ABSTRACT
Objective: To evaluate the lethal area 50 [LA50] and determinants of mortality in burn patients admitted to a single burn center
Methods: This retrospective cross-sectional study was conducted in a tertiary burn center affiliated with Shiraz University of Medical Sciences, Shiraz, Iran, during a 1 year period from 2015 to 2016. To determine prognostic factors in fatal burns, medical records of eligible burn patients were reviewed for demographic and clinical variables, as well as patient outcome. Also, LA50 was calculated using Probit analysis
Results: Overall 559 patients with the mean age of 27.2 +/- 23.65 years and including 343 [61.4%] males and 216 [38.6%] females were enrolled in this study. The average burn TBSA% was 31.38 +/- 24.41% [1-100%]. Duration of hospital stay ranged from 1 to 67 days [15.11 +/- 10.64]. With 93 expired patients, the mortality rate was calculated to be 16.6%. The total LA50 was 66.55% [58.4-79.3]. Fire was the most common cause of burn injury
Conclusion: Compared to developed countries, in our burn center the LA50 and survival rate of burn patients are lower. This indicates an urgent need for prompt attention in order to improve current policies regarding this public health issue to reduce mortality
ABSTRACT
Objectives: To compare the outcomes of early excision and grafting between pediatric and adult patients with deep burns of less than 40% total body surface area burns [TBSA]
Methods: This is a prospective comparative study. Overall, 106 patients admitted to Ghotbodin Burn Center in Shiraz, Iran from September 2012 to September 2013, were included in the study. All patients had less than 40% TBSA burn and had excision and grafting under 14 days from their injury. Patients were divided into two age groups of younger than 14 [n=49] and older than 14 [14-65] years old [n=57]. During a 6-month follow-up period, the two groups were compared regarding mean percentage of graft take, total scar score, duration of hospital stay and itching score
Results: During follow-up, the two groups did not show a significant difference in graft take, total scar score and itching score [p=0.461, p=0.363 and p=0.637, respectively]. Clinically, the pediatric group showed less hospital stay [12.25+/-9.1 vs. 16+/-12.9], however this was not statistically significant [p=0.091]
Conclusion: Adults and elderly patients [14-65 years old] compared to pediatric patients [less than 14 years old] with less than 40% TBSA burns, can expect similar results regarding scar score, graft take, itch score and hospital stay, after excision and grafting performed less than two weeks from their initial injury
ABSTRACT
Objective: To compare the outcome of patients with up to 60% total body surface area [TBSA] thermal burns undergoing ultra-early and early excision and grafting
Methods: This historical cohort study was performed in two referral burn centers of Shiraz during a 1-year period from 2015 to 2016. We included those patients with thermal burns up to 60% TBSA who underwent ultraearly [48-72 hours] and early [7-10 days] excision and grafting. We excluded those who were hemodynamically unstable and those with electrical burns. The outcome of patients was determined by graft success, operation duration, blood loss, hospital length of stay and mortality rate
Results: We included a total number of 107 patients with mean age of 32.1+/-11.6 years. There were 65 [60.7%] men and 42 [39.3%]women among the patients. Both study groups were comparable regarding the baseline characteristics. Ultra-early excision and grafting was associated with more, higher graft success rate [p=0.048], lower infection rate [p=0.037], shorter hospital length of stay [p=0.044] and lower mortality rate [p=0.027]
Conclusion: Ultra-early excision and grafting in patients with thermal burns covering less than 60% TBSA was associated with higher graft success rate, shorter hospital length of stay, lower infection rate and lower mortality rate when compared to early surgery
ABSTRACT
Objective: To compare outcome of patients with burns covering less than 15% of total body surface area[TBSA] undergoing early excision and grafting or delayed skin grafting
Method: This was a non-randomized clinical trial including 54 patients with less than 15% TBSA burn referring to Ghotboddin Hospital of Shiraz. They were assigned to two study groups, each group including 27 patients: the early excision and grafting group [EEG group] and the delayed grafting group [DG group]. Patients were followed postoperatively for 6 months. Hospital stay, graft success rate, itching score and scar formation during 6 months of follow-up were recorded and compared between two study groups
Results: During the study 1 patient was lost to follow-up in early excision and grafting group. Baseline characteristics were comparable between two study groups. The graft success rate was significantly higher in those patients who underwent early excision and grafting when compared to delayed grafting group [96.88% vs. 92.88%; p=0.033]. However the length of hospital stay, itching and scar scores were comparable between two study groups after 6 months of follow-up
Conclusion: In patients with burns covering less than 15% TBSA, early excision and grafting is associated with higher graft success rates compared to the delayed excision and grafting. How ever length of hospital stay, itching and scar formation is comparable between the two techniques
ABSTRACT
The uterine rupture during pregnancy is a catastrophic condition resulting in both maternal and perinatal morbidity and mortality. It occurs in nearly 1% of patients with previous cesarean sections. However, uterine rupture at the site of previous iatrogenic perforation which is spontaneously healed or repaired is less reported. We present a 29-year-old woman, gravida 3 para 1, at 20 weeks of gestation with abdominal pain of right half and hemodynamic instability whose laboratory evaluations revealed severe acute blood loss but still without any signs of peritonitis. The exploratory laparotomy revealed a uterine rupture at the site of fundus at the same location of previously repaired dilatation and curettage-induced perforation contributing to extrusion of whole pregnancy product in addition to severe intra-abdominal blood loss