Effectiveness of early rehabilitation in hand burns.

BACKGROUND: Hand burn trauma occurs quite commonly and the outcome of hand burns can significantly impact self-care daily function, work and employment, leisure activities, and overall health-related quality of life. The overall goal of the management of hand burn trauma is to optimize hand function. Rehabilitation and restoration of hand function are critical for the patient's independence and re-integration into society and work. The purpose of this study is to present our experience with 105 hand burn trauma patients admitted and treated in our burn center and to show the efficacy of early rehabilitation on their ability to return to their prior social life and work. METHODS: In our study, we included that 105 patients with acute severe hand burn trauma were hospitalized in Gulhane burn center between 2017 and 2021. They underwent rehabilitation program daily sessions. Patients with hand burns are evaluated by ranges of motions (ROM), grip strength, Cochin Hand Function Scale (CHFS), and Michigan Hand Questionnaire (MHQ) 12 months after the injury. RESULTS: Overall, mean digital total active motion were >180°. The mean values for grip strength of dominant hand for men were 27.2±9.3 kg, for women were 22.0±8.8 kg and non-dominant hand for men were 24.05±13.8 kg, for women were 17.8±10.3 kg. Total score of 5 items was 19.0 in CHFS. The mean overall score on the MHQ was 62.3±27.4. All obtained data were within normal or accepted functional ranges. Spearman correlation coefficient indicates a negative correlation between MHQ and CHFS (p≤0.01). CONCLUSION: A comprehensive rehabilitation program is essential in helping patients to regain optimal function after hand burn trauma. Physiotherapy and occupational therapy is most beneficial when started at the time of admission.

Effect of hyperbaric oxygen therapy when combined with fresh and frozen platelet-rich plasma on chronic wound healing in rats.

BACKGROUND: Hyperbaric oxygen therapy (HBOT) has an added dimension to the armamentarium of treating complicated chronic wounds. The purpose of this study is to investigate the effects of HBOT on chronic wounds when combined with fresh and frozen platelet-rich plasma (PRP). METHODS: Rats were divided into two main groups containing 18 rats in each group as HBOT received and non-received. Each group was divided into three subgroups as Group 1: Control, Group 2: Fresh, and Group 3: Frozen PRP applied. For PRP preparation, 10 rats were used. Histologic parameters including fibroblast, collagen fibers, lymphocytes, and vessels were evaluated by Clemex Vision Lite 3.5; wound sizes were evaluated by ImageJ digital analyzing program. RESULTS: In HBOT received group, the number of fibroblasts, collagen fibers, lymphocytes, and vessels in all fresh and frozen PRP applied and control subgroups were significantly higher than hyperbaric oxygen non-received group (p<0.05). In HBOT received group, wound surface area measurement values of control, fresh, and frozen PRP applied groups at 5-10-15 days were lower than HBOT non-received group. CONCLUSION: HBOT accelerates wound healing when combined with both fresh and frozen PRP. Frozen PRP is as effective as fresh form to be considered as an alternative in clinical setting.

Evaluation of the Healing Effects of Hypericum perforatum and Curcumin on Burn Wounds in Rats.

BACKGROUND: For centuries, medicinal plants have been extensively used in wound healing of burn injuries. The aim of this study is to analyze comparatively the effects of curcumin and Hypericum perforatum (HP) on second-degree burn wounds in rats. Materials and Methods. This experimental study was conducted on 24 male Sprague-Dawley rats with second-degree burns. The animals were randomly divided into three groups. The burns were treated with curcumin (Group B) and Hypericum perforatum (HP) on second-degree burn wounds in rats. RESULTS: All histological parameters of the control group showed statistically significant difference than the other groups (p < 0.05). There was no statistically significant difference between Groups B and C in terms of reepithelization and inflammation (p < 0.05). There was no statistically significant difference between Groups B and C in terms of reepithelization and inflammation (p < 0.05). There was no statistically significant difference between Groups B and C in terms of reepithelization and inflammation (p < 0.05). There was no statistically significant difference between Groups B and C in terms of reepithelization and inflammation (. CONCLUSION: Both curcumin and Hypericum perforatum oil are effective in burn wound healing. Our findings showed a better quality of healing in curcumin-treated rats.Hypericum perforatum (HP) on second-degree burn wounds in rats.

Comparison of the Effect of Platelet-Rich Plasma and Simvastatin on Healing of Critical-Size Calvarial Bone Defects.

OBJECTIVE: In previous studies, it has been shown that both simvastatin (chlolesterollowering drug) and platelet-rich plasma (PRP) were capable of promoting bone formation. The aim of this study was to compare the effects of PRP and simvastatin on healing of critical-size bone defects. METHODS: A total of 33 rats (3 for PRP preparation) were used in the experiment. Critical-size defect 8-mm diameter was created in 30 rats' calvarium. Rats were divided into 3 groups. Each group contained 10 animals. In Group A the defect was filled with phosphate-buffered saline only, in Group B with 0.5 mL PRP, and in Group C with 0.1 mg simvastatin. The defects were evaluated by radiographic analysis at 8th and 16th weeks. The animals were sacrificed 16 weeks after the surgery. Histological examination was performed to assess the new bone-forming area. Vessels, fibroblasts, osteoblasts, and osteoclasts were marked in 524749.1-µm area and counted with using Clemex Vision Lite 3.5 Image Analysis program. The results were statistically analyzed.

The effect of combined use of platelet-rich plasma and adipose-derived stem cells on fat graft survival.

BACKGROUND: Free fat grafts have an unpredictable survival rate that limits their successful use. To increase the viability of fat grafts, it is important to minimize the reabsorption rate. OBJECTIVE: Our aim was to investigate whether the combined use of platelet-rich plasma (PRP) and adipose derived stem cells (ADSCs) would contribute an improvement in lower resorption rates of fat grafts. METHODS: Inbred Fischer 344 rats were randomized into 4 groups (n = 10). Fat grafts were mixed with Dulbecco modified Eagle medium in group A, with PRP in group B, with ADSC in group C, and with PRP + ADSC in group D and were injected to the scalp.In vitro growth factor (vascular endothelial growth factor, transforming growth factor-ß, and fibroblast growth factor) levels were compared using enzyme-linked immunoassay method. After 12 weeks weight, volume and histology of the transplants were evaluated. RESULTS: The mean weight and volume of the fat grafts were highest in group D. Histopathological investigations revealed that the number of viable adipocytes and blood vessels were highest in group D. The level of growth factors was significantly higher in stem cell plus PRP group. CONCLUSION: Adipose-derived stem cells combined with PRP can enhance the survival of transplanted fat tissue.

Saving the zone of stasis in burns with melatonin: an experimental study in rats.

BACKGROUND: Studies aimed at recovering the zone of stasis are one of the major issues of experimental burn studies. Many drugs including antithrombotics, anticoagulants, anti-inflammatories have been investigated experimentally for saving the zone of stasis. In this study, the effect of the systemic melatonin on the zone of stasis was evaluated. METHODS: Twenty Wistar Albino rats were used in the study. Rats were assigned to two groups (n=10). The metal comb 1x2 cm in size was immersed in boiling water and held for 20 seconds on the back of the rats to create burn wounds.No treatment was given to the control group. Melatonin was given at a dose of 10 mg/kg/d by intraperitoneal injection in the treatment group for 7 days. Daily digital photographs of both groups were obtained. Total necrotic burn areas and the zone of stasis were assessed with Auto CAD and Visual Analyzing computer programs. At the end of one week, rats were sacrificed and skin biopsies were taken for histological examination. Edema, congestion, inflammatory infiltration, vascular proliferation and fibrosis were the parameters evaluated. Data were evaluated statistically by Chi-square test and Student-t test RESULTS: When histopatologic data and the measured values for total necrotic areas and zone of stasis of the experimental group werecompared to control group, the results were statistically significant (p<0.05). CONCLUSION: According to the results of this study, melatonin is efficient in saving the zone of stasis in burns.

Management of temporomandibular joint ankylosis with temporalis fascia flap and fat graft.

AIM: Temporomandibular joint (TMJ) ankylosis is a serious problem that restricts jaw mobility and causes disturbances in facial and mandibular growth. The purpose of this paper is to present an easy and versatile method for the treatment of TMJ ankylosis to decrease postoperative complications such as re-ankylosis. MATERIAL AND METHOD: Eleven patients who presented with ankylosis of the TMJ underwent surgical release. After performing gap arthroplasty through a preauricular approach, the temporalis fascia flap was transposed to the gap. An autogenous fat graft was then obtained from the abdomen and used as interpositional material. The follow-up time was 3-5 years. RESULTS: Re-ankylosis did not occur in any of the patients, and all had satisfactory mouth opening. CONCLUSION: Surgical treatment of TMJ ankylosis with gap arthroplasty, interposition of the temporalis fascia flap and fat grafting is an effective and easily procedure for preventing of re-ankylosis. The autogenous nature and close proximity to the joint are the main advantages of the temporalis fascia flap when compared with other interpositional materials, and the fat graft provides additional support by reducing pressure.

Rhabdomyosarcoma in an adult hand.

Rhabdomyosarcoma (RMS) is a malign tumour which arises from cells committed to a skeletal muscle lineage. It constitutes 4%-8% of all childhood malignancies but is rare in adults. The rare pleomorphic subtype occurs almost exclusively in adults and most often involves the extremities. RMS of the hand or foot comprise a minority of extremity cases. An adult patient with rhabdomyosarcoma in the hand, which is very rare, is presented in this article. General characteristics of the tumour and the treatment strategies are discussed.

Contact with wet cement: an unrecognized cause of chemical burn.

Chemical burns account for a small percentage of admissions to burn units. Wet cement is a poorly recognized cause of chemical burn. As the construction industry is growing, individuals will likely have more contact with this material and be more prone to its harmful effects. Wet cement can cause severe full-thickness burns with prolonged contact, but this property is not well known among professional users. The lack of information about the potential hazards of wet cement makes it an important problem that must be considered more seriously as a risk factor for chemical burn. Increasing public knowledge of the necessary preventive measures is crucial for avoiding this type of chemical burn injury. Here, we report a case with full-thickness burn that occurred while working with wet cement without proper protection.

Efficacy of bipolar release in neglected congenital muscular torticollis patients.

Surgical correction of the congenital muscular torticollis (CMT) is recommended for patients with unsuccessful conservative treatment. The aim of this study is to evaluate the efficacy of surgical release of congenital muscular torticollis in neglected cases. We retrospectively evaluated the data of our patients in terms of age, sex, clinical presentation, localization of the lesion, diagnostic tests, and additional abnormalities. The age at operation ranged from 6 to 23 years. Complete muscular release as determined by pre-operative and postoperative range of motion measurements was achieved in all of the patients by bipolar release. In this study, neck motion and head tilt showed marked improvement with surgical treatment in cases with CMT who were admitted to the hospital lately. Congenital muscular torticollis patients can benefit from surgical intervention above the age of 5. Bipolar release is an adequate and complication-free method.

An unusual cause of cold injury: liquified petroleum gas leakage.

Liquefied petroleum gas (LPG) is an odorless and colorless gas that is a mixture of hydrocarbons (propane and butane). It is now more commonly preferred among drivers as an auto-gas throughout the world because it is cheaper than petrol or diesel and produces the same amount of energy. Because of its rapid vaporization and consequent lowering of temperature, it may cause severe cold injuries. A 33-year-old male who suffered from hand burn due to LPG is presented in this article. In LPG-converted cars, if the conversion has not been done properly, LPG may leak. Thus, the public must be informed of this potential danger while undertaking repairs of their vehicles.

Extensor tendon rupture due to cutaneous leichmaniasis: a case report.

Acute cutaneous leishmaniasis is a parasitic infectious disease prevalent in tropical areas. Most doctors in non-endemic countries are not familiar with this disease. Spontaneous tendon ruptures occurring by different mechanisms have been described in the literature but a tendon rupture caused by a skin ulcer secondary to a parasitic infection has not been reported before. In this article clinical and diagnostic features of cutaneous leishmaniasis are reviewed and a case with spontaneous extensor tendon rupture due to cutaneous leishmaniasis is presented.