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Roy S, Mukherjee P, Kundu S, Majumder D, Raychaudhuri V, Choudhury L. Microbial infections in burn patients. Acute Crit Care 2024; 39:214-225. [PMID: 38863352 PMCID: PMC11167422 DOI: 10.4266/acc.2023.01571] [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: 12/08/2023] [Revised: 03/16/2024] [Accepted: 03/27/2024] [Indexed: 06/13/2024] Open
Abstract
Polymicrobial infections are the leading causes of complications incurred from injuries that burn patients develop. Such patients admitted to the hospital have a high risk of developing hospital-acquired infections, with longer patient stays leading to increased chances of acquiring such drug-resistant infections. Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Proteus mirabilis are the most common multidrug-resistant (MDR) Gram-negative bacteria identified in burn wound infections (BWIs). BWIs caused by viruses, like Herpes Simplex and Varicella Zoster, and fungi-like Candida spp. appear to occur occasionally. However, the preponderance of infection by opportunistic pathogens is very high in burn patients. Variations in the causative agents of BWIs are due to differences in geographic location and infection control measures. Overall, burn injuries are characterized by elevated serum cytokine levels, systemic immune response, and immunosuppression. Hence, early detection and treatment can accelerate the wound-healing process and reduce the risk of further infections at the site of injury. A multidisciplinary collaboration between burn surgeons and infectious disease specialists is also needed to properly monitor antibiotic resistance in BWI pathogens, help check the super-spread of MDR pathogens, and improve treatment outcomes as a result.
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Affiliation(s)
- Souvik Roy
- Postgraduate and Research Department of Biotechnology, St. Xavier’s College (Autonomous), Kolkata, India
| | - Preeti Mukherjee
- Postgraduate and Research Department of Biotechnology, St. Xavier’s College (Autonomous), Kolkata, India
| | - Sutrisha Kundu
- Postgraduate and Research Department of Biotechnology, St. Xavier’s College (Autonomous), Kolkata, India
| | - Debashrita Majumder
- Postgraduate and Research Department of Biotechnology, St. Xavier’s College (Autonomous), Kolkata, India
| | - Vivek Raychaudhuri
- Postgraduate and Research Department of Biotechnology, St. Xavier’s College (Autonomous), Kolkata, India
| | - Lopamudra Choudhury
- Department of Microbiology, Sarsuna College (under Calcutta University), Kolkata, India
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Tolouei M, Bagheri Toolaroud P, Letafatkar N, Feizkhah A, Sadeghi M, Esmailzadeh M, Daghighi Masooleh M, Mobayen M. An 11-year retrospective study on the epidemiology of paediatric burns in the north of Iran. Int Wound J 2023; 20:3523-3530. [PMID: 37160373 PMCID: PMC10588361 DOI: 10.1111/iwj.14225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/14/2023] [Accepted: 04/24/2023] [Indexed: 05/11/2023] Open
Abstract
Burn injuries in children are distressing physical and emotional events with long-term disability. However, there is little research on the epidemiology of paediatric burns. This information is essential for the development of prevention intervention and acute management. This study aimed to describe epidemiologic characteristics and clinical outcomes of paediatric burns in a burn center in the north of Iran. A retrospective, single-center study was conducted of children (<18 years) admitted to the burns center between 2011 and 2021. The data were analysed by SPSS 24.0 software. The chi-squared test and Fisher's exact test were used to assess categorical variables, and Student's t-tests or One-Way ANOVA was used to evaluate continuous variables. 2951 paediatric burns with mean age 5.30 ± 5.27 years, were admitted during the 11 years, with 1777 boys (60.2%) and 1174 girls (39.8%). By age groups, the majority of children (59.7%) were between 0 and 4 years old, followed by 5 to 8 years (15.7%), 13 to 18 years (14.6%), and 9 to 12 years (10.0%), respectively. The most cause of injury was Hot liquids & vapours (1604, 54.4%). The mean age for burns with fire & flames, hot liquids & vapours, contact, chemical, and electrical was 4.46 ± 4.84, 5.70 ± 5.39, 5.44 ± 5.42, 3.93 ± 3.86, and 3.53 ± 4.06 years, respectively. The total body surface area (TBSA) burned was 14.96 ± 11.94. The longest length of stay (LOS) related to fire and flame was 5.63 ± 7.57 days. The mortality rate was 1.56%. There were significant differences among aetiology groups for the cost per % TBSA (F = 15.784, P < 0.001), which correlated with the burn depth, TBSA, aetiology, LOS, and age. The Ministry of Health should establish strategies for burn prevention and incorporate data surveillance for burn injuries. Community education on kitchen and cooking safety could positively impact the prevalence and outcomes of paediatric burns.
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Affiliation(s)
- Mohammad Tolouei
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Parissa Bagheri Toolaroud
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Health Information Management Research CenterKashan University of Medical SciencesKashanIran
| | - Negin Letafatkar
- School of MedicineGuilan University of Medical SciencesRashtIran
| | - Alireza Feizkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical PhysicsSchool of Medicine, Guilan University of Medical SciencesRashtIran
| | - Mahsa Sadeghi
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Mojdeh Esmailzadeh
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | | | - Mohammadreza Mobayen
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
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Allahham A, Cooper MN, Fear MW, Martin L, Wood FM. Quality of life in paediatric burn patients with non-severe burns. Burns 2023; 49:220-232. [PMID: 35410696 DOI: 10.1016/j.burns.2022.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/28/2022] [Accepted: 03/16/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Burns are common worldwide, and the vast majority are non-severe burns of less than 20% of the total body surface area (TBSA). In Australia, paediatric burns account for a third of all burn admissions, thus understanding the quality-of-life outcomes after a non-severe burn in children is important. METHODS This retrospective cohort study describes a paediatric cohort from Western Australia with non-severe burns occurring between 2018 and 2020 and characterises the child's quality-of-life outcomes which is measured using the Paediatric quality of life survey (PedsQL). The PedsQL included a parent-report and child-report assessment, each with a physical function domain and a psychosocial function domain which comprised of an emotional, a social and a school category. RESULTS Data collected from 249 patients; 50.6% were male, 45.6% were toddlers. The most common cause was scald (48.19%), the majority had burns smaller than 5% TBSA (91.97%), and most included visible areas such as head, neck or hands (77.51%). The parent-report PedsQL scores were significantly different for both physical and psychosocial domains between the different age groups (p = 0.002, p = 0.001, respectively) and for burn cause (p = 0.004, p = 0.005, respectively). For child-reported scores we found evidence of an effect of burn cause across both domains that did not reach a statistical significance (p = 0.076, p = 0.078, respectively). The psychosocial functions in both the parent-report and the self-report were significantly different for the socioeconomic status groups (p = 0.015, p = 0.032, respectively). Quality of life scores were critically low in 16.46% of paediatric burn patients at three months after burn. CONCLUSION Parent-reported and child-reported psychosocial function was significantly poorer in higher socioeconomic groups, for older children and for those with flame burns. About 16% of patients had scores below the critical cut off. These data provide insight into the quality-of-life outcomes of paediatric patients with non-severe burns, allowing future studies to investigate burn prevention strategies and services to help paediatric burn patients in their recovery.
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Affiliation(s)
- Amira Allahham
- University of Western Australia, Burn Injury Research Unit, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Matthew N Cooper
- Telethon Kids Institute, University of Western Australia, 15 Hospital Ave, Nedlands, Western Australia 6009, Australia
| | - Mark W Fear
- University of Western Australia, Burn Injury Research Unit, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; Fiona Wood Foundation, 11 Robin Warren Dr, Murdoch, WA 6150, Australia
| | - Lisa Martin
- University of Western Australia, Burn Injury Research Unit, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; Fiona Wood Foundation, 11 Robin Warren Dr, Murdoch, WA 6150, Australia.
| | - Fiona M Wood
- University of Western Australia, Burn Injury Research Unit, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; Fiona Wood Foundation, 11 Robin Warren Dr, Murdoch, WA 6150, Australia; Burn Service of Western Australia, Fiona Stanley Hospital, MNH (B) Main Hospital, Level 4, Burns Unit, 102-118 Murdoch Drive, Murdoch, Western Australia 6150, Australia; Burns Unit, Perth Children's Hospital, 15 Hospital Ave, Nedlands, WA 6009 Australia.
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Shoaei P, Shojaei H, Siadat SD, Moshiri A, Vakili B, Yadegari S, Ataei B, Khorvash F. Gut microbiota in burned patients with Clostridioides difficile infection. Burns 2022; 48:1120-1129. [PMID: 34924229 DOI: 10.1016/j.burns.2021.11.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 11/03/2021] [Accepted: 11/29/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The survival rate of patients with severe burn is positively associated with increasing the incidence of the Clostridioides difficile (C. difficile) infection (CDI). The surviving rate of severe burn patients now has an improved but the incidence of Clostridioides difficile (C. difficile) infection (CDI) has been continues increasing during recent two decades. This study assessed the molecular typing and phenotypic characterization isolates of C. difficile in burn patients with diarrhea, as well as environmental and skin infections with C. difficile spores at a referral burn hospital in Isfahan, Iran. It mainly aimed to evaluate the dominant bacterial structure in the gut microbiome of burned subjects with and without CDI. METHODS In general, 309 samples were collected from 189 burned patients with hospital-acquired diarrhea and 120 swabs were collected from the healthcare workers' dominant hands, different sites of patients' skin, and medical tools. In addition, C. difficile isolates were characterized considering the existence of antibiotic resistance and toxin genes. Clinical cultures with identification of organisms and antibiotic susceptibility were done. C. difficle isolates were then genotyped and compared to clinical outcomes. Finally, the clinical characteristics of the participants were gathered through their records, and the bacterial targets of the gut microbiome were detected using quantitative real-time polymerase chain reaction (PCR). RESULTS Based on the findings, 51 C. difficile isolates were detected from 189 severe burn patients hospitalized in the hospital. Further, PCR amplification tcdB and tcdA showed 23 isolates (12.2%) as toxigenic. Overall, 18.3% (22/120) of skin and environment samples demonstrated a positive result for C. difficile colonization. A low concentration of metronidazole and vancomycin (MIC90, 0.5, and 1.2 mg/L) inhibited all toxigenic C. difficile strains. Moreover, these isolates represented the highest rates of resistance to moxifloxacin and clindamycin (MIC90, 0.5, and 1.6 mg/L). A significantly reduced abundance of Clostridium spp., Bacteroidetes, and Bifidobacterium and an increase in the quantity of Firmicutes was observed in the gastrointestinal microbiome of burn patients (P < 0.01). Burn patients with CDI showed a significant decrease in Faecalibacterium prausnitzii (F. prausnitzii) while higher Akkermansia muciniphila (A. muciniphila) loads in comparison with healthy controls (P < 0.001 and P < 0.05). Contrarily, burned cases displayed increased levels of opportunistic pathogenic bacteria including the members of Enterococcus spp. and Escherichia coli (P < 0.05). CONCLUSIONS Despite appropriate infection control strategies in the burn intensive care unit, CDI remains prevalent in severe burn patients. Eventually, the overgrowth of A. muciniphila and the decreased abundance of F. prausnitzii in burn cases with CDI could be potential predictive microbiome biomarkers in burned patients.
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Affiliation(s)
- Parisa Shoaei
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hasan Shojaei
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Davar Siadat
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran; Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran.
| | - Arfa Moshiri
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran; Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran; Laboratory of Experimental Therapies in Oncology, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Bahareh Vakili
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Sima Yadegari
- Department of Infectious Diseases, Imam Musa Kazem Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzin Khorvash
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Khaledi M, Afkhami H, Matouri RN, Dezfuli AAZ, Bakhti S. Effective Strategies to Deal With Infection in Burn Patient. J Burn Care Res 2021; 43:931-935. [PMID: 34935044 DOI: 10.1093/jbcr/irab226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Treatment of bacterial infection is difficult. Treatment protocol of burned patient is hard. Furthermore, treatment in burned patients is accompanied with problems such as complexity in diagnosis of infection's agent, multiple infections, being painful, and involving with different organelles. There are different infections of Gram-positive and Gram-negative bacteria in burned patients. From important bacteria can be noted to Pseudomonas aeruginosa, Acinetobacter baumannii, and Staphylococcus aureus that have high range of morbidity and mortality. Treatment of those bacterial infections is extremely important. Hence, many studies about methods of treatment of bacterial infections have published. Herein, we have suggested practical methods for example ant virulence therapies, nanotechnology, vaccine, and photodynamic therapy in treatment of bacterial infections. Those methods have been done in many researches and had good effect.
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Affiliation(s)
- Mansoor Khaledi
- Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Hamed Afkhami
- Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Raed Nezhad Matouri
- Department of Medical Library and Information Sciences, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | | | - Shahriar Bakhti
- Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
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Abu Ibaid AH, Hebron CA, Qaysse HA, Coyne MJ, Potokar TS, Shalltoot FA, Shalabi MA. Epidemiology, aetiology and knowledge, attitudes, and practices relating to burn injuries in Palestine: A community-level research. Int Wound J 2021; 19:1210-1220. [PMID: 34761542 PMCID: PMC9284619 DOI: 10.1111/iwj.13716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/12/2021] [Accepted: 10/20/2021] [Indexed: 12/01/2022] Open
Abstract
The aim of this study was to identify the epidemiology, aetiology as well as the knowledge, attitudes, and practices relating to burn injuries in Palestine. A mixed‐method approach was used. A survey was distributed to a total of 1500 households selected by randomised approach. The survey was standardised based on World Health Organisation's guidelines for conducting community surveys on injury. Additionally, there were 12 focus group discussions and 10 key informant interviews to collect rich qualitative data. In the West Bank and Gaza, 1.5% of Palestinians had experienced serious burn injuries in the 12 months. The total sample of 1500 yields a margin of error (plus/minus) = 2.5% at a 95% level of confidence and a response distribution (P = 50%) with 3% non‐response rate. Of the 1500 households approached, 184 reported a total of 196 burn injuries, with 87.2% occurring inside the home: 69.4% were females and 39.3% were children. The main source of reported cause of burn was heat and flame (36%), electric current (31.6%), hot liquid (28.6%), and chemicals (2.7%). The most common first aid for burns was pouring water (74.7%). People in rural, refugee, and Bedouin settings had the highest incidence of burns. This study provides the burn prevalence rate, explanatory factors that contribute to the frequency of burns in Palestine. Making burn prevention a higher priority within the national policy is crucial.
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Affiliation(s)
| | - Caitlin A Hebron
- Centre for Global Burn, Policy & Research, Swansea University, Swansea, UK.,NIHR Global Health Research Group on Burn Trauma, Swansea, UK.,International Network for Training, Education & Research in Burns "Interburns", Cardiff, UK
| | | | | | - Tom S Potokar
- Centre for Global Burn, Policy & Research, Swansea University, Swansea, UK.,NIHR Global Health Research Group on Burn Trauma, Swansea, UK.,International Network for Training, Education & Research in Burns "Interburns", Cardiff, UK
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Therapeutic effect of mesenchymal stem cells on histopathological, immunohistochemical, and molecular analysis in second-grade burn model. Stem Cell Res Ther 2021; 12:308. [PMID: 34051875 PMCID: PMC8164255 DOI: 10.1186/s13287-021-02365-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/30/2021] [Indexed: 12/12/2022] Open
Abstract
Background and aim Deleterious cutaneous tissue damages could result from exposure to thermal trauma, which could be ameliorated structurally and functionally through therapy via the most multipotent progenitor bone marrow mesenchymal stem cells (BM-MSCs). This study aimed to induce burns and examine the effect of BM-MSCs during a short and long period of therapy. Material and methods Ninety albino rats were divided into three groups: group I (control); group II (burn model), the animals were exposed to the preheated aluminum bar at 100°C for 15 s; and group III (the burned animals subcutaneously injected with BM-MSCs (2×106 cells/ ml)); they were clinically observed and sacrificed at different short and long time intervals, and skin samples were collected for histopathological and immunohistochemical examination and analysis of different wound healing mediators via quantitative polymerase chain reaction (qPCR). Results Subcutaneous injection of BM-MSCs resulted in the decrease of the wound contraction rate; the wound having a pinpoint appearance and regular arrangement of the epidermal layer with thin stratum corneum; decrease in the area percentages of ADAMs10 expression; significant downregulation of transforming growth factor-β (TGF-β), interleukin-6 (IL-6), tumor necrotic factor-α (TNF-α), metalloproteinase-9 (MMP-9), and microRNA-21; and marked upregulation of heat shock protein-90α (HSP-90α) especially in late stages. Conclusion BM-MSCs exhibited a powerful healing property through regulating the mediators of wound healing and restoring the normal skin structures, reducing the scar formation and the wound size.
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An Epidemiological Study of Burn Cases from a Single Referral Hospital in Indore, Central Part of India and a Proposal for Burn Prevention and Care Program. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02124-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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9
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Murhula GB, Musole PB, Nama Kafupi B, Tshibwid A Zeng F, Garhalangwamuntu Mayeri D, Cikomola FG, Pompermaier L. Factors associated with outcomes after burn care: A retrospective study in Eastern Democratic Republic of Congo. J Burn Care Res 2021; 43:85-92. [PMID: 33773491 DOI: 10.1093/jbcr/irab051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE In low income countries, incidence of burns is high and severe burns are frequently managed at peripheral facilities. Outcome after burn care is poorly studied although it might help identify risk-group and improve treatment strategies. This study aimed to study factors associated with in-hospital outcomes in a burn cohort in the Democratic Republic of Congo. METHODS In this retrospective study we included burn patients admitted to the surgical department at the Hôpital Provincial Général de Référence de Bukavu between January 2013 and December 2018. Differences between groups were tested using χ2 test or Fisher's exact tests or Wilcoxon rank sum test, as appropriate. Multivariate logistic regression was used to analyze the effect of patients and of burn characteristics on in-hospital mortality, prolongated length of stay (=LOS≥25days) and occurrence of complications. RESULTS The study population consisted of 100 patients, mainly young male with rural origin, moderate sized but deep burns. Of them, 46 developed complications, 12 died. Median LOS was 25 days (IQR: 15-42). In-hospital death was independently associated with Total Burn Surface Area percentage "TBSA%" (OR=3.96; 95% CI=1.67-9.40) and Full thickness Burns "FTB" (10.68; 1.34-84.74); prolongated LOS with FTB (3.35; 1.07-10.49), and complication with rural origin (5.84; 1.51-22.53), TBSA% (3.96; 1.67-9.40), FTB (4.08; 1.19-14.00) and burns on multiple sites (4.38; 1.38-13.86). CONCLUSION In-hospital death was associated with TBSA% and FTB, prolongated LOS with FTB, and complication with burns characteristics and rural origin of the patients. Further studies are necessary to investigate the effect of provided burn care on outcomes.
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Affiliation(s)
| | - Patrick Bugeme Musole
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of Congo
| | - Bienfait Nama Kafupi
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of Congo
| | - Florent Tshibwid A Zeng
- Faculty of Medicine, Department of Surgery, University of Lubumbashi, Democratic Republic of Congo
| | | | - Fabrice Gulimwentuga Cikomola
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of Congo.,Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of Congo
| | - Laura Pompermaier
- Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Rezaee R, Alimohamadzadeh K, Hossini SM. Epiemiologic Features and Hospitalization Cost of Burn Injuries in Iran Based on National Burn Registry; a Cross-sectional Study. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2019; 7:e65. [PMID: 31875219 PMCID: PMC6905413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Burn is one of the most common causes of injury in the world. The aim of this study was to determine the epidemiologic features and cost of hospitalization associated with burn injuries in Iran. METHODS In this cross-sectional study, the data related to hospitalized burn cases in 2017 were obtained from the office of curative affairs in the Ministry of Health and Medical Education of Iran and analyzed regarding the epidemiologic features and hospitalization costs. RESULTS 35933 hospitalized burn patients, from the beginning to the end of 2017, with the mean age of 29.37 ± 21.41 (1 - 99) years were studied (59.4% male). Scald burns (49.4%) were the most prevalent type of burns and 30.3% of burns occurred in spring. The most frequent severity of burn injury was second-degree burns (69.3%) with 1-20 percent involvement of body's surface area (74.7%). Frequency of scald burn was higher in females, while the frequency of flame was higher in males. Total hospitalization cost of studied cases was 66910.22 $. In male patients, the highest average direct cost was related to electrical burns; while in females, the highest average direct cost was related to chemical burns. Higher degrees and percentages of burn injuries required a more costly treatment. CONCLUSIONS Burn injuries most frequently happened in males, ages < 10 years, spring season, and with scald and flame. The most frequent injuries were second-degree burns with 1% - 20% body surface involvement. The highest direct hospitalization cost was related to chemical and electrical burns. There was a direct correlation between the degree and percentage of burn and the hospitalization costs.
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Affiliation(s)
- Reza Rezaee
- Department of Health Service Management, North Tehran Branch of IslamicAzad University, Tehran, Iran.
| | - Khalil Alimohamadzadeh
- Department of Health Service Management, North Tehran Branch of IslamicAzad University, Tehran, Iran. ,Corresponding Author: Khalil Alimohamadzadeh; Department of Health Service Management, North Tehran Branch of Islamic Azad University, Shahid Babaee Highway (West to East), the outlet of Hakimiyeh, Shahid Sadoughi Street, Vafadar Boulevard, Tehran, Iran.
| | - Seyed-Mojtaba Hossini
- Department of Health Service Management, North Tehran Branch of IslamicAzad University, Tehran, Iran.
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Muguregowda HT. An Observational Study on Clothing Characteristics Involved as Major Contributors in Sustaining Domestic Burns Injuries. World J Plast Surg 2019; 8:293-297. [PMID: 31620329 PMCID: PMC6790257 DOI: 10.29252/wjps.8.3.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 05/24/2019] [Accepted: 05/29/2019] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Fire and burn-related injuries are a leading cause of morbidity and mortality worldwide, and is a serious public health problem in developing countries. Several studies showed causes such as low socioeconomic status, poor living conditions, illiteracy, and floor level cooking, however, very few studies stated severity of the burn injuries to be dependent on ignition of type clothing garment and fabric wore at the time of incident. METHODS A cross sectional observational study done on burn injury patients admitted from February 2014 to August 2016. Data were collected from the patients or their relatives and analysed. RESULTS Among 224 burn injury patients, majority were females (59.3%) sustained burn injuries in the study population (p=0.005). Victims wearing long loose flowing garments such as sarees (41.1%), salwar (22.3%), and dupatta (9.8%) were caught fire easily and sustained more burn injuries, compared to clothes reaching down to the knee and short fitting dresses (p=0.004). Percentage of burn was higher among wearers of synthetic fabrics (50.89%) than that of cottons (20.53%, p=0.028]. CONCLUSION Every year, thousands of people are injured when their clothing catches fire. The findings reported herein documented that public knowledge about clothing related fire risks was lacking. This can be reduced by bringing about stronger regulations by government and to educate about the magnitude of the problems inflicted by burn injuries and to oversight and to promote less inflammable fabrics to be worn at home, especially in kitchen.
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Honnegowda TM, Kumar P, Udupa P, Rao P. Epidemiological study of burn patients hospitalised at a burns centre, Manipal. Int Wound J 2018; 16:79-83. [PMID: 30240126 DOI: 10.1111/iwj.12995] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 08/31/2018] [Indexed: 11/27/2022] Open
Abstract
Burn injuries constitute a major public health problem and account for a significant cause of mortality and morbidity amongst the Indian population. This 2-year prospective study was undertaken to find out the exact epidemiological determinants of 737 patients admitted with burn injuries and, thus, to try and formulate effective preventive strategies. This study was conducted in the department of plastic surgery and burns from September 2011 to June 2013. All consecutive patients with major burns admitted for in-hospital treatment during the study period were included in the study. The data collected included age, gender, cause and mode of burns, total burn surface area (TBSA), microbiological profile and outcome. More than 55% of the patients were female (58.61%). The mean age was 31.3 years ranging from 8 months to 89 years. A higher number of females (97.5%) sustained burn injuries at home compared with 36.11% males sustaining injuries outdoors. (P = 0.000). Almost one third of injuries (40.36%) occurred between 4 pm and 8 pm, followed by 28% between 7 am and 12 noon. Synthetic garments were worn by 70% of females at the time of injury, whereas 40% of males had worn mixed clothing (P = 0.000). Flame injuries contributed to 80.1% of burns in females (P = 0.006). The rate of electrical injuries (9.8%) was significantly higher in males (P = 0.005). In almost 40% of males, TBSA was <19%, whereas in 40% of females, TBSA was >68%. (P = 0.004). Microbial profile showed that pseudomonas aeruginosa (n = 260; 35.3%), Klebsiella pneumoniae (n = 209; 28.5%), and Escherichia coli (n = 145; 22.6%) were the most frequent types of Staphylococci bacterial growths. The cause for burn injury was ignition of clothes in 68.74% females, and in 35.48% males, it was because of an attempt to save other burn injury victims (P = 0.013) The case fatality rate was 29.3%. A majority of the males (60.7%) recovered, whereas 45.89% of females succumbed because of their burn injury. (P = 0.001). As the aetiological factors of burn injuries vary considerably in different communities, careful study of the pattern in every community is needed before a sound prevention programme can be planned and implemented. Hence, this study was conducted to assess epidemiological, modes, causes, and risk factors and the microbial profile of burn injuries and to study the outcomes.
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Affiliation(s)
| | - Pramod Kumar
- Department of Plastic Surgery and Burns, Kasturba Medical College, Manipal University, Udupi, India
| | - Padmanabha Udupa
- Department of Biochemistry, Kasturba Medical College, Manipal University, Udupi, India
| | - Pragna Rao
- Department of Biochemistry, Kasturba Medical College, Manipal University, Udupi, India
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Avci V, Kocak OF. Treatment algorithm in 960 pediatric burn cases: A review of etiology and epidemiology. Pak J Med Sci 2018; 34:1185-1190. [PMID: 30344573 PMCID: PMC6191793 DOI: 10.12669/pjms.345.15101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective: Burn injuries are one of the most significant threats to life in both undeveloped and developing countries. In this study, we evaluate the demographic characteristics and treatment methods in pediatric burn cases admitted to our clinic. Methods: A total of 960 patients aged 0–16 years old who were referred to our center with burn injuries between 2015 and 2016 were analyzed in terms of sex, age, etiology, epidemiology, burn percentage, the degree of burn, hospitalization duration, morbidity-mortality, and treatment methods. Results: In the present study, 512 male and 448 female patients were included. Burns were seen mostly among the patients aged 2–4, and the majority of them were extremity burns. The mean hospitalization duration was 10±6.7 days, and the most common source of burn injury was from hot liquids. Conclusion: Burn injuries are a pediatric emergency that needs to be emphasized to reduce occurrences due to the long hospitalization period, the unfavorable mortality and morbidity rates, and increased treatment costs. It is possible to obtain more positive results by way of a standard and easily applicable treatment algorithm in cases of burn injury.
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Affiliation(s)
- Veli Avci
- Veli Avci, MD. Department of Pediatric Surgery, Yuzuncu Yil University, Medical Faculty, Van, Turkey
| | - Omer Faruk Kocak
- Omer Faruk Kocak, MD. Department of Plastic, Reconstructive and Aesthetic Surgery, Yuzuncu Yil University, Medical Faculty, Van, Turkey
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Citron I, Amundson J, Saluja S, Guilloux A, Jenny H, Scheffer M, Shrime M, Alonso N. Assessing burn care in Brazil: An epidemiologic, cross-sectional, nationwide study. Surgery 2018; 163:1165-1172. [PMID: 29428152 DOI: 10.1016/j.surg.2017.11.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 10/13/2017] [Accepted: 11/22/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of this study was to describe the national epidemiology of burns in Brazil and evaluate regional access to care by defining the contribution of out-of-hospital mortality to total burn deaths. METHODS We reviewed admissions data for Brazil's single-payer, free-at-point-of-care, public-sector provider and national death registry data abstracted from DATASUS for 2008-2014. Admissions, in-hospital mortality, hospital reimbursement, and total deaths from the death registry were assessed for records coded under ICD-10 codes corresponding to flame, scald, contact, and electrical burns. RESULTS A total of 17,264 burn deaths occurred between 2008-2014 (mean annual 2,466 [SD 202]). Of all burns deaths 79.1% occurred out of hospital, with marked regional differences in the proportion of out-of-hospital deaths (P < 0.001), the greatest being in the North region. The mean annual number of admissions >24 hours was 18,551 (SD 1,504) with the greatest prevalence of flame burns overall (43.98%) and scalds prevailing in < 5 years (57.8%). Regional differences were found in per-capita admissions (P < 0.001) with the greatest number in the Central-West region. A mean of $1,022 (SD $94) US dollars was reimbursed per burn admission. CONCLUSION Given that nearly 80% of burns mortalities occurred out of hospital, prevention of burns alongside interventions improving prehospital and access to care have potential for the greatest impact.
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Affiliation(s)
- Isabelle Citron
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.
| | - Julia Amundson
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA; University of Miami Miller School of Medicine, Miami, FL, USA
| | - Saurabh Saluja
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA; Department of Surgery, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Aline Guilloux
- University of São Paulo, Department of Preventative Medicine, Brazil
| | - Hillary Jenny
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mario Scheffer
- University of São Paulo, Department of Preventative Medicine, Brazil
| | - Mark Shrime
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA; Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Nivaldo Alonso
- University of São Paulo, Department of Plastic Surgery, Brazil
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Wardhana A, Basuki A, Prameswara ADH, Rizkita DN, Andarie AA, Canintika AF. The epidemiology of burns in Indonesia’s national referral burn center from 2013 to 2015. BURNS OPEN 2017. [DOI: 10.1016/j.burnso.2017.08.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Al-Shamsi M, Othman N. The epidemiology of burns in Basra, Iraq. ANNALS OF BURNS AND FIRE DISASTERS 2017; 30:167-171. [PMID: 29849517 PMCID: PMC5946758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/01/2017] [Indexed: 06/08/2023]
Abstract
Burns are a major cause of morbidity and mortality worldwide and an important public health problem in Iraq. The current study was undertaken to describe epidemiological characteristics of hospitalized burn patients and investigate in-hospital mortality. The study was undertaken at the Al-Fayhaa Burn Centre in Basra City through analyzing hospital records of patients admitted to the centre for a new burn injury between January and December 2016. Data were extracted from all accessible files, entered into Epidata and analyzed in Stata. Hospital records of 367 patients with an age range of 1 month to 77 years and a male to female ratio of 1:2 were analyzed. One third of admissions were children aged 0 to 5 years: the most common mechanisms of injury were flame (51%) and scalds (41.7%). Total body surface area (TBSA) burnt ranged from less than 1% to 100%, with a median of 30.0% (IQR 18.0, 45.0). Length of hospital stay ranged from 0 to 5 months, with a median of 8 days (IQR 4, 12.5). In-hospital mortality was 22% and the independent factors for death were TBSA and suicidal burns. Burns remain a major public health problem in Basra, especially in children, and require sustained multidisciplinary action for their prevention and management. Improving hospital records and computerizing them is essential for better assessment and follow-up of burn care practices.
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Affiliation(s)
- M Al-Shamsi
- Iraqi Ministry of Health, Department of Public Health, Basra, Iraq
| | - N. Othman
- Kurdistan Institution for Strategic Studies and Scientific Research, Sulaimaniyah, Iraq
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Hashemi SS, Sharhani A, Lotfi B, Ahmadi-Juibari T, Shaahmadi Z, Aghaei A. A Systematic Review on the Epidemiology of Pediatric Burn in Iran. J Burn Care Res 2017; 38:e944-e951. [DOI: 10.1097/bcr.0000000000000524] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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