QLD, Australia; School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, 4072, QLD Australia
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Liu M, Zhu H, Yan R, Yang J, Zhan R, Yu X, Hu X, Zhang X, Luo G, Qian W. Epidemiology and Outcome Analysis of 470 Patients with Hand Burns: A Five-Year Retrospective Study in a Major Burn Center in Southwest China. Med Sci Monit 2020; 26:e918881. [PMID: 32417848 PMCID: PMC7222659 DOI: 10.12659/msm.918881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background This retrospective study aimed to investigate the epidemiology of burns to the hand, including the causes, demographic data, management, and outcome in a single center in Southwest China between 2012 and 2017. Material/Methods A retrospective study included 470 patients with hand burns who were treated at a single hospital in Southwest China between 2012 and 2017. Demographic, injury-related, and clinical data were obtained from the clinical electronic data collection system. Results In 470 patients, men were more commonly admitted to hospital with hand burns (73.62%). Children under 10 years (29.57%) were the main patient group. Hospital admissions occurred in the coldest months, from December to March (55.11%). In 60.21% of cases, hand burns occurred outside the workplace. Fire (40.42%), electricity (30.85%), and hot liquids (20.21%) were the main causes of hand burns. Data from 428 patients showed that burns with a larger total body surface area and deeper burns were associated with surgery and amputation. Burn depth was a risk factor for skin grafting, and lack of burn cooling before hospital admission increased the risk of amputation. Data from 117 patients with localized burns showed that full-thickness burns and lack of cooling before admission were associated with an increased hospital stay. Conclusions The findings suggest that in Southwest China, prevention programs for children aged 0–9 years, injuries occurring in winter and non-workplace sites, and fire burns were imperative.
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Affiliation(s)
- Mian Liu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Haijie Zhu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Rongshuai Yan
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Army Medical University, People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Jiacai Yang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Rixing Zhan
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Xunzhou Yu
- Department of Burn and Plastic Surgery, 80th Group Military Hospital, Weifang, Shandong, China (mainland)
| | - Xiaohong Hu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Xiaorong Zhang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Gaoxing Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Wei Qian
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
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Ding H, Huang M, Li D, Lin Y, Qian W. Epidemiology of electrical burns: a 10-year retrospective analysis of 376 cases at a burn centre in South China. J Int Med Res 2019; 48:300060519891325. [PMID: 31854209 PMCID: PMC7782948 DOI: 10.1177/0300060519891325] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To investigate the epidemiological profile and associated outcomes of electrical injuries at a major burn centre in southern China. METHODS This retrospective study enrolled consecutive electrical burn patients admitted to the burn centre of the First Affiliated Hospital of Guangxi Medical University between 2008 and 2017. Demographic and clinical data and outcomes were recorded. Mann-Whitney U tests/Pearson's chi-squared tests were used to examine the differences between low-voltage and high-voltage injuries. RESULTS There were 217 high-voltage injuries and 159 low-voltage injuries. High-voltage burns were frequently observed between March and August, and low-voltage burns peaked between June and September. Burn patients were mainly men. Most burns occurred in participants aged 21 to 50 years and in industrial workers and electricians at work or householders at home. Only one person with high-voltage burns died (a mortality rate of 0.46%). Amputation rates were 37.33% for high-voltage burns and 22.01% for low-voltage burns. High-voltage injuries were associated with more extensive burns, longer hospital stays, and more complications and amputations. CONCLUSIONS More attention should be paid to prevention of electrical burns in male adults. Particular focus is needed on industrial workers, incidents in the spring and summer, and high-voltage injuries.
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Affiliation(s)
- Huarong Ding
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Meimei Huang
- Department of Plastic and Aesthetic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Dehui Li
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yuan Lin
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wei Qian
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
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Zheng Y, Lin G, Zhan R, Qian W, Yan T, Sun L, Luo G. Epidemiological analysis of 9,779 burn patients in China: An eight-year retrospective study at a major burn center in southwest China. Exp Ther Med 2019; 17:2847-2854. [PMID: 30930977 DOI: 10.3892/etm.2019.7240] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/30/2018] [Indexed: 02/06/2023] Open
Abstract
Burns are tissue injuries caused by high temperature, chemicals or electricity. Severe burns may involve all of the organs and tissues of the human body, leading to a series of pathophysiological processes and even death. The present study reviewed the clinical data of burn patients, including cases of burn-associated death, to provide evidence for the strategy of burn prevention. Basic information from 13,205 inpatients treated between January 1, 2009 and December 31, 2016 was extracted from the database of the Institute of Burn Research at Southwest Hospital (Chongqing, China). After excluding 3,426 inpatients who were not primarily treated for burns, 9,779 patients remained; among them, 68 cases (0.7%) had died as a direct consequence of the burns. Based on baseline data, the mortality rate, total body surface area of the burn (TBSA), age, sex, cause of injury and complications were analysed. In general, males accounted for a higher percentage than female burn patients. Of the patients, 95.54% had a TBSA of <50%, and the rate of mortality of the patients was increased when the TBSA was ≥50%. The major causes of injury were scalds (41.60%), fire (26.92%) and electricity (15.29%), and the majority of victims were 14 years or younger. With improvements in burn treatment technology in recent years, burn patient mortality was significantly reduced. Complications, including multiple organ failure and severe systemic infection, may reduce the survival rate of patients. The major risk factors for death included burns resulting from explosions, as well as shock, age (aged 0-1 or ≥50 years), greater TBSA and full-thickness burn area. With increasing length of stay at the hospital, patient mortality decreased. The renewal of treatment concepts and refined patient management contributed to the shorter LOS and lower mortality in 2015 and 2016.
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Affiliation(s)
- Yin Zheng
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University, Chongqing 400038, P.R. China
| | - Guoan Lin
- Military Burn Center, The 990th (159th) Hospital of The People's Liberation Army, Zhumadian, Henan 463000, P.R. China
| | - Rixing Zhan
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University, Chongqing 400038, P.R. China
| | - Wei Qian
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University, Chongqing 400038, P.R. China
| | - Tiantian Yan
- Military Burn Center, The 990th (159th) Hospital of The People's Liberation Army, Zhumadian, Henan 463000, P.R. China
| | - Lin Sun
- Military Burn Center, The 990th (159th) Hospital of The People's Liberation Army, Zhumadian, Henan 463000, P.R. China
| | - Gaoxing Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University, Chongqing 400038, P.R. China
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Ayaz M, Karami MY, Deilami I, Moradzadeh Z. Effects of Early Versus Delayed Excision and Grafting on Restoring the Functionality of Deep Burn-Injured Hands: A Double-Blind, Randomized Parallel Clinical Trial. J Burn Care Res 2019; 40:451-456. [DOI: 10.1093/jbcr/irz033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Mehdi Ayaz
- Division of Burn and Reconstructive Surgery, Department of Surgery, Shiraz, Iran
| | | | - Iman Deilami
- Division of Burn and Reconstructive Surgery, Department of Surgery, Shiraz, Iran
| | - Zahra Moradzadeh
- Physiotherapy and Rehabilitation Department, Shiraz University of Medical Sciences, Shiraz, Iran
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Li H, Zhou J, Peng Y, Zhang J, Peng X, Luo Q, Yuan Z, Yan H, Peng D, He W, Wang F, Liang G, Huang Y, Wu J, Luo G. The progress of Chinese burn medicine from the Third Military Medical University-in memory of its pioneer, Professor Li Ao. BURNS & TRAUMA 2017; 5:16. [PMID: 28573147 PMCID: PMC5450149 DOI: 10.1186/s41038-017-0082-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 05/12/2017] [Indexed: 12/30/2022]
Abstract
Professor Li Ao was one of the founders of Chinese burn medicine and one of the most renowned doctors and researchers of burns in China. He established one of the Chinese earliest special departments for burns at Third Military Medical University (TMMU) in 1958. To memorialize Professor Li Ao on his 100th birthday in 2017 and introduce our extensive experience, it is our honor to briefly review the development and achievement of the Chinese burn medicine from TMMU. The epidemiology and outcomes of admitted burn patients since 1958 were reviewed. Furthermore, main achievements of basic and clinical research for the past roughly 60 years were presented. These achievements mainly included the Chinese Rule of Nine, fluid resuscitation protocol, experience in inhalation injury, wound treatment strategies, prevention and treatment of burn infections, nutrition therapy, organ support therapies, and rehabilitation. The progress shaped and enriched modern Chinese burn medicine and promoted the development of world burn medicine.
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Affiliation(s)
- Haisheng Li
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Junyi Zhou
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Yizhi Peng
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Jiaping Zhang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Xi Peng
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Qizhi Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Zhiqiang Yuan
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Hong Yan
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Daizhi Peng
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Weifeng He
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Fengjun Wang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Guangping Liang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Yuesheng Huang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Jun Wu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Gaoxing Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
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Li H, Yao Z, Tan J, Zhou J, Li Y, Wu J, Luo G. Epidemiology and outcome analysis of 6325 burn patients: a five-year retrospective study in a major burn center in Southwest China. Sci Rep 2017; 7:46066. [PMID: 28383066 PMCID: PMC5382583 DOI: 10.1038/srep46066] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 03/08/2017] [Indexed: 11/09/2022] Open
Abstract
Burns are a major cause of injury worldwide. We investigated the epidemiology and outcomes of burn patients in a major burn center in southwest China between 2011 and 2015 to provide guidance for burn prevention. Of the 6,325 included burn patients, 66.8% were male and 34.7% were 0 ~ 6 years old. The incidence of burns peaked in autumn. Scald was the most common cause of burns, which was predominant in patients aged 0 ~ 6 years. The mean total body surface area (TBSA) of burns was 13.4%, and patients with burns ≤10% TBSA comprised 64.1% of all cases. Patients with full-thickness burns accounted for 40.1% of all patients and 81.0% of operated patients; these burns were primarily caused by flame (34.8%), scald (21.0%), and electricity (20.4%). Fifty-six deaths occurred (mortality 0.9%), and risk factors included full-thickness burns, larger TBSA and older age. The median length of stay was 17 days, and major risk factors included more operations, better outcomes and larger TBSA. Our data showed that closer attention should be paid to children under 6 years old, males, incidents in autumn and scald burns to prevent burn injuries. Furthermore, individualized burn prevention and treatment measures based on related risk factors should be adopted.
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Affiliation(s)
- Haisheng Li
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Zhihui Yao
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing, China
- People’s Liberation Army Hospital 59, Kaiyuan, Yunnan Province, China
| | - Jianglin Tan
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Junyi Zhou
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Yi Li
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Jun Wu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Gaoxing Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing, China
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Knight A, Wasiak J, Salway J, O'Brien L. Factors predicting health status and recovery of hand function after hand burns in the second year after hospital discharge. Burns 2016; 43:100-106. [PMID: 27608528 DOI: 10.1016/j.burns.2016.07.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/17/2016] [Accepted: 07/24/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Hands are the most commonly burnt body part given humans' innate response to guard their face from injury, and are known to have detrimental functional and psychological consequences. Conflicting evidence exists regarding the impact of hand burns on long-term health status and global functioning. The objective of this study was to identify patient and clinical characteristics that predict health status and hand function of people at 12-24 months after hand burn. METHODS The Burns Specific Health Scale-Brief (BSHS-B) and the Brief Michigan Hand Outcome Questionnaire (Brief MHQ) were administered to community-dwelling adults who were between one and two years after admission to a statewide burns service for burns including one or both hands. Demographic, injury, and treatment data were collected to identify which factors predict health status and hand function in the second year after admission. Linear regression analyses adjusted for total burn surface area and burn depth were conducted to identify important predictors or outcomes. RESULTS The sample (n=41) was 80.5% male, with a mean age of 44.5 years and total body surface area (TBSA) of 8.4%. Psychiatric illness (regression coefficient -56.6, confidence interval (95% CI) -76.70, -36.49) and female gender (-20.3; 95% CI -0.77, -40.29) were key predictors of poorer global health status on the BSHS-B. Females also scored worse on body image (-5.35; 95% CI -1.83, -8.87) and work (-4.13; 95% CI -0.64, -7.62) domains of BSHS-B. The need for reconstructive or secondary surgery (-38.84; 95% CI -58.04, -19.65) and female gender (-16.30; 95% CI -4.03, -28.57) were important predictors of poorer hand function. CONCLUSION Women and those with a history of psychiatric illness are particularly vulnerable to poorer outcomes in health status and/or hand function after burns, and may benefit from more intensive rehabilitation support and long-term follow-up.
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Affiliation(s)
- Amber Knight
- Monash University, Peninsula Campus, McMahons Rd, Frankston, Victoria 3199, Australia.
| | - Jason Wasiak
- Epworth Radiation Oncology, Epworth HealthCare, Melbourne, Australia; The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Jacqueline Salway
- Victorian Adult Burns Service, Alfred Health, 55 Commercial Rd, Prahran, Victoria 3181, Australia.
| | - Lisa O'Brien
- Monash University, Peninsula Campus, McMahons Rd, Frankston, Victoria 3199, Australia.
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