ABSTRACT
BACKGROUND: Burn injuries are a serious problem worldwide, with most occurrences in low- and middle-income countries. Depending on the extent of injury, burn victims are faced with the challenges of fitting into society due to complications such as extensive scarring and contractures. The current study seeks to determine whether epidemiological studies of burn patients can provide guidelines to enhance burn prevention among the Ghanaian population. METHODS: Data from the Burns Registry of the Burns Intensive Care Unit (BICU) of Komfo Anokye Teaching Hospital (KATH) was obtained. Data on sex, age, aetiology, % total body surface area (TBSA), and admission outcomes from May 1, 2009, to April 30, 2013, were retrieved for a total of 487 patients during this period. RESULTS: Data on burn admissions comprising 263 (54.0 %) males and 224 (46.0 %) females were obtained from the Burns Registry. Children 0-10 years were the most affected age group. The yearly mean % TBSA ranged from 24.74 % to 35.07 %. The majority of burns was caused by scalding. Mortality rates ranged from 8.4 % to 32.0 % during the period under review. CONCLUSIONS: The study shows that children of 10 years old and below are the most affected group; this may be due to inattention to these children by parents/caretakers. Safety and safe working environments should be provided at home and workplaces, and promotion of education on burn prevention should be intensified.
ABSTRACT
The usefulness of electricity in daily life offers several advantages which cannot be underestimated. Electricity is needed by industries for manufacturing and also in homes for lighting, cooking, washing, etc. However, electricity can cause severe life-threatening complications. This study investigates the trend and mortality risk factors of electrical burn injuries at the Burns Intensive Care Unit (BICU) of the Komfo Anokye Teaching Hospital (KATH), Ghana. The Burns Registry at KATH BICU containing information on patients who were admitted for electrical burns was used. Data on the sex, age, occupation, cause of injury, Total Body Surface Area burned (TBSA) and outcome of admissions was obtained. GraphPad version 5 was used for the analysis. There were 13 (2.7%) electrical burns, suffered by 11 males (84.6%) and 2 females (15.4%) out of a total 487 BICU admissions over a 4-year period (July 1, 2009 - June 30, 2013); the mean age of the electrical burn victims was 37.8 years (range = 22-56); the TBSA ranged from 5.0% - 98.0%. Mortality risk factors identified were high voltage electrical burns, older age (P=0.0250) and TBSA>20% (P=0.048). Four cases (30.8%) were transferred to the Main Burns Ward (Ward D2C); 6 cases (46.1%) were discharged home; 3 patients (23.1%) died; all deaths were recorded in persons who had high voltage electrical burns. Electrical burns can be severe and can cause death. Even though the current study showed that a small population was affected by electrical burns, society has to be continually conscious of the detrimental effects of electrical energy and take the necessary precautions to minimize this type of accident.
L'utilité de l'électricité dans la vie quotidienne offre plusieurs avantages qui ne peuvent être sous-estimés. L'électricité est nécessaire par les industries de fabrication et aussi dans les maisons pour l'éclairage, cuisson, lavage, etc. Toutefois, l'électricité peut provoquer de graves complications potentiellement mortelles. Cette étude examine l'évolution et les facteurs de risque de mortalité de brûlures électriques à l'Unité de soins intensifs aux brûlures de l'Hôpital Komfo Anokye, Ghana. Le registre des brûlures contenant des informations sur les patients qui ont été admis pour des brûlures électriques a été utilisé. Les données sur le sexe, l'âge, la profession, la cause de blessure, la surface corporelle total brûlée (SCT) et les résultats d'admissions ont été obtenu. GraphPad Prism 5 a été utilisé pour l'analyse. Il y avait 13 (2,7%) des brûlures électriques, subis par 11 hommes (84,6%) et 2 femmes (15,4%) sur un total de 487 admissions à l'Unité sur une période de 4 ans (du 1er juillet 2009 - 30 Juin, 2013) ; l'âge moyen des victimes de brûlures électriques était de 37,8 ans (extrêmes = 22-56); le SCT variait de 5,0% à 98,0%. Les facteurs de risque de mortalité identifiés pour les brûlures électriques à haute tension étaient: personnes plus âgés (p = 0,0250) et SCT >20% (p = 0,048). Quatre cas (30,8%) ont été transférés à la section principale pour le traitment des brûlures (Ward D2C); 6 cas (46,1%) ont obtenu leur congé; 3 patients (23,1%) sont décédés; tous les décès ont été enregistrés chez les personnes atteintes de brûlures électriques causées par la haute tension. Les brûlures électriques peuvent être graves et peuvent entraîner la mort. Même si l'étude a montré qu'une petite population a été affectée par des brûlures électriques, la société doit être constamment consciente des effets néfastes de l'énergie électrique et doit prendre les précautions nécessaires pour minimiser ce type d'accident.
ABSTRACT
Brachial plexus lesions are among the most severe injuries of the upper extremity. Despite intensive conservative and surgical treatment efforts, patients frequently suffer from serious impairments in the quality of life. This contribution presents the results of a retrospective clinical survey on the quality of life after brachial plexus injuries. Out of 38 treated patients, 25 patients could be included in the study. The disability of arm, shoulder and hand was evaluated by the DASH score and the quality of life by the FLZm, a questionnaire on life satisfaction. In addition, demographic data, work situation and mechanism and type of injury were recorded. The examined patients were mainly young males who were injured in traffic, in particular motorcycle accidents. The DASH score analysis revealed that plexus injuries are among the most disabling injuries of the upper extremity. The associated restrictions in the different sections of the quality of life involve not only the health-related section but also partnership, family and leisure time activities. A strong relation between the possibility to return to work and the quality of life was found. We recommend the use of the DASH score and the FLZm questionnaire on life satisfaction as routine tools for the evaluation of the therapeutic outcome after brachial plexus injuries.
Subject(s)
Brachial Plexus/injuries , Paresis/psychology , Paresis/surgery , Quality of Life/psychology , Accidents, Traffic , Adult , Arm/innervation , Brachial Plexus/surgery , Disability Evaluation , Female , Follow-Up Studies , Hand/innervation , Humans , Male , Middle Aged , Motorcycles , Patient Satisfaction , Retrospective Studies , Shoulder/innervation , Surveys and QuestionnairesABSTRACT
AIM: To study the survival and mortality trends in four fire disasters in the middle belt of Ghana from 2007 to 2008 and to explore measures that could minimize the risk of future disasters. METHODS: Data were collected from clinical records from the Burns Intensive Care Unit and the Casualty Unit of the Komfo Anokye Teaching Hospital, Kumasi, Ghana and from the various disaster sites and the Ghana Police Service. RESULTS: A total of 212 were injured from four burn disasters; 37 (17%) died on the spot; 175 (83%) reported to the Casualty Unit out of which 46 (26%) were admitted. The victims admitted had mean age 24.6 years with male to female ratio 2.3:1; 25 (54%) of the admitted victims died. The average burned surface area of the admitted victims was 63%, with a mean survival rate of 46%. Statistical analysis for mortality when the surface area of the burn was >70% was 0.0005 (P-value). CONCLUSION: The four petrol-related fire disasters showed variable mortality rates. Death and severe disability of victims of future disasters can be avoided if intensive road accident preventive measures and massive public education are encouraged.
Subject(s)
Burns/mortality , Disasters , Fires , Adolescent , Adult , Age Distribution , Burn Units , Burns/therapy , Child , Child, Preschool , Female , Fires/statistics & numerical data , Ghana/epidemiology , Humans , Infant , Length of Stay , Logistic Models , Male , Middle Aged , Sex Distribution , Survival Analysis , Young AdultABSTRACT
The aim of the study was to investigate the factors affecting the outcome of treatment of burns patients admitted to the Burns Intensive Care Unit (BICU) of the Komfo Anokye Teaching Hospital, Kumasi, Ghana. Information on patients admitted to the BICU from February 2001 to January 2006 was recorded. Parameters recorded included: admission record and demographics, causes of the injury, burned surface area, laboratory investigations, treatment regime, and record of discharge/death. The data were analysed with SPSS version 12.0 and Spearman's rank correlation. A total of 826 patients were recorded; males (n = 492, 60%) outnumbered females (n= 334, 40%). The mean age was 10.5 ± 5 yr, the majority (n = 441, 53%) in the range 0-10 yr. Flame burns (n = 587, 71%), scalds (n = 209, 25%), and chemicals (n = 19, 2%) were the three significant causes of burn injuries. The mean range of the total body surface area (TBSA) burned was 11-20%; 94% (n = 775) had up to 60% TBSA; 64% (n = 527) had only wound dressings for treatment; 21% (n = 174) had early excision with skin grafting, while 15% (n = 125) had delayed excision with skin grafting. The majority (n = 563, 68%) of the patients stayed for less than 10 days after admission. The mortality rate fell over the years, decreasing drastically between 2001 (20.4%) and 2002 (8.6%) and remaining at single digit level in 2003 (7.6%), 2004 (7.9%), and 2005 (7.4 %). The factors affecting the mortality trends were proper case management, increases in the number of professional medical personnel, and their greater dedication.
ABSTRACT
Extravasations of chemotherapeutic drugs may lead to large soft-tissue losses in the hand and forearm and necessitating surgical excision with secondary flap coverage. Unfortunately, a delayed referral to a hand and plastic surgical unit with an already established soft-tissue defect is most common. Nevertheless, in our unit the method of choice is early emergency subcutaneous "wash-out", which facilitates dilution and reduction of concentration of the extravasation and therefore reliably avoids the development of soft-tissue defects. The aim of this paper is to present the surgical technique.
