RESUMO
To study the demographic and clinical factors associated with burn septicaemia patients in Kuwait. Materials and All burn in-patients, who developed septicaemia at the Burns Unit, Al-Babtain Centre for Burns and Plastic Surgery, Kuwait, during a 9-year period [June 1992 to May 2001] were included in the study. The data were recorded for age, sex, nationality, cause and percentage of burns, inhalation injury, resuscitation, number of episodes, septicaemia on post-burn day, the microorganisms responsible in each episode, treatment and outcome for statistical analysis. Using SPSS [PC version 11.0] software, a probability level of p < 0.05 was considered significant. Of the 2,082 patients treated in the Burns Unit, 166 [8%; 99 [60%] males and 67 [40%] females] with a mean age of 26 years [range 1-70] had septicaemia. Significantly higher [p < 0.001] cases were recorded among Kuwaiti children [= 14 years] and non-Kuwaitis [25-59 years] than other corresponding age groups. The total body surface area burned ranged from 2 to 95% [mean 42%] and the main cause of burn was flame [77.1%]. Inhalation injury was diagnosed in 39 [23.5%] patients. A total of 253 septicaemic episodes occurred in all patients. The majority, 123 [74.1%], had a single episode and the remaining 43 [25.6%] had multiple [2-10] episodes. One hundred and fifty-five [61.3%] episodes were due to gram-positive organisms, mainly methicillin-resistant Staphylococcus aureus, and 32 [12.7%] were polymicrobial. One hundred and twenty-four [74.7%] patients had wound excision and skin grafting procedures and their survival was significantly higher [OR = 4.3; 95% CI: 1.98-9.31] than non-surgically treated patients. Thirty-nine [23.5%] patients died mainly due to multi-organ failure. The findings indicate that the patients with extensive flame burns were prone to developing septicaemia due mainly to gram-positive bacteria. The surgical excision of eschar and wound covering improved the outcome of the patients while prophylactic antibiotic treatment had no role in the incidence and outcome of the burn patients
Assuntos
Humanos , Masculino , Feminino , Sepse/etiologia , Demografia , Resistência a Meticilina , Staphylococcus aureus , CriançaRESUMO
We report two cases of alkali burn, one sustained 100% total body surface area [TBSA] burn due to immersion in caustic soda in an unusual manner, and another had a minor burn due to splash while rescuing his colleague from the tank. Their high morbidity and mortality is further increased due to associated inhalation and ingestion of the chemical agent due to immersion. Ocular burn with corneal opacity is another problem one finds in such injuries. Our patient with 100% TBSA burn with eyes and respiratory tract involvement rapidly deteriorated, and died 76 hours post burn. The other patient with the minor burn made a good recovery and healed following surgical excision
Assuntos
Humanos , Masculino , Álcalis/efeitos adversos , Cáusticos/efeitos adversos , Queimaduras Oculares/induzido quimicamente , Doenças Respiratórias/induzido quimicamenteRESUMO
Four cases of heterotopic bone formation in abdominal scars are presented and possible causative factors discussed with reference to the literature. The awareness of the condition will prevent unnecessary investigations and anxiety. Excision of the bony mass is indicated only when symptomatic, without the need for local irradiation