- MeSH
- biologické krytí MeSH
- dítě MeSH
- popálení MeSH
- Check Tag
- dítě MeSH
- Publikační typ
- abstrakt z konference MeSH
We need central venous catheters (CVCs) in management of critically ill patients with severe burns, either for the administration of fluids or monitoring hemodynamic status. Central venous catheterization may cause different early or late complications, which depend on the physician's erudition, the quality of the catheters and quality of Intensive Care Unit (ICU) nursing care for insertion. 272 CVCs were inserted in 114 both adult and pediatric patients from 2004 to 2006 in the ICU of the Burn Centre in Ostrava. The average insertion length of the catheter was 10.2 days, and the average total length of catheterization was 24 days. The total number of catheter-days was 2768. All catheter tips removed were routinely cultured. The most frequent infecting pathogens were coagulase-negative Staphylococci. Peripheral blood cultures were examined in case of fever. Bacterial findings from wounds, sputa and urine were monitored in all patients. No exogenous catheter sepsis according to Maki's criteria occurred in our study group. Endogenous catheter colonization with positive peripheral blood culture and bacteraemia occurred in 4 cases, which means an incidence density of 1.44 endogenous colonizations per 1000 catheter-days. The quality of used catheters and particularly the technique of placement and maintenance of catheters are considered crucial for good results in the ICU of Burn centre in Ostrava.
- MeSH
- bakteriální infekce komplikace prevence a kontrola MeSH
- interpretace statistických dat MeSH
- jednotky intenzivní péče využití MeSH
- katetrizace centrálních vén metody škodlivé účinky využití MeSH
- katetrizace metody škodlivé účinky využití MeSH
- popáleninové jednotky využití MeSH
- sepse etiologie komplikace prevence a kontrola MeSH
- Staphylococcus cytologie izolace a purifikace patogenita MeSH
- Geografické názvy
- Česká republika MeSH
Integra® artificial skin was applied on 16% of TBSA after necrectomy on a 7-month-old girl who was scalded on 26% of TBSA by her mother when she was cooking goulash. Nutritional parameters were monitored during the period of 25 days from the 1st necrectomy and application of Integra® up to the first autotransplantation – in the period when the other burnt surfaces were almost healed. The average intake of proteins and energy to achieve normal levels of monitored nutritional parameters was lower than that recommended by calculations for similarly burnt children. Our observation is similar to that of King (1).
- Klíčová slova
- Integra,
- MeSH
- kojenec MeSH
- lidé MeSH
- metody výživy MeSH
- nutriční hodnota MeSH
- popálení klasifikace terapie MeSH
- poruchy výživy dietoterapie terapie MeSH
- umělá kůže využití MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- Publikační typ
- kazuistiky MeSH
- srovnávací studie MeSH
The advantages of Integra have lead to an increase in its use after extensive burn injuries, in reconstructive surgery after burns, and abroad in general reconstructive surgery as well. At the Burn Center of FNsP Hospital in Ostrava Integra was used for the first time in March 2003. Since then, seven patients have undergone operations, involving the use of Integra in 14 body areas. In four of the patients scars after burns were corrected – on the neck, axilla, two on the trunk, two in the popliteal area and one between the toes. In three patients the artificial skin was applied after necronectomy. In a 7-month-old baby and in a 2-year-old child with burn injuries exceeding 25% of the body surface it was applied twice on the trunk, once on the upper extremity and once on the lower extremity. In an adult female Integra was applied on her neck and axilla after burns to a lesser extent.We have evaluated the scars one year after surgery in two patients. Cosmetic appearance was good in both of them.We have noted good functional result after the reconstruction of axilla. After reconstruction in the neck area and reconstruction of the necrectomy in the neck area and axilla, the functional results were average. The average functional results in both patients are probably due to poor compliance with the immobilization and following rehabilitation program.
Electrical burns are a serious problem within burn medicine even though they are relatively uncommon. The size of the burn is small, but the wound is often deep, and frequently the patient has systemic complications as well. In the majority of patients with such injuries immediate surgical intervention is essential, consisting of escharotomy, fasciotomy, and debridement of the devitalized tissues, necrectomy of the burn area, and closure of the defect by a direct suture, a dermo-epidermal graft, or local flap. Our report consists of three case studies. The patients underwent local flap plastic surgery after a full thickness soft tissue loss. All three patients healed primarily and did not require further correction of flaps. Final functional and aesthetic results are very good if the local flap is used appropriately.
- MeSH
- chirurgické laloky využití MeSH
- lidé MeSH
- popálení elektrickým proudem chirurgie MeSH
- transplantace kůže metody využití MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
This is a retrospective analysis of a group of 67 senior citizens over 75 years of age who had been hospitalized at the Burn Center of the FNsP Hospital in Ostrava – Poruba in the years 1999 – 2003.We have studied a group of males and females, noting their average age, most common causes of burn injuries, mechanisms of burn injuries, average extent of burn injuries, and most commonly burned body parts.We have also reviewed the seriousness of burn injury in senior citizens, factors that complicated the course of treatment as well as its impact on the final therapeutic effect. The importance of specific approach and individual therapeutic strategy is emphasized. We would also like to emphasize the need for complex therapy approach due to secondary diseases that are very common in this age group. The treatment of burn patients in this age group is very challenging from a personal and economic point of view. The goals of therapy are a full recovery and the return of the patient to normal life. However, goals and therapeutic results are determined and limited by the above-mentioned factors. Nevertheless, every therapeutic success, although partial, should be perceived as positive. For the patient, every success from the point of view of the ability to take care of himself or herself and the overall quality of life is fundamental.
Morykwas and Argenta developed Vacuum Assisted Closure (VAC®) in the early 90s for the treatment of tissue defects. In 2004, for the first time at our workplace, we used this method in the treatment of six patients between 54 and 91 years of age. Two of the patients were treated for a varicose ulcer on a lower extremity, two patients for loss of skin after an inflammation secondary to infection, one high-risk patient for deep burns, and one patient for a deep defect caused by an inappropriate medical care.We observed blood circulation improvement in all patients, which permitted an early dermo-epidermal graft.
