The aim of our study was to retrospectively evaluate the epidemiological characteristics of patients with high voltage electrical injury from 1999 to 2009. The Clinic of Burns and Reconstructive Surgery, Faculty Hospital Brno is located in a region of 2,505,000 inhabitants. In total 13,911 patients (including both children and adults, and outpatients as well as hospitalized patients) were treated at our burn center during the period of study. Of these patients, 1,030 were hospitalized for burns treatment. For the purposes of this study, we have included only patients with high voltage electrical trauma, of which there were 58, 2 of whom were female. Basic epidemiological indicators were gathered on these patients, including age, gender, place of accident, extent of trauma, mortality and whether the injury was occupational or non-occupational. Electrical burns (caused by both low-voltage and high-voltage electric current) made up 1.10% of all burns treated in our burn center and high voltage electrical injuries represented 0.42% of all burn injuries. The average incidence of high voltage electrical trauma was 0.21 cases/100,000 inhabitants. The average age of the patients was 28.59 years. Nine patients died and the mortality was fixed at 15.52%. The average length of hospitalization was 53.43 days. The average extent of burnt area was 35.01% TBSA. In our study, we were able to define the basic epidemiological parameters in 58 patients with high voltage electrical trauma. We also have to highlight the still disappointingly high number of non-occupational electrical injuries affecting those in the lower age groups, especially children. However, preventive programmes for educating specific risk groups have shown positive results.
- Publikační typ
- časopisecké články MeSH
Toxic epidermal necrolysis is a rare condition involving the skin at the dermoepidermal junction, with possible inclusion of mucous membranes. The condition is associated with systemic toxicity and high mortality rates. Successful treatment requires optimization of local as well as systemic therapy. We report the case of a young woman who developed toxic epidermal necrolysis, possibly resulting from lamotrigine therapy. Local therapy included a combination of a biological cover and alginate together with a synthetic cover (Aquacel Ag®).
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: The study aims to evaluate the impact of early and late tracheostomy on microbiological changes in the airways in severely burned children. MATERIALS AND METHODS: Early tracheostomy is sometimes performed within 3 days after the start of mechanical ventilation regular microbiological surveillance of the respiratory tract was done in all patients. From each sputum, tracheobronchial aspirate and bronchoalveolar lavage (BAL), a microscopic slide was made and the material was seeded in a culture medium. The standard culture media used for the growth of respiratory pathogens are blood agar, McConkey agar, VL agar and chocolate agar. The obtained values were statistically analysed. RESULTS: In the observed period, a total of 68 children underwent mechanical ventilation in our department. A total of 31 (45.59%) children had undergone surgical tracheostomy (18 patients with early tracheostomy and 13 patients with late tracheostomy). The most common bacterium isolated from the lower respiratory tract in patients with early and late tracheostomy was Acinetobacter baumannii (31.53% resp. 44.30% of all bacterial strains). In patients with early tracheostomy, the ratio of G+/G- during the 6-7th day of mechanical ventilation was 1.29:1 and during the 8-10th day, 1:1.43. In patients with late tracheostomy the G+/G- ratio was 1:2.25 and during the 8-10th day, 1:2.25. There was not any statistically significant deviation in the G+/G- ratio in patients with early and late tracheostomy in any of the monitored periods. CONCLUSION: The main reasons for performing early tracheostomy are: extent, localisation and depth of the burn. Difficult weaning in an uncooperative patient, failure of extubation with subsequent reintubation and other complications may be an indication for late tracheostomy. The study confirms that the use of appropriately indicated early tracheostomy provides a microbiological benefit for burned children.
- MeSH
- Bacteria izolace a purifikace MeSH
- bakteriální infekce mikrobiologie MeSH
- časové faktory MeSH
- dítě MeSH
- kojenec MeSH
- kvasinky izolace a purifikace MeSH
- lidé MeSH
- mladiství MeSH
- nemoci dýchací soustavy mikrobiologie MeSH
- popálení komplikace chirurgie MeSH
- předškolní dítě MeSH
- tracheostomie škodlivé účinky metody MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
UNLABELLED: The aim of this study was to determine the basic epidemiological characteristics of severely burned children who were admitted to the intensive care unit (ICU), Department of Burns and Reconstructive Surgery Faculty Hospital Brno, Czech Republic in the years 1997-2009. METHODS: We collected and evaluated epidemiological data such as age, sex, burn etiology, length of hospitalization, duration of the ICU stay, surgical or conservative therapeutic strategies, the use of mechanical ventilation and its duration, day and month of injury and the extent of burned area. RESULTS: In total 383 children (253 boys, 130 girls) aged 0-14 years, underwent intensive care for at least 48h. Male to female ratio was 1.95:1. The average range of burn area in the group was 16.43±12.86% TBSA (total body surface area). During the reporting period, 16 children were admitted with burns over 50% TBSA. 328 children suffered burns indoors, with 55 children being burned outdoors. Indoor/outdoor ratio was set at 5.96:1. The most frequent etiological agent was scalding (hot water, soup, coffee, oil, tea). The total number of scalded children in this group was 312 (81.46%). Mechanical ventilation was used in 96 cases (25.07% of all the admitted patients). The duration of mechanical ventilation in these patients was 8.03±5.67 days in average. The average length of stay in ICU was 10.71±10.92 days and total length of hospital stay was an average of 21.55±14.55 days. A total of 184 patients (48.04%) were treated surgically and therefore required necrectomy and skin grafting. The other 199 (51.96%) patients were treated conservatively. During the reporting period 3 children died (0.78%). CONCLUSION: In our report we identify basic epidemiological data defined in the aim of this study for burned children requiring intensive care.
- MeSH
- délka pobytu MeSH
- dítě MeSH
- jednotky intenzivní péče pediatrické statistika a číselné údaje MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- popálení epidemiologie etiologie MeSH
- popáleninové jednotky statistika a číselné údaje MeSH
- předškolní dítě MeSH
- rizikové faktory MeSH
- rozložení podle pohlaví MeSH
- úrazy v domácnosti statistika a číselné údaje MeSH
- věkové rozložení MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- dítě MeSH
- kvalita života MeSH
- lidé MeSH
- popálení komplikace psychologie MeSH
- sociální izolace psychologie MeSH
- životní styl MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- kongresy MeSH
V letech 1999–2005 bylo na pracovišti Kliniky popálenin a rekonstrukční chirurgie Fakultní nemocnice v Brně hospitalizováno pro úraz elektrickým proudem o vysokém napětí celkem 41 pacientů, což činilo 6,06 % počtu všech pacientů léčených na popáleninové JIP pro rozsáhlé popáleninové trauma. Průměrný věk pacientů s těžkým elektrotraumatem byl 27,29 let. Nejmladší pacient byl ve věku 9 let, nejstarší ve věku 64 let. V letech 2001–2005 bylo na brněnském popáleninovém pracovišti ošetřeno celkem 8 695 popálených pacientů (dětí i dospělých). Pacientů s úrazem elektrickým proudem bylo léčeno celkem 46 , což činí 0,53 % všech léčených pacientů s popáleninovým traumatem. Úrazů elektrickým proudem o vysokém napětí bylo léčeno 27, což činí 0,31 % pacientů léčených v letech 2001–2005 na brněnském popáleninovém pracovišti. Zůstává otázkou, zda část poraněných elektrickým proudem o nízkém napětí není ošetřena na jiných pracovištích našeho regionu. Příspěvek jasně ukazuje hrozivý počet případů nepracovních úrazů elektrickým proudem o vysokém napětí v prostředí železnice, postihující především nejmladší věkové skupiny – mladistvé a děti.
Between 1999 and 2005, a total of 41 patients were hospitalized at the Burn Centre of Brno University Hospital with high voltage electrical injuries, representing 6.06% of the total number of patients treated at the Burn Intensive Care Unit (ICU) for extensive burn trauma. The average age of patients with serious electrotraumas was 27.29 years. The youngest patient was 9 years old, the oldest 64 years. Lethality amounted to 17.07% of the total number of patients. The article clearly shows the sinister dimension (a frighteningly high number of cases) of high voltage electrical injuries suffered outside work context in the vicinity of railway tracks and affecting in particular the youngest age groups – children.
