Pediatric burns due to hot water from water dispenser: a neglected issue that should be highly concerned / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>More and more Chinese drink hot water from water dispensers while many children were scalded due to this change. The present study aimed to propose a feasible strategy for prevention.</p><p><b>METHODS</b>A retrospective study was conducted for all water dispensers related pediatric burns admitted to Changhai Hospital from January 2005 to December 2009.</p><p><b>RESULTS</b>The number of new cases and incidences of pediatric burns due to hot water from water dispensers was significantly increasing year after year. In the total 238 involved cases, 175 cases happened on males and 78.9% were at the age of 1 - 4 years. The burn areas were mainly located in upper extremities. All water dispensers in the surveyed families had no isolate protection devices and 85.2% of their locations were easy for children to reach. Nearly half of the children were in the same room with their guardians when injured. Total 196 burned children were playing the taps of water dispensers before injured, unfortunately, 80.6% of them have not been stopped until burned.</p><p><b>CONCLUSION</b>As the kind of burns is quite serious and with bad outcome, some recommendations should be followed, such as buying water dispensers with protection devices, keeping children from touching them and so on.</p>

Unplanned decannulation of tracheotomy tube in massive burn patients: a retrospective case series study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Unplanned extubation is associated with adverse outcomes in intensive care unit. The massive burn patient differs from other critically ill patients in many ways. However, little is known about the unplanned decannulation (UD) in Burn Intensive Care Unit. This paper describes the special features of the circumstances and outcome of UD of tracheotomy tube in massive burn patients.</p><p><b>METHODS</b>A case series study was performed between January 1999 and December 2008 and UD of tracheotomy tube was analyzed retrospectively. A total of 21 patients with 29 UD events were identified. Demographic data, diagnosis, intervention, UD events and outcome of UD patients were collected. Differences in proportions were compared using the chi-square (χ(2)) or Fisher's exact test.</p><p><b>RESULTS</b>Patients with UD were often burned with head and neck (67%) and combined with inhalation injury (62%). The majority of them (76%) were transferred patients, occurred early (55%) and were accidental UD (79%). UD events tended to happen in day shift (90%) and to be associated with the medical procedure that was performing by caregivers at besides (79%). Loose of the stabilizing rope, medical procedure and tracheotomy malposition were the main causes of UD. Early UD and reintubation failure were associated with patients' death.</p><p><b>CONCLUSIONS</b>UD happened to massive burn patients can lead to patient death. Careful management of respiratory tract was essential for massive burn patients.</p>

Repair system engineering and the concept of sequential cytoprotection in treatment of burn / 中华烧伤杂志

It has been an essential trend to understand and solve the difficult problems arising in the treatment process of burn with views of holistic theory. Recent researches have indicated that the driven factors and the termination signals of repair system engineering in treatment of burn are the unity of two opposite rather than two independent bodies with chronological order. Repair driven factors are germinated at the cost of systemic inflammatory response and even multiple organ damage. Inflammatory response is both a necessary procedure of burn repair and the pathological basis of multiple system dysfunction after burn. A comprehensive burn therapy nominated sequential cytoprotection (SCP) strategy has emerged in which the knowledge derived from basic research is translated to clinical practice stepwise, and it might play an important role in treatment of severe burn. Further multi-center randomized controlled clinical trials should be conducted in order to raise the level of SCP strategy in guideline of evidence-based medicine.