604 Epidemiology and Microbiologic Profile of Pediatric Burn Patients: Eight-years’ Experience in a Tertiary Hospital

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S154-S155
Author(s):  
Stephen Matthew B Santos ◽  
Jed-Waylon L Jumao-as
Keyword(s):  
Hospital Stay ◽  
Total Body Surface Area ◽  
Tertiary Hospital ◽  
School Age ◽  
Age Group ◽  
Burn Wound ◽  
The Mean ◽  
Total Body ◽  
The City ◽  
Flame Burn

Abstract Introduction Burn injury is major morbidity and is the third most common cause of mortality among the pediatric population. Methods This study retrospectively analyzed pediatric burn admissions from a tertiary hospital in an 8-year period from 2009–2016. A total of 218 pediatric patients were reviewed for demographics, burn incidence, characteristics, cause of burn and microbiologic profile. Results There were 107(49.08%) Infants, 47 (21.56%)Toddlers, 32 (14.68%) Preschoolers, 17 (7.79%) belonged to school age and 15 (6.88%) were adolescent. Most of the admitted patients were within the city 122 (56%) while 96 (44%) were from other localities outside the city. Scald burn was the most common cause of burn with 160 (73.39%) cases and was highest in the infant age group (49.8%). The mean total body surface area was 10%, the highest being caused by flame burn at 13% TBSA among toddlers and preschoolers having the highest total body surface area involved (12%). The most commonly involved body area is the chest (13.6%). The mean transfer time from injury to the admission of patients coming from within and outside the city was 8.8 and 28 hours respectively. The mean length of hospital stay was 9.08 days. There was also a decrease in mean transfer time and hospital stay from 2009 to 2016. Flame burn accounted for the longest hospital stay at 20.27 days. Microbiologic profile of burn wound cultures showed a predominance of gram-negative rods (90%) with Enterobacter cloacae and Klebsiella pneumonia as common isolates. Culture studies also showed amoxicillin-clavulanic, ampicillin-sulbactam, and cefuroxime have the highest resistance, while most isolates are still susceptible to Amikacin, Ertapenem, Meropenem, and Ciprofloxacin. Conclusions Patients belonging to the school-age group has the highest mean number of hospital days (27.3 days). On review of culture study results from wound tissue samples, Gram-negative rods were the most common and Enterobacter cloacae were the most common isolate. Antibiotics such as Amoxicillin clavulanic, ampicillin-sulbactam, cefuroxime, and ceftazidime had high resistance rates and therefore should not be initially used for patients suspecting of the infected burn wound.

scholarly journals Duration of stay and outcome in different types of burn cases in paediatric age group

2020 ◽  
Vol 8 (3) ◽  
pp. 104-107
Author(s):  
Satish Gadade ◽  
Monali Sonawane
Keyword(s):  
Length Of Stay ◽  
Hospital Stay ◽  
Economic Status ◽  
Total Body Surface Area ◽  
Age Group ◽  
Duration Of Stay ◽  
Significant Difference ◽  
Different Types ◽  
Paediatric Age ◽  
Flame Burn

The incidence of burns, their treatment and rehabilitation have considerably marked effect on children both physically and psychologically. The hospital stay and the outcome also important in the cases of burns patients because the socio economic status and chances of life long disability. Aim of the study is to analyze the duration of stay and outcome in different types of burn cases in paediatric age group. The Data was collected from 83 paediatric patients less than 15 years admitted in GMC, Miraj, Maharashtra during the period from September 2014 to September 2016. The overall length of stay at hospital, factors influencing length of stay and outcome of patients were analyzed. Out of 83 patients 50 percent was cured over the period of time. The death rate was 10.8%.Lower the percentage of burns had good outcome and higher percentage of burns had poor outcome (66.7% had mortality when burns was >60%). In the study 30% patients were cured with duration of stay 6 to 10 days. Out of subjects who died 44.4% stayed for less than 5 days in hospital, as they were having more % of burn area. Also 72.7% patients who improved was stayed < 5 days. Subjects cured in scald and flame burn were 60.66% and 59.1% respectively with no significant difference, while subjects died in scald and flame burn 6.56% and 22.72% respectively more in flame burn. In our study 8.4% of subjects underwent Escharotomy. It is concluded that surgical intervention increases the hospital stay and outcome of the mean duration of stay was high among subjects who deteriorated, followed by cured subjects. Lowest duration of hospital stay was observed among improved subjects, as they were having lower percent total body surface area (TBSA) burn. More hospital stay increase the chance of infections and vice versa.

scholarly journals A Comparative Study between C-Reactive Protein and Procalcitonin in Iraqi Burn Patients

2017 ◽  
Vol 28 (1) ◽  
pp. 41
Author(s):  
Alia E. Al-Ubadi
Keyword(s):  
Burn Injury ◽  
Total Body Surface Area ◽  
Latex Agglutination ◽  
Burn Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Survivor Group ◽  
Significant Difference ◽  
The Mean ◽  
Total Body

Association between Procalcitonin (PCT) and C-reactive protein (CRP) and burn injury was evaluated in 80 burned patients from Al-Kindy and Imam Ali hospitals in Baghdad-Iraq. Patients were divided into two groups, survivor group 56 (70%) and non-survivor group 24 (30%). PCT was estimated using (Human Procalcitonin ELISA kit) provided by RayBio/USA while CRP was performed using a latex agglutination kit from Chromatest (Spain). Our results declared that the mean of Total Body Surface Area (TBSA %) affected were 63.5% range (36%–95%) in non-survivor patients, while 26.5% range (10%–70%) in survivor patients. There is a significant difference between the two groups (P = 0.00), the higher mean percentage of TBSA has a significant association with mortality. Serum PCT and CRP were measured at the three times of sampling (within the first 48hr following admission, after 5thdays and after 10th days). The mean of PCT serum concentrations in non-survivor group (2638 ± 3013pg/ml) were higher than that of survivor group (588 ± 364pg/ml). Significantly high levels of CRP were found between the survivor and non-survivor groups especially in the 10th day of admission P=0.000, present study show that significant differences is found within the non-survivor group through the three times P= 0.01, while results were near to significant differences within survivor group through the three times (P= 0.05).

524 Effectiveness of Burns Wound Cleansing by Comparison of Prewash and Post Wash Swab Reports

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M A Sayed ◽  
S Jabeen ◽  
A Soueid
Keyword(s):  
Bacterial Load ◽  
Total Body Surface Area ◽  
Wound Management ◽  
Burn Patients ◽  
Burn Wound ◽  
Staph Aureus ◽  
Sex Type ◽  
Total Body ◽  
Burns Unit ◽  
Type Of Injury

Abstract Aim The main aim and objective were to optimise wound healing through infection prevention. This clinical audit aimed to investigate the effectiveness of burn wound cleansing in decreasing bacterial load by comparing pre-wash and post-wash swab results against local burn wound management and aseptic non touch technique (ANTT) guidelines. Method The audit was conducted retrospectively on children admitted to Burns Unit during August 2019, excluding resuscitation burn patients. Pre- and post-wash swabs taken on admission were included and the results obtained from Chameleon database. Data were collected on excel spread sheets including demographic variables such as age, sex, type of injury, percentage total body surface area (TBSA) and mechanism of injury. Data were analysed and results compiled. Results Fifty patients were admitted over a month period; amongst those 60% were male and 40% female of ages ranging from 5 months to 14 years. Scald (50%) was found to be the most common mode of injury followed by contact burn (36%) involving 0.30 to 9% TBSA. Among 50 patients, 30 (60%) showed no growth in pre-wash and 36 (72%) in post-wash swabs. However, 6% post-wash swabs that were initially negative later showed bacillus cereus, staph aureus, Enterobacter, and Acinetobacter. Similarly, another 4% post-wash swabs developed new microorganisms as compared to pre-wash swabs. Conclusions The most common bacteria colonising both pre- and post-wash swabs was staph aureus. Overall, cleansing had reduced the bacterial load significantly around 82% very effective. It is imperative to stick to local guidelines to reduce morbidity and mortality in burn patients.

scholarly journals A comparative study to evaluate the effect of honey dressing and silver sulfadiazene dressing on wound healing in burn patients

2009 ◽  
Vol 42 (02) ◽  
pp. 176-181
Author(s):  
P. S. Baghel ◽  
S. Shukla ◽  
R. K. Mathur ◽  
R. Randa
Keyword(s):  
Wound Healing ◽  
Average Duration ◽  
Total Body Surface Area ◽  
Burn Patients ◽  
The Mean ◽  
Total Body ◽  
Time Of Admission ◽  
And Control ◽  
Burn Contractures

ABSTRACTTo compare the effect of honey dressing and silver-sulfadiazene (SSD) dressing on wound healing in burn patients. Patients (n=78) of both sexes, with age group between 10 and 50 years and with first and second degree of burn of less than 50% of TBSA (Total body surface area) were included in the study, over a period of 2 years (2006-08). After stabilization, patients were randomly attributed into two groups: ‘honey group’ and ‘SSD group’. Time elapsed since burn was recorded. After washing with normal saline, undiluted pure honey was applied over the wounds of patients in the honey group (n=37) and SSD cream over the wounds of patients in SSD group (n=41), everyday. Wound was dressed with sterile gauze, cotton pads and bandaged. Status of the wound was assessed every third and seventh day and on the day of completion of study. Patients were followed up every fortnight till epithelialization. The bacteriological examination of the wound was done every seventh day. The mean age for case (honey group) and control (SSD group) was 34.5 years and 28.5 years, respectively. Wound swab culture was positive in 29 out of 36 patients who came within 8 hours of burn and in all patients who came after 24 hours. The average duration of healing in patients treated with honey and SSD dressing at any time of admission was 18.16 and 32.68 days, respectively. Wound of all those patients (100%) who reported within 1 hour became sterile with honey dressing in less than 7 days while none with SSD. All of the wounds became sterile in less than 21 days with honey, while tthis was so in only 36.5% with SSD treated wounds. The honey group included 33 patients reported within 24 hour of injury, and 26 out of them had complete outcome at 2 months of follow-up, while numbers for the SSD group were 32 and 12. Complete outcome for any admission point of time after 2 months was noted in 81% and 37% of patients in the honey group and the SSD group. Honey dressing improves wound healing, makes the wound sterile in lesser time, has a better outcome in terms of prevention of hypertrophic scarring and post-burn contractures, and decreases the need of debridement irrespective of time of admission, when compared to SSD dressing.

Presentation and Management of Staphylococcal Scalded Skin Syndrome in a Child After a Burn Injury: A Case Report

2019 ◽  
Author(s):  
Thomas Edward Pidgeon ◽  
Federica D’Asta ◽  
Malobi Ogboli ◽  
Yvonne Wilson
Keyword(s):  
Case Report ◽  
Burn Injury ◽  
Wound Care ◽  
Total Body Surface Area ◽  
Granular Cell ◽  
Burn Wound ◽  
Staphylococcal Scalded Skin Syndrome ◽  
The Face ◽  
Total Body ◽  
Learning Points

Abstract This case report describes the clinical course of a child who developed staphylococcal scalded skin syndrome (SSSS) after a burn injury. The intent is to aid other units in recognizing the presentation of SSSS after a pediatric burn and to optimize subsequent management. The main clinical finding was of rapid, progressive, superficial epidermal loss at sites separate from the original burn, involving 55% of the total body surface area, 13 days after a 6% scald burn to the face, neck, and chest. Diagnosis was confirmed by multidisciplinary team clinical assessment and histopathology of an intraoperative skin biopsy. This confirmed epidermal cleavage at the granular cell layer. These findings were later supported by Staphylococcus aureus cultured from the burn wound, and a positive epidermolytic toxin A assay. Management was with general medical supportive care, clindamycin and flucloxacillin intravenous antibiotic therapy, and cleansing and dressing of the areas of epidermal loss. Key learning points from this case were that SSSS presented after a burn injury and that 13 days elapsed between the burn and SSSS. Factors differentiating it from toxic epidermal necrolysis are described, including the value of histopathology in confirming the diagnosis. The prompt use of antibiotics and attentive wound care are advocated as an effective management strategy.

scholarly journals Varicose Veins Among Different Occupational Background in City of Mosul-Iraq

2021 ◽  
Vol 15 (5) ◽  
pp. 1399-1402
Author(s):  
H. J. Mahmood ◽  
R. H. Ibrahim ◽  
M. F. Abdulghani ◽  
Z. F. Al-Zaidy
Keyword(s):  
Clinical Practice ◽  
Varicose Veins ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Study Results ◽  
The Mean ◽  
Occupational Background ◽  
The City

Background and aim: The Objectives of the present study to determine the VV among people with different background occupations in the City of Mosul, Iraq. Materials and method: A cross-sectional study was performed at Mosul Teaching Hospital between November 2019 and February 2020. Two hundred people who were physically examined represented different jobs in Iraqi society (Nurses, address, Policemen, and teachers). A physical examination was conducted of all participants who agreed to engage in this study. Results: The overall prevalence rate of VV among different occupational backgrounds in the City of Mosul is 19.5%. The study found that the percentage of men (50.5%) and women (49.5%). Most of the patient was beyond to age group (41-45) years and the mean age of the participants was (39.1+3.1). According to the BMI, the results indicated that most subjects belong to a class<30 (77%). Conclusions: The nurses will seek to prevent excessive extended occupational standing and using sitting or walking when appropriate. As a result, an improvement in clinical practice may reduce the incidence of vascular disease. Keywords: Varicose, Veins, Occupational

scholarly journals Accessibility of Elderly Citizens to Basic Facilities In Akure Metropolis in Nigeria

2020 ◽  
Vol 2 (2) ◽  
pp. 38-52
Author(s):  
Musilimu Adeyinka Adetunji
Keyword(s):  
Secondary Data ◽  
The Elderly ◽  
Tertiary Hospital ◽  
Long Distance ◽  
Health Care Centre ◽  
Transport Services ◽  
Basic Services ◽  
The Mean ◽  
Distance Travel ◽  
The City

This study examined the accessibility of elderly citizens to some basic services in Akure metropolis. This was carried out with a view to determine the patterns of distribution and accessibility of these services in the city. Primary and secondary data were employed for this study. Geographical Positioning System was used to capture the coordinates of important locations and of some basic facilities such as Public Tertiary Hospital, Primary Health care centre and banks in the city. Nearest Neighbour Analysis was used to calculate the mean distance travel to some basic services from 13 major localities in Akure metropolis. Descriptive and inferential statistics were employed to analyse the data. Finding reveals that some basic facilities are not evenly distributed across different localities in Akure. The mean distance travel to Public Tertiary Hospital is 3.36kms. The pattern of distribution of Public Tertiary Hospital is dispersed rather than random. More than 60% of the elderly rely on public transport services for their trip to access some basic facilities in the city. Traffic delay was ranked highest (66%) among the problems militating against the effective utilisation of urban facilities in Akure metropolis. The study recommends that more basic facilities should be provided in localities where such services are lacking. This would reduce long distance trip to these facilities in the city. The study concludes that better transport services should be made available at reasonable transport fares in order to promote accessibility of the elderly and other segments of the population to urban facilities in Akure and similar other cities in Nigeria.     

scholarly journals Face burns: A four-year experience

2021 ◽  
Author(s):  
Stephanie A Rasmussen ◽  
Kathleen S Romanowski ◽  
Soman Sen ◽  
Tina L Palmieri ◽  
David G Greenhalgh
Keyword(s):  
Total Body Surface Area ◽  
Adult Patients ◽  
P Value ◽  
Chi Square ◽  
Lengths Of Stay ◽  
Degree Burn ◽  
The Face ◽  
The Mean ◽  
Total Body ◽  
Student’S T

Abstract Introduction Burns on the face pose unique management challenges because they are in a place that is constantly visible, so scars are hard to hide. The goal of this study was to review our experience of adult patients who had face burns. Methods We performed a retrospective review of adult patients (≥ 18 years old) who were admitted to a regional burn center from July 2015 – June 2019 with face burns. Sex, age, ethnicity, burn etiology, burn size, and discharge status were collected from electronic medical records of the patients who met study criteria. Descriptive statistics, student’s t-tests, and chi-square tests were performed in Stata/SE 16.1. Significance was defined as a p-value &lt;0.05. Results In four years, 595/1705 patients (~35% of admissions) were admitted with face burns. The mean age was 44.9 ± 17.0 (mean ± SD) years, with the majority being men (475, 80%). The mean burn size was 19.8 ± 20.9% total body surface area (TBSA) with 10.1 ± 19.8% TBSA being third degree. The mean head burn size for any face burn was 2.8 ± 1.8% TBSA. The majority of burns were due to flames (478, 80%) and of those 122 (21%) were from accelerant use and 43 (7%) resulted from propane or butane use. Scalds caused 53 (9%), electric 25 (4%), hot tar 5 (1%), and chemical 5 (1%). Overall, 208 (35%) patients had grafting of some portion of their body, but only 31 patients (5.2%) had face grafting. The mean age of those with face grafting compared to patients who did not need grafting was 45.9 ± 13.8 and 44.9 ± 17.2 years, respectively. Patients who needed grafting had a mean third degree burn size of 31.7 ± 25.4% TBSA and a mean head (including face) burn size of 4.7 ± 2.0% TBSA, whereas patients who did not need grafting had a mean third degree burn size of 8.9 ± 18.7% TBSA and a mean head burn size of 2.7 ± 1.8% head TBSA. Patients requiring face grafts had longer lengths of stay, intensive unit stays, ventilator days, and mortality than those whose face burns healed spontaneously. Discussion Overall, head burns in adults were common within the four-year time span we studied, but only a small fraction (5%) had face grafts. The patients who needed grafting for their head burns had significantly larger total body and face burns, and had a 2.4-fold higher mortality rate compared to patients who did not need grafting. Most face burns were caused by flame, especially the use of accelerants or flammable gases. Prevention efforts should focus on avoiding the use of accelerants and being careful with flammable gases.

A Prospective Clinical Study of the Effect of Recombinant Human Growth Hormone in Wound Healing of Severely Burned Children

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Salah Nasser Mohamed ◽  
Nahed Samir Boghdady ◽  
Mina Agaiby Estawrow ◽  
Mariam Loutfy Ahmed Mohamed
Keyword(s):  
Growth Hormone ◽  
Wound Healing ◽  
Recombinant Human Growth Hormone ◽  
Total Body Surface Area ◽  
Human Growth ◽  
Control Group ◽  
P Value ◽  
Significant Difference ◽  
The Mean ◽  
Total Body

Abstract Background A burn is a thermal injury caused by biological, chemical, electrical and physical agents with local and systemic repercussions. There are several ways of classifying burns: Classification by mechanism or cause, depth and extent of burn . Objectives The objective of this study was to determine the safety and efficacy of using recombinant human growth hormone (rhGH) in the treatment of pediatric burn victims and their probable effect on accelerating burn wound healing. Patients and Methods This study was an Interventional randomized controlled Double Blind Study in which Patients subdivided randomly into 2 groups: Group A received somatotropine hormone after their 3 days of resuscitation besides their conventional treatment during their stay in the Burn ICU. Group B received the conventional treatment only in the Burn ICU. Results The comparison between the GH group and the control group showed that that there was statistically significant difference found between the two studied groups regarding TBSA of burn at 3rd week. The mean TBSA in GH group was ( 9.06 ± 7.47 ) while in the control group (13.94 ± 11.96) with P value (0.041). There was highly statistically significant difference found between the two studied groups regarding Insulin like growth factor .the mean Insulin like growth factor in GH group was (16.48 ± 11.40) while in the control group(2.77 ± 0.64) with P value(0.000). Conclusion The use of recombinant Growth hormone with a dose of 0.2 mg/Kg SQ 2 days per week with 3 days time interval in pediatric burn patients after their primary resuscitation from the burn injury, shows a marvelous improvement concerning the total body surface area of burn(TBSA) as the patient received the growth hormone showed a decrease total body surface area of burn(TBSA) than the control group. This may be accounted for the faster wound healing and readiness for grafting .

scholarly journals Study on Time-related Changes in Aerobic Bacterial Pattern of Burn Wound Infection

1970 ◽  
Vol 6 (1) ◽  
pp. 41-45 ◽  
Author(s):  
SK Saha ◽  
N Muazzam ◽  
SA Begum ◽  
A Chowdhury ◽  
MS Islam ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Hospital Stay ◽  
Bacterial Colonization ◽  
Total Body Surface Area ◽  
Burn Wound ◽  
Female Ratio ◽  
E Coli ◽  
Antimicrobial Sensitivity ◽  
Sensitivity Pattern

A prospective study was carried out in 50 burn patients admitted in Burn unit of Dhaka Medical College Hospital over a period of one year from January 2005 to December 2005 to evaluate time-related changes in aerobic bacterial colonization and their sensitivity pattern. Periodic swabs were taken from the burn wound on Day 0, Day 7, Day 14 and Day 21 to see the changing pattern of organisms during hospital stay of patients. In the present study burn injury was highest in the age group 11-20 yrs (34%). Male to female ratio was 1.38:1. The mean percentage of burn was 35.79% of total body surface area (TBSA). Fire was the major cause of burn (38%) followed by electric burn (20%). Among the 200 samples, single organism was isolated in 71% samples and mixed organism in 13.5% and no growth in 14.5%. Among single isolates Pseudomonas aeruginosa was leading (28%) followed by Escherichia coli (17.5%), Staphylococcus aureus (16%), coagulse negative Staphylococcus (4.5%) and Klebsiella (2%). Among mixed growth Pseudomonas aeruginosa was still leading (11%) follow by E. coli (9.5%) Staphylococcus (5.5%), Proteus (1%) and Klebsiella (0.5%).There were time -related changes in bacterial isolation from burn wound during hospital stay of patients. On admission 42% of the isolated organisms were Staphylococcus aureus and only 6% each Pseudomonas aerunginosa and E. coli were isolated. No growth was found in 28%. samples. These findings were gradually changing with time and on day 21 Staphylococcus aureus were only 4% whereas Pseudomonas aeruginosa were 40% and E. coli 28%. Antimicrobial sensitivity test showed that pseudomonas aeruginosa was highly resistant to antimicrobial agents. It was most sensitive to Imipenem (98.72%) followed by Aztreonam (33.44%), Ceftazidime (38.32%) and Gentamicin (19.23%). E. coli was also found most sensitive to Imipenem (98.15%) followed by Gentamicin (38.95%), Chloramphenicol (37.1%), Ciprofloxacin (35.25%) and ceftraixone (29.70%). Staphylococcus aureus was 100% sensitive to Vancomycin followed by Amoxiclav and Oxacillin (53.43% each), Gentamicin (44.70%) and Cloxacillin (39.52%). It is crucial for every burn institution to determine the specific pattern of burn wound microbial colonization, the time-related changes in dominant flora, and the antimicrobial sensitivity profiles. This would enable early treatment of septic episodes with proper empirical systemic antibiotics without waiting for culture results, thus improving overall infection related morbidity and mortality. DOI: 10.3329/fmcj.v6i1.7410 Faridpur Med. Coll. J. 2011;6(1): 41-45

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