Burns in older patients.

An increasing percentage of the burn victims admitted to the Western Pennsylvania Hospital and Burn Care Center are aged 65 or older. Among 108 such elderly patients admitted during the past six years, 68 died and 40 survived--a mortality rate of 63 percent. Those who died of burns (average age 76.4) had burns over 44.8 percent of the mean body surface, whereas the survivors (average age 73.5) had burns over a smaller area (16.7 percent). Survival also was related to the presence of significant heart and lung disease which antedated the thermal injury. Treatment of the burns was in keeping with standard recommendations for intravenous fluid resuscitation, wound care, and skin grafting. Cimetadine and antacids proved effective in the prevention of significant gastrointestinal bleeding. Ninety percent of the survivors returned to their homes after treatment. Although the mortality for elderly burn patients remains high, the favorable results in rehabilitation of the survivors are encouraging. Increased attention should be paid to safety programs for the elderly and those who care for them to prevent such serious accidental injuries.

Management of recurrent salivary gland tumors.

The management of 129 patients with recurrent tumors of the salivary glands is analyzed, Principles of approaching recurrent tumors and guidelines for their management are outlined in detail. Age distribution, symptoms, time to recurrence, cases that showed possible malignant degeneration, and complications are reviewed. The surgical procedures, recurrence rate, and survival rates are recorded.

First branchial cleft cysts and sinuses.

A brief review of the embryology and anatomy of first branchial cleft cysts and sinuses, with a resume of our experience, is presented. An illustrative case of each general type of this anomaly is given. The surgical treatment of these lesions, with special reference to technique and the precautions to be applied to minimize complications and recurrence, is discussed.