The epidemiology of burns in Indonesia’s national referral burn center from 2013 to 2015

Autologous fat grafting and adipose-derived stem cells therapy for acute burns and burn-related scar: A systematic review

Objectives

The objective of this study was to analyze all available research on the application of autologous fat grafting (AFG) and adipose-derived stem cells (ADSC) to present evidence-based recommendations, particularly in the clinical treatment of acute burns and burn-related scars.

Materials and Methods

We conducted a systematic search of PubMed, COCHRANE, and EMBASE, as well as a manual search of previous reviews' reference lists up. The risk of bias (RoB) was assessed using RoB 2.0 and ROBINS-I, where appropriate.

Results

Six eligible studies were selected (2 randomized clinical trials [RCT], 1 retrospective cohort, and 3 experimental studies) with subjects ranging from 3 to 100. Only one study evaluated the use of AFG for acute burns. Improvements in wound healing, vascularization, scar characteristics, and tissue architecture were generally observed in some studies, supported by molecular markers, while one study reported nonsignificant results. Subjective patient satisfaction was reported to have improved. Functional outcomes improvement in the treated regions was minimal. However, study heterogeneity arose mainly from treatment protocols. Cautious results interpretation due to potential bias, especially in selection and confounding domains, and limited clinical trials are important to note. More studies are needed to evaluate.

Conclusion

AFG and ADSC hold potential as valuable treatment options for burn-related scars, supported by a body of evidence, but further well-designed RCT are needed. The efficacy of acute burn settings is yet to be further evaluated since evidence is limited.

Outcome of burn injury and associated factor among patient visited at Addis Ababa burn, emergency and trauma hospital: a two years hospital-based cross-sectional study

BACKGROUND

Burn is one of the critical health problems worldwide. Developing countries with sub-Saharan and Asian populations are affected more. Its mortality and non-fatal complications depend on several factors including age, sex, residency, cause, the extent of the burn, and time and level of care given.

OBJECTIVE

The purpose of this study was to assess the outcome of burn injury and its associated factor among patients who visited Addis Ababa burn emergency and trauma hospital.

METHODS

The institutional-based, retrospective cross-sectional study design was conducted from April 1, 2019, to March 30, 2021. After checking the data for its consistency the data were entered and analyzed by using SPSS version 25. A total of 241 patients who had visited Addis Ababa burn, emergency and trauma Hospitals after sustained burn injury were recruited through convenience sampling method for final analysis. Model goodness-of-fit was checked by Hosmer and Lemeshow test (0.272). After checking multi-collinearity both the bi-variable and multivariable logistic regression model was fitted and variables having a p-value less than or equal to 0.05 at 95% CI in the multivariable analysis were considered statistically significant.

RESULT

Adults (age 15 to 60 years) are the most affected groups accounting for 55.2% followed by pediatric age groups (age <15 years) (43.6%) and the elderly (age > 60 years) (1.2%). Scald burn was the major cause accounting for 39 % followed by Flame burn (33.6%), Electrical burn (26.6%), and chemical burn (0.8%). The mean TBSA% was 15.49%, ranging from1% to 64%. Adult males are more affected by electrical burns while adult females and the elderly encounter flame burn. 78.4% of patients were discharged without complications, 14.9% were discharged with complications and 6.6% died. The commonest long-term complication is the amputation of the extremity (19, 7.9%). Age greater than 60 years and TBSA% greater than 30% is a strong predictors of mortality with odds of 2.2 at 95% CI of [1.32, 3.69] and 8.7 at 95% CI of [1.33, 57.32] respectively.

CONCLUSION AND RECOMMENDATION

The mortality rate show decrement from previous studies. Overall scald burn is common in all age groups but electrical burns and flame burns affected more adult and elderly age groups. Extremities were by far, the commonest affected body parts. The extent of burn injury and the age of the patient independently predict mortality. Early intervention will reduce mortality and complications.

Epidemiology of non-fatal burn injuries in children: evidence from Bangladesh Health and Injury Survey 2016

BACKGROUND

Burn is a major cause of childhood injury-related morbidity and mortality. Global estimates suggest that 90% of all cases occur in low-income and middle-income countries and over half of the disability-adjusted life-years are lost from fire-related burns in children. In Bangladesh, there is a scarcity of data on childhood burn injuries. The goal of the study was to describe the epidemiology of non-fatal burns in Bangladeshi children, including incidence estimates and identify high-risk groups.

METHODS

Bangladesh Health and Injury Survey 2016 was a large scale cross-sectional survey. The survey was conducted among 299 216 population utilising a multistage cluster sampling method. Among the 100 842 children, there were 437 non-fatal burn cases.

RESULTS

Among different injury mechanisms in children, burn was ranked fifth (7.4%). The overall yearly incidence rate (IR) of burns was 866.7 per 100 000 children (95% CI 785.6 to 947.8) in Bangladesh. The incidence was highest among 1-4 years old children (IR 2028.3, 95% CI 1761.1 to 2334.7) and had a 3.5 times higher risk of burns compared with the 15-17 years age group. Females had a much higher IR of non-fatal burns than males between the ages of 10-15 years (1655.2 vs 482.2). About 70% of burns occurred in rural areas. Hot liquid (44.7%), flames (32.5%) and hot objects (20.7%) were identified as the main causes of burns. The kitchen (60.9%), yards (20.8%) and bedroom and living room (10.5%) were the three most common places for burns. According to the study, 34.8% of burn incidences occurred between the hours of 7:00 and 10:00.

CONCLUSION

Children in Bangladesh suffer from a high rate of non-fatal burns. The high-risk category was identified as preschool-aged boys and adolescent girls. The majority of the incidents occurred in the morning and inside the kitchen. These findings will help raise awareness and create intervention measures to reduce the high incidence of non-fatal childhood burns in Bangladesh.

Effect of Manual Acupuncture and Laser Acupuncture on Wound Closure in Rat with Deep Partial Thickness Burn Injury

Background

Burns are defined as tissue damage that occurs as a result of the action of heat. Although many advanced treatments have been made in burn therapy, slow wound healing remains a challenge in burn treatment. Acupuncture can accelerate burn healing through its anti-inflammatory effect, increasing re-epithelialization and angiogenesis.

Objectives

This study assessed the effect of manual acupuncture and laser acupuncture on the healing of burns that were observed macroscopically and microscopically.

Methods

Thirty-six male Wistar rats with deep partial thickness burns were randomly divided into control group (n = 12), acupuncture group (n = 12), and laser acupuncture group (n = 12). Wound measurements and treatments were given every 2 days for 14 days.

Results

On the 14th day of macroscopic evaluations, there was a significant difference (P = 0.009) between the acupuncture group (66.96 ± 9.17) and the control group (49.93 ± 9.15), and a significant difference (P = 0.009) between laser acupuncture group (72.48 ± 14.62) and the control group. However, there was no significant difference (P = 0.451) between acupuncture and laser acupuncture groups. On the 14th day of microscopic evaluations, there was a significant difference (P < 0.001) between the acupuncture group (16.17 ± 1.17) and the control group (10.33 ± 1.21), and a significant difference (P = 0.004) between the laser acupuncture group (17.83 ± 1.47) and the control group. However, there was no significant difference (P = 0.058) between acupuncture and laser acupuncture groups.

Conclusion

The results showed that either acupuncture therapy or laser acupuncture therapy could be used as an adjunct therapy to accelerate burn healing.

The Epidemiology of Unintentional Burn Case in Sanglah General Hospital, Denpasar, from 2014 to 2018

BACKGROUND: Burn injury is one of the serious public health problems. Many of burn patients end up with experiencing disability (morbidity). Meanwhile, the epidemiology of burn patients in eastern part of Indonesia is rarely reported. AIM: We aimed to investigate the sociodemographic characteristic of burn patients in Sanglah General Hospital as the center referral hospital for eastern part of Indonesia. MATERIALS AND METHODS: Viable data were collected from burn patients admitted to Burn Center of Sanglah Hospital between January 2014 and December 2018. A cross-sectional study design was used with statistical analysis which was performed using IBM Statistics 23 for Windows. RESULTS: A total of 725 subjects were involved in this study. Subjects were divided into two groups of emergency (n = 607, 83.72%) and non-emergency (n = 118, 17.28%). There were 525 (72.4%) burn subjects who were ≥17 years old with combustion caused by flame as the most common case (n = 264, 56.9%), whereas 200 (27.6%) subjects were <17 years old, while the group of age 0–5 years old (n = 115, 57.5%) gave largest proportion admission in pediatric group of scalding as the main cause (n = 100, 69.4%). CONCLUSION: We found that adults and elders had the highest risk of acquiring combustion caused by flame. Scalding was the most burns case found in the pediatric population.

Epidemiology and Characteristics of Burn Patients in Dr. Soedarso General Hospital during 2017 – 2020: Retrospective Study

Background: Burns are devastating injuries, often resulting in significant morbidity, impairment of emotional well-being, and experienced quality of life. The etiological factors of burn injuries is vary considerably in different communities and regions, hence the need for detailed epidemiological studies to understand the problem status in different regions. Methods: A retrospective study of non-random consecutive sampling of medical records of Dr. Soedarso Regional Hospital in the period August 2017 – December 2020 Results: A total 108 samples were included in this study. There were 88 (81,5%)  male and 20 (18,5%) female; mostly adult (>18 years) 57 (52,8%). The etiology of burn injury was flame (35,2%), electrical (34,3%) and scald (30,6%). The most total body surface area (TBSA) of burns from 1-10%. The mortality rate was obtained by 8 (7.4%) respondents. Conclusion: : Based on the results of this study, that the major proportion of burn patients were male  and in the age group of > 18 years old. Flame was the most leading cause of burn. Considering the size of the burn, it was revealed that the most TBSA of  burns was 1-10%.

Microbiology and Infection Profile of Electric Burned Patients in a Referral Burn Hospital in Mexico City

Electrical burn injuries are one of the most severe forms of trauma. This study aims to investigate the infection complications in electrical burn patients in a referral hospital in Mexico City. A longitudinal retrospective study was conducted, involving electrical burn patients admitted from April 2011 to December 2016. Demographic and clinical data including type of electric burns, infection complications, and mortality was sought. Data were collected at admission and daily until discharge. Number and type of infections and microorganism isolations were sought. Risk factors for death were analyzed. A total of 111 patients were included, of which 96.4% were males, mean age of 31.6±16.22, most injuries were high voltage associated. The total body surface area average was 27.8% ± 19.63. The overall infection rate was 72.9 cases per 100 patients. Mortality was observed in 4 (3.6%) patients. About 59.1% (443/749) had growth for Gram-negative bacteria. Multidrug-resistant Pseudomonas aeruginosa was the most frequent microorganism isolated. Fungi were present in 4.9% of cases. Electrical burn injuries occurred in young males in our study. Infection was frequent, most of them caused by Gram-negative rods with an important rate of antimicrobial resistance; however, an important microbial diversity was present.

The treatment challenges and limitation in high-voltage pediatric electrical burn at rural area: A case report

INTRODUCTION

Although rare, electrical injury in pediatrics is potentially life threatening and has significant and long-term impact in life. It is challenging to manage such cases in rural areas.

PRESENTATION OF CASE

A fully conscious 13-year-old boy was admitted to the emergency room after being electrocuted by high-voltage power cable, with superficial partial thickness burn over right arm, trunk, and left leg (26 % of total body surface area). Tachycardia and non-specific ST depression was found on ECG examination and was diagnosed with high-voltage electrical injury. Treatments were based on ANZBA algorithm with several modifications, i.e., administering lower concentration of oxygen with nasal cannula instead of non-rebreathing mask as well as Ketorolac and Antrain® for analgesic instead of morphine.

DISCUSSION

Different choices of treatments were given due to limited resources. Despite possible cardiac and renal complication, further tests could not be done. Fortunately, after strict monitoring, no signs of abnormality were found. We used silver sulfadiazine, Sofratulle® and dry sterile gauze as a dressing of choice following immediate surgical debridement. The patient was observed daily through 7 days of hospitalization and followed-up for 1 year, achieving normal physiologic function of the affected area but unsatisfactory esthetic result.

CONCLUSION

Lack of infrastructure, drugs, and trained personnel are some of the challenges that still exist in most rural areas. Thus, implementation of available standardized guidelines such as ANZBA, and giving similar training to personnel as well as providing feasible equipment followed by strict monitoring for the patient are needed to achieve maximum results.

Clinical Profile of Pediatric Burn Patients in Burn Care Unit of Halibet Hospital in 2018: Asmara, Eritrea

Background

Pediatric burn injuries result in severe and long-term complications in the developing world, especially in sub-Saharan Africa. Accurate data on burn injuries are either unavailable or incomplete in Eritrea.

Objective

The objective of this study was to define the clinical characteristics of pediatric burn injuries in the Burn Care Unit of Halibet hospital in 2018 in Asmara, Eritrea.

Methods

The study design was a retrospective cross-sectional descriptive study. The medical records of pediatric patients aged 15 years and below admitted to the Burn Care Unit of Halibet hospital between January 2018 and December 2018 were assessed.

Results

In the study period, 524 children with burn injuries were admitted to the Unit. The mean age of the study group was 4.2±3.7 years. Nearly 75% of the patients were in the age group 1–5 years. In 95.3% of the patients, scalds were the most common type of burn with burn injury occurring mostly indoor in 98.1% of cases. The average length of hospital stay was 4.6±8.4 days with a median of 1 day. In 94.8% of the patients, the body surface area involved was 1–10%, and the most body part involved was the extremity in 80.7% of the cases. Patients with body surface involvement >10% and who came from rural areas stayed longer in hospital and those with scald burns have a shorter hospital stay. Patients with body surface area involvement >10% and who came from rural areas also have more complications.

Conclusion

The most affected age group were 1–5 years old children with scalds being the most common type of burns with injury occurring mostly indoors in this population. Teaching parents about household safety, seeking early medical attention, and raising public awareness could decrease the incidence of burn injury in children.

Epidemiological analysis of patients with burns in third-line hospitals in Turkey

Burns are a major health problem worldwide. Burn injury resulting from making contact with hot objects, direct or indirect contact with flame, and exposure to chemical agents or electric current is usually preventable. In this study, epidemiological data of the patients who had been hospitalised in the burn unit was assessed. The records of 1453 patients who were admitted to the burn unit of Diyarbakir Gazi Yaşargil Training and Research Hospital between July 2008 and April 2018 were retrospectively examined. Out of 1453 cases, 81.7% (1187) were children and 18.3% (266) were adults, 58.3% of the cases were male (847) and 41.7% (606) were females. Patients had a mean age of 11 ± 5 years (1-81 years). The most common cause of burns was contact with hot liquids (82.86%) while other causes were flame burns (12.04%), electrical contact burn (3.02%) contact with chemical substances (2.06%). Most of the cases were found to have burned 10% to 20% of the body surface. Localization was most frequently seen in the lower extremity and less frequently in the upper limb, trunk, head and neck, and perineal regions. The majority of burn injuries are preventable. Therefore, epidemiological studies in the field of burns will provide vital preventive information to develop strategies to reduce injury frequency and spend on health. Because burns are a social problem, prevention efforts require social co-operation. Promotional meetings in schools are important to increase family-school cooperation to inform children of school age, to give lectures and first aid measures to rural areas.

A case series of negative pressure wound therapy as a promising treatment in patients with burn injury

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NPWT significantly reduced length of hospitalization.

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Also had minimal complication.

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This procedure can be an alternative treatment for burn patients.

Introduction

Burn injuries continue to be a global burden. Burn wound treatment often requires a long treatment time and often results in high morbidity and mortality. Until now, there is still no ideal burn wound treatment for all patients.

Presentation of cases

Here we report 3 cases of burn patients. Every patient underwent wound debridement and followed by installation of Negative Pressure Wound Therapy (NPWT) on the site of burn injuries. All of patients was discharged in a good condition.

Discussion

NPWT is an application of sub-atmospheric pressure that is placed on the wound. Today, the use of negative pressure therapy is a new strategy in managing burn injuries. NPWT can reduce the length of stay of burn patients that can be associated with faster wound healing, and reduce bacterial levels in burns.

Conclusion

The combination of debridement and NPWT in burn patients can be an alternative procedure because it can promote faster wound healing and reduce the length of hospitalization. Furthermore, this is the first report of NPWT usage for the treatment of burn patients in Indonesia.

The role of concomitant alcohol and drug use in increased risk for burn mortality outcomes

BACKGROUND

Burn injuries are a major cause of mortality and morbidity in low- and middle-income countries, with high rates in Sub-Saharan Africa. The risks may be heightened for persons who present with concomitant use of alcohol and illicit substances, which increase the risk for injury and severely compromise prognosis following injury.

METHODS

This study utilised a national dataset on hospitalised burns in South Africa to explore the risk for mortality relative to morbidity. To assess the influence of alcohol and drugs in mortality outcomes, the analysis was restricted to adult cases, 18 years and older (N = 918). The primary statistical procedures used in the analysis were logistic regression models.

FINDINGS

The results indicate that burn victims with full thickness and partial thickness burn degree and more than 30% TBSA had a significantly increased risk of mortality. In addition, the risk for mortality was increased ten times when concomitant alcohol and drugs were indicated compared to cases where these were absent. The length of stay in hospital diminished the risk for mortality by about 10%.

INTERPRETATION

The findings may be explained by the role of skin as the main barrier against infections and the concurrent increase in risk of infection based on the degree and extent of any damage. The combined presence of both alcohol and drugs may predispose towards more severe burns and greatly compromise liver function with heightened risk for sepsis and death.