Brûlure Par Foudre: A Propos D'Un Cas.

Lightning strikes are infrequent but possibly deadly incidents. Their consequences on the human body vary and are still little known. Cardiac arrest is the main cause of death. Neurological and psychological sequelae should systematically be looked for. The most frequently reported signs are Lichtenberg figures and keronauparalysis. Care of a victim of a strike mainly depends on first aid. We found only case reports in the literature. We report here another case and discuss it including a literature review.

A Moroccan plastic surgery department approach during COVID-19 pandemic.

COVID-19 pandemic is an obstacle for all health systems, especially in African countries. This paper shows how plastic surgery teams can adapt human resources and an efficient approach to provide the best care to our patients in this troubled time.

The Cost Of Acute Burn Patients Treated In A Moroccan Intensive Burn Care Unit.

Eighty-five percent of burns occur in low- and middle-income countries, but reports on the cost of burn treatment in these countries are still rare. It is important for patients, their families, the government, society and insurance companies to be aware of the costs of burn treatment. Burn care in specialized burn units requires trained doctors and staff, specialist equipment, facilities, special tissue banks and specific dressings, and is thus very expensive. Burn care in Morocco is not as expensive as in other countries but nonetheless proves to be a high financial burden for patients, their families and the wider society. In this report we comprehensively calculate almost all the direct costs of managing in-hospital acute burns. The mean burn cost per patient in our country is US$ 16 975. We also compare the results of treatment with other reports. In this way, governmental and burn hospital authorities can have a better estimation of the direct costs of a burn center and the total budget that may be required for the whole country to cover the annual costs of treating burn patients.

Alors que 95% des brûlures surviennent dans les pays à IDH bas ou moyen, les données concernant le coût de leur prise en charge restent rares. Il est important pour les patients, leurs familles, les gouvernements et les sociétés d'assurance de connaître ce paramètre. Les soins aux brûlés dans les unités spécialisées nécessitent du personnel médical et non médical qualifié, des infrastructures, des équipements et du matériel spécifiques, une banque de peau, investissements très lourds. Bien que moins chère que dans d'autres pays, la prise en charge des brûlés au Maroc représente une charge financière importante pour les patients, leur famille, la société entière. Nous avons calculé la quasi- totalité des coûts directs d'une hospitalisation en service de soins intensifs aux brûlés, qui est en moyenne de 16 975$ et l'avons comparé aux données de la littérature. Ceci permet au gouvernement et aux directeurs d'hôpitaux de modéliser le budget nécessaire au fonctionnement d'un centre de traitement des brûlés, afin de l'abonder et de prévoir l'enveloppe nécessaire à la prise en charge des brûlés à l'échelle du pays.

[Not Available]. / Brûlure chez l'épileptique: brûlure pas comme les autres.

The association of burns and epilepsy is frequent in Morocco. These burns, often recurring, mainly occur in young women living in rural areas. The accidents usually occur in the kitchen and involve falling onto stoves situated on the floor during an epileptic crisis. Such burns may occur during a first attack before epilepsy has been diagnosed although, more often than not, the patient's illness is already known but insufficiently treated and managed. Consequences of these burns, which are always deep, are often tragic considering the sequelae, in patients whose social reintegration is already marred by epilepsy. Treatment should focus on both burns and epilepsy. Preventive measures to keep the epilepsy in check and avoid these sufferers being left alone in proximity to heat sources should be put in place.

[Not Available]. / La greffe de peau totale dans le traitement des séquelles de brûlures de la main et des doigts: A propos de 84 cas.

We conducted a retrospective study of data from September 2004 to September 2012, involving roughly 84 patients with burn sequelae of the hand who were treated surgically with full thickness skin grafts. The purpose of our study was to show the simplicity, effectiveness and reliability of this surgical technique. The average age at which the burn occurred was 4 years old. The average age of our patients was 18,3 years old (range=2-62 years old); males were affected in 60% of cases. The most frequent cause of injury were thermal burns, most often caused by hot liquids (56%). The mean delay between the burn having healed and the management of the sequelae to the hand was 36 months (2 months-16 years). The lesions were localized in the palm of the hand in 69 cases (82,5%). The sequelae were dominated by finger contractures (65%). A functional deficit was noted in the physical examination of all our patients. Full thickness skin grafts were applied in all our patients following release of the contractures and excision of the scar tissue. Commissural contractures were treated with Z-plasties. In 95% of the cases, the full thickness skin grafts were taken from the inguinal crease. The mean follow-up was 5,5 years (1-8 years). Eleven patients went missing from the study. The results after healing and rehabilitation were deemed to be satisfactory (good) in 62 cases (85%) and fairly satisfactory (quite good) in 11 cases (15%). Well-conducted initial treatment, carried out under the best conditions, can not only reduce the number of burn sequelae but also make them less severe.

[Not Available]. / Ulcere de Marjolin: complication redoutable des sequelles de brûlures.

Marjolin's ulcer refers to the malignant, ulcerous transformation of burn scars or any other wounds. The predominant histological type is squamous cell carcinoma (SCC), and it is characterized by its aggressiveness and increased risk of recurrence and metastases compared to non-SCC scars. The work presented here is a retrospective study of 21 cases of Marjolin's ulcer, collected at the plastic surgery department of the CHU Mohammed VI in Marrakesh, with the aim of addressing the epidemiological, therapeutic and evolutionary aspects of this pathology. Improved prognosis requires not only early diagnosis and treatment, but also a preventive approach which consists of early skin grafts and regular care of any burn scar.

Epidemiology and treatment of paediatric burns in a large children's hospital in Morocco: analysis of 394 cases

Introduction:Injury from burns represents 2 of emergency admissions in university hospitals in Morocco. Burn injuries can lead to substantial morbidity in the paediatric population including an impact on later life. Methods:A retrospective study of 394 paediatric burn patients was performed. Subjects were identified by review of the emergency centre logs and data were extracted from patient records. Data included demographic information; mechanism of burn; treatment prior to arrival at the hospital; hospital management and follow up conditions : ResultsThe majority (65.7; n=259) of patients were between 1 and 4years old with an average age of 4.26years and male predominance (male:female=2:1). Scalding was the main mechanism of injury (83.5; N=329). The trunk and upper limbs were the most commonly affected areas of the body (59 and 50; respectively) with the face affected in 9.6 of cases. The total body surface area burned ranged from 1 to 10 in 86 of patients. Seventy-five patients (19) required hospitalisation; 57 patients (14) required skin grafting and 27 (6.9) had major sequelae. Discussion: This large case series highlights the current epidemiology; management and outcome of paediatric burn victims in Morocco. Current burn management in low resources settings can be challenging and several additional measures should be taken to reduce morbidity among paediatric burn victims