Electrical Burns and Their Treatment in a Tertiary Hospital in Albania.

INTRODUCTION: The electrical current burns represent a very aggressive pathology that leaves many functional and aesthetic consequences. AIM: To evaluate the epidemiology of electrical burn injury and its associated complications and treatment. MATERIAL AND METHODS: Demographic data, aetiology, burn percentage and other measures related to electrical burn injury of 33 electrical burn patients in a tertiary hospital during the years 2015-2017. RESULTS: The mean age of patients is 31 (± 8.3) years old with a predominance of males (94%). The vast majority of injuries occurred at work (p < 0.01), superior extremities were more affected with hand (21.2%) and fingers (18.2%) being the main point of contact (p < 0.01). Muscular fasciotomy was performed in all patients who were treated surgically (n = 27), amputation was performed in 11 (40.7%) of cases, but amputated sites were more than the number of patients affected. Myoglobinuria (39.4%), cardio-respiratory distress (12.1%) contusion cerebri (6.1%), were the complication encountered in patients. CONCLUSIONS: Electrical burn injuries are still amongst the highest accident-related morbidities. Educating the population about the dangers and hazards associated with improper use of electrical devices and instruments is imperative.

Epidemiology of Hand Burn in Albania 2011-2016.

INTRODUCTION: Hand burns occur commonly both as part of larger burn injuries as well as isolated injuries. AIM: To give an overview of epidemiologic features and outcome of burn hand patients who admitted to our Service. This study was performed at University Hospital Center "Mother Teresa" Tirana which is the only tertiary hospital in Albania. MATERIAL AND METHODS: This prospective study included all patients who had combustion of the hands solely or hands accompanied with burns to other areas of the body, treated and followed up at our service during the years 2011-2016. RESULTS: Of the 333 included burn patients, 64% were males. The median age of patients is 25.9 years. About half of patients belong to the age group 20-60 years (49.5%) and only 10.2% belong to the age of 60 years. In most of the cases (73.6%), the burn of hands is associated with the burn of the other anatomical region, mostly forearm. CONCLUSION: The surgical treatment is used for less 30% that of patients. The undesirable results of the burn of hands are presented in the 33% of the patients. The contractures were the main unfavourable outcome of the burned hand.

Comparison of hypertonic vs isotonic fluids during resuscitation of severely burned patients.

BACKGROUND: The hypertonic lactate saline (HLS) solutions with mild concentration of sodium have been used in some burn centers to maintain plasma volume without infusing larger fluids volumes. To evaluate the fluid requirements during resuscitation with lactated Ringer's solution and to realize resuscitation with HLS, we suggest the following clinical trial. Specific objectives include fluid loads, sodium loads, and fluid accumulation. METHOD: This prospective study included 110 patients with severe burns. The first group included patients resuscitated in the beginning with lactated Ringer's solution, according to Parkland formula for adults and Shriner formula for children. In the other group, the patients were resuscitated with HLS solution. Patients are divided in 2 groups for comparison. RESULTS: There is difference between sodium loads (P = .03), fluid load in the first hour (P = .001), sodium load in the first hour (P = .001), and net fluid accumulation (P = .0025). There is a difference regarding plasma sodium and plasma osmolality in the first hour (P = .003, P = .002). There is difference regarding sodium given (P = .001) and sodium excreted (P = .001) in 2 groups. CONCLUSIONS: Hypertonic resuscitation consists in giving a higher fluid and sodium load in the first hour of therapy that is accompanied with a decrease in fluid requirements and fluid accumulation for the first 24 hours of burn shock.

Review of statistical data about severe burn patients treated during 2001 and evidence of septic cases in Albania.

The objective of this study is to review the incidence of severe burns and the complications of burns sepsis in Albanians. The data are from clinical records of the patients hospitalised in the intensive care unit (ICU) of the Service of Burns, "Mother Teresa" University Hospital Center (UHC), Tirana, Albania during 2001. For the identification of sepsis in burned patients the classification of the American College of Chest Physicians/Society Critical Care Medicine (ACCP/SCCM) was used. All the cases were evaluated according to the clinical, diagnostic and laboratory data. The study presents some epidemiological data about the causative agent, the extent of burn, the depth of burn and the subjects injured. The study also identifies the pathogens responsible for the development of sepsis among patients. Such data was used to establish compound therapies focused on two or three antibiotics for each subject in order to treat sepsis and its possible complications. As a most important part of the treatment regime it is essential to identify patients at risk of sepsis, and to apply compound therapy with antibiotics in order to resist and treat this sepsis, which is the main cause of high mortality among our severely burned patients.