ABSTRACT
Ceramic and metal hair straightening and curling irons are common household items which reach up to 450°F in as little as five seconds. Of particular concern is the threat these devices pose to children. Our objective is to characterize and bring attention to this preventable injury in the pediatric population. Retrospective records from a high-volume level I trauma center and regional burn center from 2011-2015 were analyzed. Inclusion criteria were defined as patients <11 years of age, as those presenting with burns above this age were more likely to be utilizing the tools for hair styling. A total of 59 patients were identified with an average age of 2.4 years. The average burn size was 0.30%, with an average 0.24% 2nd degree TBSA. The etiology of the burns included touching a hair iron that was within reach (61%), pulling a hair iron's power cord (15%), stepping/rolling/jumping onto a hair iron left on the ground (17%), and hair irons falling (7%). The majority of households were comprised of unemployed (64%), single (60%) parents. CPS consult was required for 20% of patients. Grafting and excision was necessary for 20% of patients The pediatric population is at risk for accidental burns with household hair irons. These burns typically have a small TBSA, but may require excision and grafting and extended follow-up.
Les lisseurs et fers à friser, en céramique ou en métal, sont des objets courants au domicile. Leur température peut monter à plus de 230°C en quelques secondes. Le risque qu'encourent les enfants est préoccupant. Nous avons explorés ces brûlures afin de déterminer des stratégies de prévention. Nous avons analysé rétrospectivement les données d'un CTB régional, recueillies entre 2011 et 2015. Nous n'avons retenu que les brûlures atteignant les enfants de 11 ans au maximum (59 cas, âge moyen 2,4 ans), les enfants plus âgés étant susceptibles d'utiliser ces instruments à leur propre bénéfice. La surface brûlée était de 0,3 % dont 0,24 % de 2ème degré. La brûlure était consécutive au toucher d'un ustensile atteignable (61%), à la traction sur le cordon d'alimentation (15%), à la marche dessus (17%), à la chute de l'objet (7%). Les familles concernées étaient en majorité monoparentales (60%) sans emploi (64%). Les services de protection de l'enfance ont été sollicités dans 20% des cas. Les enfants sont particulièrement à risque de brûlures lors d'accidents domestiques, pouvant impliquer des fers à friser et des lisseurs. Ces brûlures sont typiquement peu étendues mais peuvent être profondes, nécessiter une greffe et un suivi prolongé.
ABSTRACT
The aim of this study is to review the outcomes of Wassel type IV thumb duplications with a minimum of one year follow-up, and to identify any factors that may compromise the quality of results. Forty one patients (42 thumbs) returned for assessment of thumb alignment, metacarpophalangeal joint and interphalangeal joint stability and motion; carpometacarpal joint motion; pinch and grip strengths; and thumb size. The subjective assessment considered thumb shape and contour, scarring, nail deformity and examiner and patient/parent satisfaction. The mean age at surgery was 16 months and the mean follow-up time was 79 months. Metacarpophalangeal joint and interphalangeal joint mal-alignment was present in 56% and 38% of cases, respectively. Interphalangeal ulnar collateral ligament laxity was significant. Metacarpophalangeal joint and interphalangeal joint motion was significantly decreased. Pinch and grip strength measurements were normal. A novel and comprehensive assessment scale is introduced, which revealed results of one (2.5%) excellent, 23 (59%) good, 14 (36%) fair and one (2.5%) poor. We consider that greater attention should be directed to the avoidance of mal-alignment and instability to improve these results.
Subject(s)
Hand Deformities/surgery , Outcome Assessment, Health Care/methods , Postoperative Complications/etiology , Thumb/abnormalities , Child , Child, Preschool , Cicatrix/etiology , Female , Follow-Up Studies , Hand Deformities/diagnosis , Hand Deformities/physiopathology , Hand Strength/physiology , Humans , Infant , Male , Patient Satisfaction , Pinch Strength/physiology , Postoperative Complications/diagnosis , Postoperative Complications/physiopathology , Range of Motion, Articular/physiology , Retrospective Studies , Thumb/physiopathology , Thumb/surgerySubject(s)
Anesthesia , Diabetes Complications , Malignant Hyperthermia/prevention & control , Adult , Female , Humans , LaminectomyABSTRACT
Anaesthesia for nine patients with the carcinoid syndrome is described. With the exception of one case in which severe bronchospasm and hypertension occurred, complications were minor. Steroids, aprotonin and methotrimeprazine appear to be useful agents in the management of such patients. An anaesthetic technique employing thiopentone, pancuronium and nitrous oxide proved satisfactory.
