Etiological & clinical spectrum of Liquefied Petroleum Gas (LPG) related burns: A three-year study from a tertiary care burn centre in New Delhi.

Burns, an endemic public health problem has had a dynamic epidemiology in India, in sync with economic and social changes. In the last decade a major shift of kitchen fuel usage from kerosene to the Liquefied Petroleum Gas has resulted in an increase in the incidence of burns from LPG mishaps. This prospective descriptive study conducted in a tertiary care burn centre in an urban area aims to determine the causes of LPG related burns, its injury profile, identify the population at risk and also to determine the level of knowledge of users regarding the safety issue with LPG usage. In the study LPG burns accounted for 52.3% of the admitted flame burns. On the whole there were 33 incidents of LPG mishaps involving multiple victims. Most common age group affected was 26-50 years. Leakage from larger cylinders was more common and malfunction of valve/regulator was the most common cause. Level of knowledge was dismally low across all socioeconomic strata. Our study highlights impact of changing socioeconomic pattern of the country on burns epidemiology and the glaring lack of public awareness regarding safe management principles.

Postauricular Tubed Flap in the Reconstruction of Auricular Margin Defects: Revisited.

Background Reconstruction of the auricular margin defects is challenging due to the ear's intricate architecture. Tubed flap raised from the postauricular area is a simple and reliable option for reconstructing marginal defects. Methods Eight patients with various auricular margin defects were reconstructed, using a postauricular tubed flap in a staged manner. Parameters like flap survival, reliability, complications, and cosmesis were assessed. Results Out of eight patients, one patient had marginal necrosis, which was managed with debridement and lengthening of the flap. All the flaps settled well with a good aesthetic outcome. Conclusion Postauricular tubed flap is a reliable and efficient method for reconstructing auricular margin defects.

Calcium Homeostasis Comparison in Thermal Burn Patients-Early Tangential Excision and Grafting versus Conservative Management.

Introduction With the advent of better burn wound management protocols, early excision and grafting, increased number of burns patients are surviving and entering the struggle of prolonged rehabilitation. Calcium homeostasis and its influence on bone mineralization plays an important role, but it is adversely influenced by the proinflammatory state in burns, leading to hypocalcemia and paradoxical hypercalciuria which, in turn, leads to excessive bony resorption and pathological fractures. The role of early excision in the overall metabolism of calcium is being investigated in the study. Method This study was undertaken in a tertiary level government-run hospital from February 2018 to August 2019. A total of 28 patients with second degree thermal burns were included. For all patients, fasting serum parathormone levels along with various serum electrolytes like Ca 2+ , Mg 2+ , PO 4 3- and urinary calcium levels were serially measured from day of admission to 2 months. The first group of 14 patients (Group A) underwent early tangential excision and skin grafting, whereas another 14 patients (Group B) underwent conservative management. All categorical variables were analyzed with the help of Chi square test. A p value of < 0.05 was considered statistically significant. Result There was a statistically significant improvement in serum parathormone and other electrolytes' levels in the tangential excision group. Similarly, urinary excretion of calcium also showed favorable results in the group. Conclusion Early tangential excision and grafting in burns plays an important role in maintaining serum parathormone and calcium levels, leading to prevention of hypercalciuria and optimization of other factors affecting calcium homeostasis.

An algorithmic approach to posttraumatic nail deformities based on anatomical classification.

BACKGROUND AND AIMS: Most of the clinical series on posttraumatic nail deformities (PTNDs) address an individual deformity and its correction. The aim of the study was to classify PTND on the basis of its anatomical defect, devise the reconstructive modality and propose an algorithmic approach to PTND. We have also analysed our results of surgical correction and compared the data with the published literature. METHOD: A 5-year retrospective study of 45 patients with PTND was conducted. The deformities were classified into three groups: intact nail bed, partially amputated nail bed and completely amputated nail bed on the basis of the remnant nail bed. RESULTS: PTNDs with intact nail bed were present in 78%, with partially amputated nail bed in 16% and with completely amputated nail bed in 7% of the patients. Deformities in intact nail bed group were nonadherence (33%), ridged nail (31%), split nail (9%) and nail horn (4%). All patients with partially amputated nail bed presented with hooked nail deformity. A satisfactory result was seen in 87% of nonadherence, 71% of ridged nail, 50% of split nail and 57% of hooked nail. None of the patients with nail horn and absent nail showed a satisfactory result. CONCLUSION: PTND with intact nail bed are consistently benefitted when the option is only split-thickness sterile matrix (STSM) grafting. Appreciable correction of hooked nail deformity can be achieved by the reconstruction of lost components. In our opinion, there is no role of split-thickness germinal matrix (STGM) and STSM graft transfer in total nail reconstruction. LEVEL OF EVIDENCE: III.