30 CFR 816.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Coal mine waste: Burning and burned waste...-SURFACE MINING ACTIVITIES § 816.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or burned coal mine waste shall be removed from a permitted disposal...

Lessons from the fires of 2000: Post-fire heterogeneity in ponderosa pine forests

USGS Publications Warehouse

Kotliar, Natasha B.; Haire, Sandra L.; Key, Carl H.; Omni, Phillip N.; Joyce, Linda A.

2003-01-01

We evaluate burn-severity patterns for six burns that occurred in the southern Rocky Mountains and the Colorado Plateau in 2000. We compare the results of two data sources: Burned Area Rehabilitations Teams (BAER) and a spatial burnseverity model derived from satellite imagery (the Normalized Burn Ratio; NBR). BAER maps tended to overestimate area of severe burns and underestimate area of moderate-severity burns relative to NBR maps. Low elevation and more southern ponderosa pine burns were predominantly understory burns, whereas burns at higher elevations and farther north had a greater component of high-severity burns. Thus, much, if not most, of the area covered by these burns appears to be consistent with historic burns and contributes to healthy functioning ecosystems.

Do burns increase the severity of terror injuries?

PubMed

Peleg, Kobi; Liran, Alon; Tessone, Ariel; Givon, Adi; Orenstein, Arie; Haik, Josef

2008-01-01

The use of explosives and suicide bombings has become more frequent since October 2000. This change in the nature of terror attacks has marked a new era in the Israeli-Palestinian conflict. We previously reported that the incidence of thermal injuries has since risen. However, the rise in the incidence of burns among victims of terror was proportionate to the rise in the incidence of burns among all trauma victims. This paper presents data from the Israeli National Trauma Registry during the years 1997--2003, to compare the severity of injuries and outcome (mortality rates) in terror victims with and without burn injuries. We also compare the severity of injuries and outcome (mortality rates) for patients with terror-attack related burns to non terror-attack related burns during the same period. Data was obtained from the Israeli National Trauma Registry for all patients admitted to 8 to 10 hospitals in Israel between 1997 and 2003. We analyzed and compared demographic and clinical characteristics of 219 terror-related burn patients (terror/burn), 2228 terror patients with no associated burns (Terror/no-burn) and 6546 non terror related burn patients (burn/no-terror). Severity of injuries was measured using the injury severity score, and burn severity by total body surface percentage indices. Admission rates to Intensive Care Units (ICU) and total length of hospitalization were also used to measure severity of injuries. In-hospital mortality rates were used to indicate outcome. Of burn/terror patients, 87.2% suffered other accompanying injuries, compared with 10.4% of burn/no-terror patients. Of burn/terror patients, 49.8% were admitted to ICU compared with only 11.9% of burn/no-terror patients and 23.8% of no-burn/terror patients. Mean length of hospital stay was 18.5 days for the terror/burn group compared with 11.1 days for the burn/no-terror group and 9.5 days for the terror/no-burn group. Burn/terror patients had a significantly higher injury severity score compared with the other groups. In-hospital mortality rate for the burn/no-terror group was 3.4%. The burn/terror group had a mortality rate of 6.4% which was similar to the no-burn/terror group (6.6%). Terror-attack injuries with accompanying burns have a more complex presentation, are of higher severity, and are associated with increased length of hospital stay and a higher ICU admissions rate, compared with terror-attack injuries without burns and non terror-attack related burns. However, mortality rates in terror-attack injuries are not affected by burns.

Accuracy of Currently Used Paper Burn Diagram vs a Three-Dimensional Computerized Model.

PubMed

Benjamin, Nicole C; Lee, Jong O; Norbury, William B; Branski, Ludwik K; Wurzer, Paul; Jimenez, Carlos J; Benjamin, Debra A; Herndon, David N

Burn units have historically used paper diagrams to estimate percent burn; however, unintentional errors can occur. The use of a computer program that incorporates wound mapping from photographs onto a three-dimensional (3D) human diagram could decrease subjectivity in preparing burn diagrams and subsequent calculations of TBSA burned. Analyses were done on 19 burned patients who had an estimated TBSA burned of ≥20%. The patients were admitted to Shriners Hospitals for Children or the University of Texas Medical Branch in Galveston, Texas, from July 2012 to September 2013 for treatment. Digital photographs were collected before the patient's first surgery. Using BurnCase 3D (RISC Software GmbH, Hagenberg, Austria), a burn mapping software, the user traced partial- and full-thickness burns from photographs. The program then superimposed tracings onto a 3D model and calculated percent burned. The results were compared with the Lund and Browder diagrams completed after the first operation. A two-tailed t-test was used to calculate statistical differences. For partial-thickness burns, burn sizes calculated using Lund and Browder diagrams were significantly larger than those calculated using BurnCase 3D (15% difference, P < .01). The opposite was found for full-thickness burns, with burn sizes being smaller when calculated using Lund and Browder diagrams (11% difference, P < .05). In conclusion, substantial differences exist in percent burn estimations derived from BurnCase 3D and paper diagrams. In our studied cohort, paper diagrams were associated with overestimation of partial-thickness burn size and underestimation of full-thickness burn size. Additional studies comparing BurnCase 3D with other commonly used methods are warranted.

Accuracy of burn size estimation in patients transferred to adult Burn Units in Sydney, Australia: an audit of 698 patients.

PubMed

Harish, Varun; Raymond, Andrew P; Issler, Andrea C; Lajevardi, Sepehr S; Chang, Ling-Yun; Maitz, Peter K M; Kennedy, Peter

2015-02-01

The purpose of this study was to compare burn size estimation between referring centres and Burn Units in adult patients transferred to Burn Units in Sydney, Australia. A review of all adults transferred to Burn Units in Sydney, Australia between January 2009 and August 2013 was performed. The TBSA estimated by the referring institution was compared with the TBSA measured at the Burns Unit. There were 698 adults transferred to a Burns Unit. Equivalent TBSA estimation between the referring hospital and Burns Unit occurred in 30% of patients. Overestimation occurred at a ratio exceeding 3:1 with respect to underestimation, with the difference between the referring institutions and Burns Unit estimation being statistically significant (P<0.001). Significant overestimation occurs in the early transfer of burn-injured patients as well as in patients transferred more than 48h after the burn (P<0.005). Underestimation occurs with less frequency but rises with increasing time after the burn (P<0.005) and with increasing TBSA. Throughout the temporal spectrum of transferred patients, severe burns (≥20% TBSA) were found to have more satisfactory burn size estimations compared with less severe injuries (<20% TBSA; P<0.005). There are significant inaccuracies in burn size assessment by referring centres. The systemic tendency for overestimation occurs throughout the entire TBSA spectrum, and persists with increasing time after the burn. Underestimation occurs less frequently but rises with increasing time after the burn and with increasing TBSA. Severe burns (≥20% TBSA) are more accurately estimated by the referring hospital. The inaccuracies in burn size assessment have the potential to result in suboptimal treatment and inappropriate referral to specialised Burn Units. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Ultrasound assessed thickness of burn scars in association with laser Doppler imaging determined depth of burns in paediatric patients.

PubMed

Wang, Xue-Qing; Mill, Julie; Kravchuk, Olena; Kimble, Roy M

2010-12-01

This study describes the ultrasound assessment of burn scars in paediatric patients and the association of these scar thickness with laser Doppler imaging (LDI) determined burn depth. A total of 60 ultrasound scar assessments were conducted on 33 scars from 21 paediatric burn patients at 3, 6 and 9 months after-burn. The mean of peak scar thickness was 0.39±0.032 cm, with the thickest at 6 months (0.40±0.036 cm). There were 17 scald burn scars (0.34±0.045 cm), 4 contact burn scars (0.61±0.092 cm), and 10 flame burn scars (0.42±0.058 cm). Each group of scars followed normal distributions. Twenty-three scars had original burns successfully scanned by LDI and various depths of burns were presented by different colours according to blood perfusion units (PU), with dark blue <125, light blue 125-250, and green 250-440 PU. The thickness of these scars was significantly different between the predominant colours of burns, with the thinnest scars for green coloured burns and the thickest for dark blue coloured burns. Within light blue burns, grafted burns healed with significantly thinner scars than non-grafted burns. This study indicates that LDI can be used for predicting the risk of hypertrophic scarring and for guiding burn care. To our knowledge, this is the first study to correlate the thickness of burns scars by ultrasound scan with burn depth determined by LDI. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

[Etiological analysis of subambient temperature burn in 351 cases of Hefei area].

PubMed

Shi, Jie; Qi, Weiwei; Xu, Qinglian; Zhou, Shunying; Wang, Guobao

2010-06-01

To study the preventive measure of the subambient temperature burn by analysing the pathogenesis feature. The clinical data were analysed from 351 cases of subambient temperature burn between February 2004 and February 2009, including age, sex, burn season, burn factors, burn position, burn area, burn degree, treatment way, and wound healing. Subambient temperature burn occurred in every age stage. The susceptible age stages included infant, children, and the elderly. Female patients were more than male patients. The common burn reasons were hot-water bottle burn, honey warm keeper burn, and heating device burn. The peak season was winter. Lower limb was the most common site of the subambient temperature burn. The deep II degree to III degree were the most common level, and the burn area was always small, often < or = 1% of total body surface area. Most of patients were treated with changing dressings at clinic and few patients needed hospitalization. Though the surface of wound could heal finally, and the wound healed well with no obvious scar in patients who received operation. Subambient temperature burn is the frequently encountered disease in winter. Use of the warming articles should be cautious, at the same time safety awareness should be strengthened so as to decrease the incidence rate of subambient temperature burn and the injury degree.

Effects of a skin rehabilitation nursing program on skin status, depression, and burn-specific health in burn survivors.

PubMed

Roh, Young Sook; Seo, Cheong Hoon; Jang, Ki Un

2010-01-01

The objective of this study was to identify the effects of a skin rehabilitation nursing program (SRNP) on skin status, depression, and burn-specific health in Korean burn survivors. A pretest-posttest design with a nonequivalent control group was used to examine the effects of SRNP for 3 months in a group of 26 burn survivors. The SRNP group of 13 burn survivors received massage therapy 30 minutes three times a week for 3 months compared to a control group of 13 burn survivors receiving typical care. The SRNP group showed no significant changes in the burn scar, subjective skin status, depression, or burn-specific health. Burn survivors receiving SRNP had reduced burn scar depth after the intervention compared to the control group. The findings of this study demonstrate that SRNP for burn survivors may improve burn scars, and findings suggest that future studies with a larger sample should be conducted using SRNP as an intervention for burn survivors.

[Surgical treatment of burns : Special aspects of pediatric burns].

PubMed

Bührer, G; Beier, J P; Horch, R E; Arkudas, A

2017-05-01

Treatment of pediatric burn patients is very important because of the sheer frequency of burn wounds and the possible long-term ramifications. Extensive burns need special care and are treated in specialized burn centers. The goal of this work is to present current standards in burn therapy and important innovations in the treatment of burns in children so that the common and small area burn wounds and scalds in pediatric patients in day-to-day dermatological practice can be adequately treated. Analysis of current literature, discussion of reviews, incorporation of current guidelines. Burns in pediatric patients are common. Improvement of survival can be achieved by treatment in burn centers. The assessment of burn depth and area is an important factor for proper treatment. We give an overview for outpatient treatment of partial thickness burns. New methods may result in better long-term outcome. Adequate treatment of burn injuries considering current literature and guidelines improves patient outcome. Rational implementation of new methods is recommended.

Minor burn management: potions and lotions

PubMed Central

Hyland, Ela J; Connolly, Siobhan M; Fox, Jade A; Harvey, John G

2015-01-01

Summary The first aid for burns is to run cold water over the burn for 20 minutes. This is effective for up to three hours after the injury. Assess the affected body surface area using the rule of nines. Consult a burn unit if more than 5% of the total body surface area is burnt in a child or if more than 10% in an adult. Extensive or deep burns and burns to special areas, such as the hands, should be referred. Chemical or electrical burns should also be assessed by a burn unit. For minor burns, antimicrobial dressings are recommended, but oral antibiotics should be avoided unless there are signs of infection. As burns are tetanus prone, check the patient’s immunisation status. Burns that become infected or are slow to heal should be discussed with a burn unit. The burn unit can also provide advice if there are uncertainties about how to manage a patient. PMID:26648640

Incidence and cost of non-fatal burns in Iran: a nationwide population-based study.

PubMed

Abouie, Abolfazl; Salamati, Payman; Hafezi-Nejad, Nima; Rahimi-Movaghar, Afarin; Saadat, Soheil; Amin-Esmaeili, Masoumeh; Sharifi, Vandad; Hajebi, Ahmad; Rahimi-Movaghar, Vafa

2018-03-01

To determine the incidence and cost of non-fatal burns in Iran; this cross-sectional household survey of a nationally representative sample of 15-64 years old was conducted. Through face-to-face interviews and telephone calls, the data on the demographics, history and cost of burns were collected. The annual incidence rate of burns was estimated 129.85 per 1000 population. Burns occurred higher in younger age, female gender and urban residency. The most common burn description was as follows: unpaid work (activity during burn), home (place of burn), heat and hot substances (mechanism of burn) and upper limb (site of burn). The average total cost of burn includes victims seeking medical care was US$124 per case. The main findings of this study suggest that burns are a major public health concern in Iran. To stop this important health issue, a national program for burn prevention and education must be developed.

Epidemiology of burn injuries in Nepal: a systemic review.

PubMed

Tripathee, Sanjib; Basnet, Surendra Jung

2017-01-01

Burn is a global public health problem associated with significant morbidity and mortality, mostly in low- and middle-income countries. Southeast-Asian countries share a big burden of burn injuries, and Nepal is not an exception. We performed a systemic review to examine the epidemiological characteristics of burn injures in Nepal. Relevant epidemiological studies were identified through systemic search in PubMed, EMBASE, and Google Scholar. Reference lists from relevant review articles were also searched. Studies were included if they meet our selection criteria. Eight studies were included in our systemic review. Most of the burn victims belong to the working age group between 15-60 years old. Flame burns were found to be the most common cause of burn injury followed by scald burns, whereas scald burns were the most common cause of burn injury among the pediatric population. Most patients sustained less severe burn injuries, with home being the most common place of burn injury. The average hospital stay among the burn victims ranged from 13 to 60 days. Mortality among the burn victims ranged from 4.5 to 23.5%, with highest mortality among the flame burn patients. Developed nations have significantly reduced the burn incidence through effective intervention program. Although, burn injuries are the leading cause of morbidity and mortality in Nepal, effective intervention programs are lacking due to the limited epidemiological data related to burn injuries. Further large scale research is imperative to investigate the problem and assess the effectiveness of an intervention program.

Tracking non-burn center care: what you don't know may surprise you.

PubMed

Davis, James S; Dearwater, Stephen; Rosales, Oscar; Varas, Robin; Quintana, Olga D; Pizano, Louis; Namias, Nicholas; Schulman, Carl I

2012-01-01

The American Burn Association publishes a list of defined criteria for patients who require admission or transfer to a burn center. This study examines the extent to which those criteria are observed within a regional burn network. Hospital discharge data for 2008 were obtained for all hospitals within the South Florida regional burn network. Patients with International Classification of Diseases, 9th revision discharge diagnoses for burns were reviewed, and their triage destination was compared with the burn triage referral criteria to determine whether patients were inappropriately triaged. Descriptive statistics were used to analyze the data. Four hundred ninety-eight burn admissions were documented to non-burn center center hospitals, 269 (54%) of which were deemed inappropriate by burn triage referral criteria. Burn center patients had greater length of stay when compared with non-burn center patients (14 vs 7 days), but a greater percentage were discharged home for self-care (88 vs 57%). Thirty-three percent of the inappropriate admissions were in a neighboring county, whereas 27% were in the same county where the burn center is located. Inappropriate burn patient triage may be occurring to more than half of the burn patients within our regional burn network despite better functional outcomes at the burn center. This may be because of a lack of knowledge regarding triage criteria, patient insurance status, or other factors. Further studies are necessary to fully characterize the problem and implement education or incentives to encourage appropriate burn patient triage.

Preparation of Partial-Thickness Burn Wounds in Rodents Using a New Experimental Burning Device.

PubMed

Sakamoto, Michiharu; Morimoto, Naoki; Ogino, Shuichi; Jinno, Chizuru; Kawaguchi, Atsushi; Kawai, Katsuya; Suzuki, Shigehiko

2016-06-01

The manual application of hot water or hot metal to an animal's skin surface is often used to prepare burn wound models. However, manual burn creation is subject to human variability. We developed a new device that can control the temperature, time, and pressure of contact to produce precise and reproducible animal burn wounds and investigated the conditions required to prepare various burn wounds using our new device. We prepared burn wounds on F344 rats using 3 contact times 2, 4, and 10 seconds using a stamp heated to 80°C. We observed the wound-healing process macroscopically and histologically and evaluated the burn depth using a laser speckle contrast-imaging device, which evaluated the blood flow of the wound. The changes in the burned area over time, tissue perfusion of the burn wounds, histological evaluation of the burn depth by hematoxylin-eosin and azocarmine and aniline blue staining, and the epithelialization rate (the ratio of the epithelialized area to the wound length) were evaluated on histological sections. Results indicated that the burn wounds prepared with contact times of 2, 4, and 10 seconds corresponded to superficial dermal burns, deep dermal burns, and full-thickness burns, respectively. We demonstrated that partial- and full-thickness burn wounds can be precisely and reproducibly created with our new automated burning device.

Epidemiology and outcome analysis of 6325 burn patients: a five-year retrospective study in a major burn center in Southwest China

PubMed Central

Li, Haisheng; Yao, Zhihui; Tan, Jianglin; Zhou, Junyi; Li, Yi; Wu, Jun; Luo, Gaoxing

2017-01-01

Burns are a major cause of injury worldwide. We investigated the epidemiology and outcomes of burn patients in a major burn center in southwest China between 2011 and 2015 to provide guidance for burn prevention. Of the 6,325 included burn patients, 66.8% were male and 34.7% were 0 ~ 6 years old. The incidence of burns peaked in autumn. Scald was the most common cause of burns, which was predominant in patients aged 0 ~ 6 years. The mean total body surface area (TBSA) of burns was 13.4%, and patients with burns ≤10% TBSA comprised 64.1% of all cases. Patients with full-thickness burns accounted for 40.1% of all patients and 81.0% of operated patients; these burns were primarily caused by flame (34.8%), scald (21.0%), and electricity (20.4%). Fifty-six deaths occurred (mortality 0.9%), and risk factors included full-thickness burns, larger TBSA and older age. The median length of stay was 17 days, and major risk factors included more operations, better outcomes and larger TBSA. Our data showed that closer attention should be paid to children under 6 years old, males, incidents in autumn and scald burns to prevent burn injuries. Furthermore, individualized burn prevention and treatment measures based on related risk factors should be adopted. PMID:28383066

Dual therapeutic functions of F-5 fragment in burn wounds: preventing wound progression and promoting wound healing in pigs.

PubMed

Bhatia, Ayesha; O'Brien, Kathryn; Chen, Mei; Wong, Alex; Garner, Warren; Woodley, David T; Li, Wei

2016-01-01

Burn injuries are a leading cause of morbidity including prolonged hospitalization, disfigurement, and disability. Currently there is no Food and Drug Administration-approved burn therapeutics. A clinical distinction of burn injuries from other acute wounds is the event of the so-called secondary burn wound progression within the first week of the injury, in which a burn expands horizontally and vertically from its initial boundary to a larger area. Therefore, an effective therapeutics for burns should show dual abilities to prevent the burn wound progression and thereafter promote burn wound healing. Herein we report that topically applied F-5 fragment of heat shock protein-90α is a dual functional agent to promote burn wound healing in pigs. First, F-5 prevents burn wound progression by protecting the surrounding cells from undergoing heat-induced caspase 3 activation and apoptosis with increased Akt activation. Accordingly, F-5-treated burn and excision wounds show a marked decline in inflammation. Thereafter, F-5 accelerates burn wound healing by stimulating the keratinocyte migration-led reepithelialization, leading to wound closure. This study addresses a topical agent that is capable of preventing burn wound progression and accelerating burn wound healing.

Burn Incidence and Treatment in the U.S.

MedlinePlus

... state health data systems, and the National Burn Repository (NBR) of the American Burn Association (ABA). ABA ... Burn Admissions to Burn Centers (ABA National Burn Repository 2015) Survival Rate: 96.8% Gender: 68% Male, ...

40 CFR 49.11021 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Permits for general open burning, agricultural burning, and forestry and silvicultural burning. 49.11021 Section 49.11021 Protection of... Tribes of the Umatilla Reservation, Oregon § 49.11021 Permits for general open burning, agricultural...

40 CFR 49.11021 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Permits for general open burning, agricultural burning, and forestry and silvicultural burning. 49.11021 Section 49.11021 Protection of... Tribes of the Umatilla Reservation, Oregon § 49.11021 Permits for general open burning, agricultural...

40 CFR 49.11021 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Permits for general open burning, agricultural burning, and forestry and silvicultural burning. 49.11021 Section 49.11021 Protection of... Tribes of the Umatilla Reservation, Oregon § 49.11021 Permits for general open burning, agricultural...

40 CFR 49.11021 - Permits for general open burning, agricultural burning, and forestry and silvicultural burning.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Permits for general open burning, agricultural burning, and forestry and silvicultural burning. 49.11021 Section 49.11021 Protection of... Tribes of the Umatilla Reservation, Oregon § 49.11021 Permits for general open burning, agricultural...

Jaggery: an avoidable cause of severe, deadly pediatric burns.

PubMed

Light, T D; Latenser, B A; Heinle, J A; Stolpen, M S; Quinn, K A; Ravindran, V; Chacko, J

2009-05-01

Jaggery is the non-industrial refinement of sugar cane into a sugar product. Sugar cane cultivation, harvest and refinement are central aspects of rural Indian life. We present a retrospective review of pediatric burns at a single institution in Southern India, drawing special attention to scald burns incurred when young children fall into the cauldron of boiling jaggery. Descriptive statistics comparing children burned by jaggery and children burned by other mechanisms were performed. Multivariable logistic regression including burn size and mechanism of burn (jaggery and non-jaggery) was performed to determine the increased risk of death when burned by jaggery. Children burned by jaggery immersions are older, more likely male, and have larger burns. They have longer hospital stays, more operations, and are more likely to die. When controlling for age, gender, size of burn, and mechanism, jaggery exposure was associated with a higher mortality. Jaggery burns are deadly, devastating burns which could be prevented. While jaggery and sugar cane production can lead to economic independence for rural Indian villages, the cost it exacts from burns and death to the youngest and most vulnerable children must be addressed and prevented.

A Computer Program to Evaluate Experimental Therapies for Treating Burned Patients

PubMed Central

Flora, Jairus D.; Flora, Sharyl Ann

1980-01-01

Determining the worth of new therapies for burn patients has been difficult because of the rarity of the burn injury and the disparate survival chances associated with different sizes of burns. Recently a burn survival model has been developed that estimates the risk of death from a burn as a function of the patient's age, sex, area of full thickness (third degree) burn, area of partial thickness burn, involvement of the perineum, and time from burn to admission. An alternative risk model uses the total area burned in place of the areas of partial thickness burn and full thickness burn, and is appropriate if the amount of full thickness burn is not determined accurately. This paper describes a program that uses these risk models to correct or standardize for demographic and severity factors, then, after that adjustment, tests whether a group of burn patients who received a new or experimental therapy shows a significantly better survival rate than that predicted by a baseline model. The program is a simple one written in Fortran for easy adaptation to other computer systems.

Evaluation of infrastructure, equipment and training of 28 burn units/burn centers in Germany, Austria and Switzerland.

PubMed

Vogt, Peter M; Busche, Marc N

2011-03-01

Treatment of burn patients requires special training and skills, and an adequate infrastructure. In the United States, burn center referral criteria and requirements of burn centers are defined by the American Burn Association (ABA) in the Guidelines for the Operation of Burn Centers, and in Germany, by the German Society for Burn Treatment (DGV). The European Burn centers in Austria and the German-speaking part of Switzerland share the standards in the setting of the German-speaking Association for Burn Therapy (DAV) with some modifications. The aim of this study was to evaluate the current infrastructure of burn centers in the three German-speaking countries with respect to the existing guidelines. Therefore, guidelines for burn center referral criteria and burn center requirements were compared between the USA (ABA) and Germany (DGV). In addition, a questionnaire was sent to all burn centers in Germany, Austria and the German-speaking part of Switzerland, in order to collect current information regarding the architectural and medical infrastructure, available equipment and care-providing personnel. The comparison of guidelines for the USA and Germany revealed similar burn center referral criteria for both countries. With respect to burn center requirements, both the USA and Germany have similar requirements, albeit with different focus points. In Germany, the main focus lies on the infrastructural requirements for burn centers, while in the US, the main focus lies on the requirements for medical and nursing personnel. Critical review of the responses from the burn centers of German-speaking countries revealed that the biggest infrastructural differences among centers were observed in burn units providing pediatric care, as compared to adult burn centers. In summary, the DGV guidelines for German-speaking countries reflect an overall adoption of the ABA guidelines, and the burn centers included in this study met those requirements. As a result of the positive experience and effective treatment of burn patients in German-speaking countries, we recommend an adoption of the ABA guidelines to those countries and societies that are in need of appropriate standards of burn care. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

How is the chlorophyll count affected by burned and unburned marsh areas?

NASA Astrophysics Data System (ADS)

Kendrick, C.

2017-12-01

Does marsh burnings, either man made or natural, hinder or help Louisiana's vitally important coastal plant life? Does the carbon produced from the fires have a negative effect on the chlorophyll count of these precious living protective barriers? Or does it help contribute to raising the plants chlorophyll count? Along Louisiana's Gulf Coast, marsh burnings are conducted every 2-4 years to destroy some of the Spartina patens. Fires and smoke may have an effect on the chlorophyll count of the plants found in Louisiana's marshes. Peat burns, root burns, and cover burns are the three types of marsh fires. These burns can be either man made or started by natural causes. Peat burns occur when the soil is dry due to a drained marsh. Root burns occur when plant roots are burned without the soil being consumed. Cover burns occur when several centimeters of water covers the soil. Cover burns are often used by Wildlife and Fisheries personnel to promote preferred plant food growth like Scirpus olneyi rather than the dominant Spartina patens. Our project was conducted by testing marsh plants and obtaining chlorophyll count of both a burned (cover burn) and an unburned area. Approximately one year after the burn, in August 2015, we tested the burned area's site. We retested the same site in December 2016. The results from our testing showed that there was a slightly higher chlorophyll count in the burned area. The chlorophyll count average from the two testing days was 33.5 in the burned area and 30.15 in the unburned area. Our hypothesis was that the chlorophyll content of "controlled" burned wetland areas will have a higher amount than the "no" burn area. The experiment results supported this hypothesis by showing an increase of 3.35 average in the burned area.

Orion Burn Management, Nominal and Response to Failures

NASA Technical Reports Server (NTRS)

Odegard, Ryan; Goodman, John L.; Barrett, Charles P.; Pohlkamp, Kara; Robinson, Shane

2016-01-01

An approach for managing Orion on-orbit burn execution is described for nominal and failure response scenarios. The burn management strategy for Orion takes into account per-burn variations in targeting, timing, and execution; crew and ground operator intervention and overrides; defined burn failure triggers and responses; and corresponding on-board software sequencing functionality. Burn-to- burn variations are managed through the identification of specific parameters that may be updated for each progressive burn. Failure triggers and automatic responses during the burn timeframe are defined to provide safety for the crew in the case of vehicle failures, along with override capabilities to ensure operational control of the vehicle. On-board sequencing software provides the timeline coordination for performing the required activities related to targeting, burn execution, and responding to burn failures.

In view of standardization: comparison and analysis of initial management of severely burned patients in Germany, Austria and Switzerland.

PubMed

Münzberg, Matthias; Ziegler, Benjamin; Fischer, Sebastian; Wölfl, Christoph Georg; Grützner, Paul Alfred; Kremer, Thomas; Kneser, Ulrich; Hirche, Christoph

2015-02-01

Initial treatment of severely injured patients in German speaking trauma centers follows precise sequences. Several guidelines and training courses ensure a constant quality in providing evidence-based treatment for these patients. Similar standards, algorithms and guidelines for the treatment of severely burned patients are lacking. This raises the question about the current standard of care for burn victims in German speaking burn centers. In order to achieve standardization, as a first step this study surveys principles of burn room organization and management in these burn centers. A questionnaire including 40 questions regarding burn room organization, personnel structure and qualification, infrastructural conditions and quality management was developed and sent to 21 level one burn centers in Germany, Austria and Switzerland. The rate of returned questionnaires was 81%. The analysis revealed varying personnel and infrastructural conditions in participating burn centers. Indications for admission to the burn room and admission procedures itself are different throughout surveyed hospitals. Individual standard operating procedure (SOP) for burn trauma admissions was available in most burn centers and nearly all participants register their burn trauma cases using an in-house burn register. The survey suggests a lack of standardization in personnel structure, infrastructure and treatment approach for the initial clinical care of severely burned patients in burn centers across the German speaking countries. Further evaluation of existing protocols and international standards in burn care is inevitable to develop standardized guidelines for burn care and to improve quality of care. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

30 CFR 817.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Coal mine waste: Burning and burned waste...-UNDERGROUND MINING ACTIVITIES § 817.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or unburned coal mine waste shall be removed from a permitted disposal...

30 CFR 817.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Coal mine waste: Burning and burned waste...-UNDERGROUND MINING ACTIVITIES § 817.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or unburned coal mine waste shall be removed from a permitted disposal...

30 CFR 817.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Burning and burned waste...-UNDERGROUND MINING ACTIVITIES § 817.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or unburned coal mine waste shall be removed from a permitted disposal...

30 CFR 817.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Coal mine waste: Burning and burned waste...-UNDERGROUND MINING ACTIVITIES § 817.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or unburned coal mine waste shall be removed from a permitted disposal...

30 CFR 817.87 - Coal mine waste: Burning and burned waste utilization.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Coal mine waste: Burning and burned waste...-UNDERGROUND MINING ACTIVITIES § 817.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine... extinguishing operations. (b) No burning or unburned coal mine waste shall be removed from a permitted disposal...

Unsupervised Spatio-Temporal Data Mining Framework for Burned Area Mapping

NASA Technical Reports Server (NTRS)

Kumar, Vipin (Inventor); Boriah, Shyam (Inventor); Mithal, Varun (Inventor); Khandelwal, Ankush (Inventor)

2016-01-01

A method reduces processing time required to identify locations burned by fire by receiving a feature value for each pixel in an image, each pixel representing a sub-area of a location. Pixels are then grouped based on similarities of the feature values to form candidate burn events. For each candidate burn event, a probability that the candidate burn event is a true burn event is determined based on at least one further feature value for each pixel in the candidate burn event. Candidate burn events that have a probability below a threshold are removed from further consideration as burn events to produce a set of remaining candidate burn events.

Fundamentals of acute burn care and physical therapy management.

PubMed

Wright, P C

1984-08-01

The purpose of this paper is to discuss general treatment guidelines for treating patients with acute burns and to review pathophysiology of acute burn injuries. I will discuss skin composition briefly, give a review of acute burn pathophysiology and medical treatment, outline the psychological factors physical therapists should consider when working with these patients, and discuss physical therapy for the patient with acute burns. Physical therapy for patients with burns has become a specialty as knowledge of burn injuries increases. I have attempted to review physical therapy burn knowledge for inexperienced clinicians beginning to treat patients with acute burns.

Dual therapeutic functions of F-5 fragment in burn wounds: preventing wound progression and promoting wound healing in pigs

PubMed Central

Bhatia, Ayesha; O’Brien, Kathryn; Chen, Mei; Wong, Alex; Garner, Warren; Woodley, David T.; Li, Wei

2016-01-01

Burn injuries are a leading cause of morbidity including prolonged hospitalization, disfigurement, and disability. Currently there is no Food and Drug Administration-approved burn therapeutics. A clinical distinction of burn injuries from other acute wounds is the event of the so-called secondary burn wound progression within the first week of the injury, in which a burn expands horizontally and vertically from its initial boundary to a larger area. Therefore, an effective therapeutics for burns should show dual abilities to prevent the burn wound progression and thereafter promote burn wound healing. Herein we report that topically applied F-5 fragment of heat shock protein-90α is a dual functional agent to promote burn wound healing in pigs. First, F-5 prevents burn wound progression by protecting the surrounding cells from undergoing heat-induced caspase 3 activation and apoptosis with increased Akt activation. Accordingly, F-5–treated burn and excision wounds show a marked decline in inflammation. Thereafter, F-5 accelerates burn wound healing by stimulating the keratinocyte migration-led reepithelialization, leading to wound closure. This study addresses a topical agent that is capable of preventing burn wound progression and accelerating burn wound healing. PMID:27382602

The Burn Wound Exudate – an under-utilized resource

PubMed Central

Widgerow, Alan D; King, Kassandra; Tussardi, Ilaria Tocco; Banyard, Derek A.; Chiang, Ryan; Awad, Antony; Afzel, Hassan; Bhatnager, Shweta; Melkumyan, Satenik; Wirth, Garrett; Evans, Gregory R.D

2014-01-01

Introduction The burn wound exudate represents the burn tissue microenvironment. Extracting information from the exudate relating to cellular components, signaling mediators and protein content can provide much needed data relating to the local tissue damage, depth of the wound and probable systemic complications. This review examines the scientific data extracted from burn wound exudates over the years and proposes new investigations that will provide useful information from this underutilized resource. Method A literature review was conducted using the electronic database PubMed to search for literature pertaining to burn wound or blister fluid analysis. Key words included burn exudate, blister fluid, wound exudate, cytokine burn fluid, subeschar fluid, cytokine burns, serum cytokines. 32 relevant article were examined and 29 selected as relevant to the review. 3 papers were discarded due to questionable methodology or conclusions. The reports were assessed for their affect on management decisions and diagnostics. Furthermore, traditional blood level analysis of these mediators was made to compare the accuracy of blood versus exudate in burn wound management. Extrapolations are made for new possibilities of burn wound exudate analysis. Results Studies pertaining to burn wound exudate, subeschar fluid and blister fluid analyses may have contributed to burn wound management decisions particularly related to escharectomies and early burn wound excision. In addition, information from these studies have the potential to impact on areas such as healing, scarring, burn wound conversion and burn wound depth analysis. Conclusion Burn wound exudate analysis has proven useful in burn wound management decisions. It appears to offer a far more accurate reflection of the burn wound pathophysiology than the traditional blood/serum investigations undertaken in the past. New approaches to diagnostics and treatment efficacy assessment are possible utilizing data from this fluid. Burn wound exudate is a useful, currently under-utilized resource that is likely to take a more prominent role in burn wound management. PMID:24986597

Clinical and demographic features of pediatric burns in the eastern provinces of Turkey

PubMed Central

2011-01-01

Background The aim of this study is to perform a retrospective analysis of the causes of burns observed in children in the eastern provinces of Turkey. Method In this study, patients were studied retrospectively with regard to their age, sex, cause of burns, seasonal variations, social and economic factors, length of hospital stay, burned body surface area, medical history, site of injury, and mortality. Results A total of 125 patients undergoing inpatient treatment were male, (53.2%) and 110 were female (46.8%). The most common causes of burns in patients treated on an inpatient basis were scald burns (65.5%) and tandir burns (15.7%). The mean total body surface area of all the patients was 12.17+9.86%. When the patients were grouped according to tandir, cauldron, and others burn causes, a significant difference was seen between the in burn percentages caused by tandir and cauldron burns and other causes (p < 0.001). Higher burn percentages were seen for cauldron burns than for tandir burns (p < 0.05). The average length of hospital stay was 17.67+13.64 days. When the patients were grouped according to burn causes (tandir, cauldron, and others), a significant difference was determined between the hospitalization periods of patients with tandir burns and other burn causes (p = 0.001) The most commonly proliferating microorganism in burned areas was Pseudomonas aeruginosa (20.4%). Of the 235 patients, 61 were treated in operating rooms. During the 24-month period of the study, 2 of the 235 patients died (0.85%). Conclusion Pediatric burns in the eastern part of Turkey are different from those in other parts of Turkey, as well as in other countries. Due to the lifestyle of the region, tandir and cauldron burns, which cause extensive burn areas and high morbidity, are frequently seen in children. Therefore, precautions and educational programs related to the use of tandirs and cauldrons are needed in this region. PMID:21244683

Quality of life and mediating role of patient scar assessment in burn patients.

PubMed

Oh, Hyunjin; Boo, Sunjoo

2017-09-01

In this study, we examined the plausibility of the mediating effect of the levels of patient scar assessment on the relationship between burn severity measured with total body surface area and burn-specific health-related quality of life (HRQL) among patients with burns in South Korea. In this cross sectional descriptive study, we collected data from 100 burn patients in three burn centers specializing in burn care in South Korea. Patient scar assessment, burn specific HRQL, and burn-related characteristics were self-reported with anonymous, paper-based surveys. The findings showed a positive correlation between burn severity, patient scar assessment, and HRQL in burn patients. The evidence of this paper is that quality of life after burns more determined by scar characteristics than burn severity. In the light of the poor HRQL in burn patients, the results of this study support that improving scar status could improve patients' HRQL. Health care providers should keep in mind that patients' perspectives of their scars would be a great indicator of their HRQL, so the providers' focus should be on intensive scar management intervention in their care. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Severity of burn and its related factors: A study from the developing country Pakistan.

PubMed

Adil, Syed Omair; Nisar, Nighat; Ehmer-Al-Ibran; Shafique, Kashif; Baig-Ansari, Naila

2016-06-01

Burns are leading cause of fatal injuries and major cause of morbidity and mortality in developing countries. The major obstacle in controlling severity is factors related to burn. This study determines frequency of burns and the factors related to it in Karachi, Pakistan. A cross-sectional study was conducted and 384 hospitalized adult patients with burns were consecutively interviewed during August 2013 to February 2014. Information was collected on socio-demographic profile, intent of burn, severity of burn, health hazards, physical and psychological characteristics. TBSA burn of >15% was considered as higher severity of burn. Higher severity of burns was found in 76.3% patients. Multivariate analysis showed that higher severity of burns were significantly associated with age less than 25 years (OR 2.7, 95% CI 1.5-4.9), never had been to school (OR 3.1, 95% CI 1.7-5.9) and intentional burn (OR 20.6, 95% CI 5.0-84.9). Majority of patients had higher severity of burn. The intent of injury was intentional, age less than 25 years and no schooling were found significantly associated with higher severity of burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Burns education for non-burn specialist clinicians in Western Australia.

PubMed

McWilliams, Tania; Hendricks, Joyce; Twigg, Di; Wood, Fiona

2015-03-01

Burn patients often receive their initial care by non-burn specialist clinicians, with increasingly collaborative burn models of care. The provision of relevant and accessible education for these clinicians is therefore vital for optimal patient care. A two phase design was used. A state-wide survey of multidisciplinary non-burn specialist clinicians throughout Western Australia identified learning needs related to paediatric burn care. A targeted education programme was developed and delivered live via videoconference. Pre-post-test analysis evaluated changes in knowledge as a result of attendance at each education session. Non-burn specialist clinicians identified numerous areas of burn care relevant to their practice. Statistically significant differences between perceived relevance of care and confidence in care provision were reported for aspects of acute burn care. Following attendance at the education sessions, statistically significant increases in knowledge were noted for most areas of acute burn care. Identification of learning needs facilitated the development of a targeted education programme for non-burn specialist clinicians. Increased non-burn specialist clinician knowledge following attendance at most education sessions supports the use of videoconferencing as an acceptable and effective method of delivering burns education in Western Australia. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

30 CFR 56.6903 - Burning explosive material.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Burning explosive material. 56.6903 Section 56... Requirements § 56.6903 Burning explosive material. If explosive material is suspected of burning at the blast... after the burning or suspected burning has stopped. ...

30 CFR 56.6903 - Burning explosive material.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Burning explosive material. 56.6903 Section 56... Requirements § 56.6903 Burning explosive material. If explosive material is suspected of burning at the blast... after the burning or suspected burning has stopped. ...

30 CFR 56.6903 - Burning explosive material.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Burning explosive material. 56.6903 Section 56... Requirements § 56.6903 Burning explosive material. If explosive material is suspected of burning at the blast... after the burning or suspected burning has stopped. ...

30 CFR 56.6903 - Burning explosive material.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Burning explosive material. 56.6903 Section 56... Requirements § 56.6903 Burning explosive material. If explosive material is suspected of burning at the blast... after the burning or suspected burning has stopped. ...

30 CFR 56.6903 - Burning explosive material.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Burning explosive material. 56.6903 Section 56... Requirements § 56.6903 Burning explosive material. If explosive material is suspected of burning at the blast... after the burning or suspected burning has stopped. ...

Assessment of burn-specific health-related quality of life and patient scar status following burn.

PubMed

Oh, Hyunjin; Boo, Sunjoo

2017-11-01

This study assessed patient-perceived levels of scar assessment and burn-specific quality of life (QOL) in Korean burn patients admitted to burn care centers and identified differences in scar assessment and QOL based on various patient characteristics. A cross-sectional descriptive study using anonymous paper-based survey methods was conducted with 100 burn patients from three burn centers specializing in burn care in South Korea. Mean subject age was 44.5 years old, and 69% of the subjects were men. The overall mean QOL was 2.91 out of 5. QOL was lowest for the work subdomain (2.25±1.45) followed by the treatment regimen subdomain (2.32±1.16). The subjects' mean total scar assessment score was 35.51 out of 60, and subjects were most unsatisfied with scar color. Subjects with low income, flame-source burns, severe burns, visible scars, and scars on face or hand reported significantly lower QOL. Subjects with severe burn degree and burn range perceived their burn scar condition to be worse than that of others. The results show that burn subjects experience the most difficulties with their work and the treatment regimen. Subjects with severe burn and visible scarring have a reduced QOL and a poor scar status. Scar management intervention may improve QOL of burn patients especially those with severe burn and visible scars. Further studies are warranted to evaluate the relationship between scar assessment and QOL. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Burn hazards of the deployed environment in wartime: epidemiology of noncombat burns from ongoing United States military operations.

PubMed

Kauvar, David S; Wade, Charles E; Baer, David G

2009-10-01

Service in the deployed military environment carries risks for accidental (noncombat-related) burns. Examining these risks can assist in the development of military burn prevention measures. This study endeavored to examine noncombat burn epidemiology in the context of similar civilian data. We performed a retrospective cohort study of consecutive casualties evacuated from operational military theaters in Iraq and Afghanistan to the sole tertiary military burn center in the US. Military data were compared with database samples of the US population from the American Burn Association and the Centers for Disease Control and Prevention. The main causes of the 180 noncombat burns seen from March 2003 to June 2008 were waste burning, fuel mishaps, and unintentional ordinance detonations. Overall prevalence of noncombat burns was 19.5 burns/100,000 person-years lived. If causes specific to military operations are removed, military prevalence was 13.0/100,000. More than one-third of noncombat burns occurred in the first year of the study; a period of stability followed. A similar US population had an accidental burn prevalence of 7.1/100,000 from 2003 to 2007. Burn size, presence of inhalation injury, and burn center mortality were not different from those in a similar civilian cohort. Deployed service members have a greater risk of unintentional burns than a similar civilian cohort does. This is in part because of the specific dangers of military activities. More attention to deployed military burn prevention is needed, especially early in combat support operations.

Transfer time to a specialist burn service and influence on burn mortality in Australia and New Zealand: A multi-centre, hospital based retrospective cohort study.

PubMed

Cassidy, T John; Edgar, Dale W; Phillips, Michael; Cameron, Peter; Cleland, Heather; Wood, Fiona M

2015-06-01

In Australia and New Zealand (ANZ), health care is provided for ∼26 million people dispersed across the eight million square kilometres of the two countries. Providing optimal care prior to and during transfer across such vast distances is challenging. Lengthening the time taken to definitive burn care has a negative impact on burn outcome. The aims of this study were to determine if transfer time and admission pathway influenced burn mortality and to identify the factors predicting burn mortality in ANZ. The study included all adult burn patient admission data from 15 of 17 burn services submitted to the Australian and New Zealand Burn Association bi-national registry (2010-2012). Multivariate logistic regression analyses were conducted to address the study aims. Of the 2892 patients, 69 (2.4%) died following burn. Time to admission and direct admission to a burn centre did not independently influence burn mortality except when patients with inhalation injury took >16 h to transfer to definitive care. The risk of death was increased 5.7 times in the presence of inhalation injury. Burn size and age amplified the risk of death while gender did not. In ANZ, pre-hospital transport systems and peripheral hospital stabilisation were not associated with an increased risk of death due to burn except when inhalation injury was present. The results of this study indicate that burn patients with inhalation injury should be stabilised and transferred to a burn service within 16 h of burn. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Disaster planning: the basics of creating a burn mass casualty disaster plan for a burn center.

PubMed

Kearns, Randy D; Conlon, Kathe M; Valenta, Andrea L; Lord, Graydon C; Cairns, Charles B; Holmes, James H; Johnson, Daryhl D; Matherly, Annette F; Sawyer, Dalton; Skarote, Mary Beth; Siler, Sean M; Helminiak, Radm Clare; Cairns, Bruce A

2014-01-01

In 2005, the American Burn Association published burn disaster guidelines. This work recognized that local and state assets are the most important resources in the initial 24- to 48-hour management of a burn disaster. Historical experiences suggest there is ample opportunity to improve local and state preparedness for a major burn disaster. This review will focus on the basics of developing a burn surge disaster plan for a mass casualty event. In the event of a disaster, burn centers must recognize their place in the context of local and state disaster plan activation. Planning for a burn center takes on three forms; institutional/intrafacility, interfacility/intrastate, and interstate/regional. Priorities for a burn disaster plan include: coordination, communication, triage, plan activation (trigger point), surge, and regional capacity. Capacity and capability of the plan should be modeled and exercised to determine limitations and identify breaking points. When there is more than one burn center in a given state or jurisdiction, close coordination and communication between the burn centers are essential for a successful response. Burn surge mass casualty planning at the facility and specialty planning levels, including a state burn surge disaster plan, must have interface points with governmental plans. Local, state, and federal governmental agencies have key roles and responsibilities in a burn mass casualty disaster. This work will include a framework and critical concepts any burn disaster planning effort should consider when developing future plans.

Forward-looking infrared imaging predicts ultimate burn depth in a porcine vertical injury progression model.

PubMed

Miccio, Joseph; Parikh, Shruti; Marinaro, Xavier; Prasad, Atulya; McClain, Steven; Singer, Adam J; Clark, Richard A F

2016-03-01

Current methods of assessing burn depth are limited and are primarily based on visual assessments by burn surgeons. This technique has been shown to have only 60% accuracy and a more accurate, simple, noninvasive method is needed to determine burn wound depth. Forward-looking infrared (FLIR) thermography is both noninvasive and user-friendly with the potential to rapidly assess burn depth. The purpose of this paper is to determine if early changes in burn temperature (first 3 days) can be a predictor of burn depth as assessed by vertical scarring 28 days after injury. While under general anesthesia, 20 burns were created on the backs of two female Yorkshire swine using a 2.5cm×2.5cm×7.5cm, 150g aluminum bar, for a total of 40 burns. FLIR imaging was performed at both early (1, 2 and 3 days) and late (7, 10, 14, 17, 21, 24 and 28 days) time points. Burns were imaged from a height of 12 inches from the skin surface. FLIR ExaminIR(©) software was used to examine the infrared thermographs. One hundred temperature points from burn edge to edge across the center of the burn were collected for each burn at all time points and were exported as a comma-separated values (CSV) file. The CSV file was processed and analyzed using a MATLAB program. The temperature profiles through the center of the burns generated parabola-like curves. The lowest temperature (temperature minimum) and a line midway between the temperature minimum and ambient skin temperature at the burn edges was defined and the area of the curve calculated (the "temperature half-area"). Half-area values 2 days after burn had higher correlations with scar depth than did the minimum temperatures. However, burns that became warmer from 1 day to 2 days after injury had a lower scar depth then burns that became cooler and this trend was best predicted by temperature minima. When data were analyzed as a diagnostic test for sensitivity and specificity using >3mm scarring, i.e. a full-thickness burn, as a clinically relevant criterion standard, temperature minima at 2 days after burn was found to be the most sensitive and specific test. FLIR imaging is a fast and simple tool that has been shown to predict burn wound outcome in a porcine vertical injury progression model. Data showed that more severe burn wounds get cooler between 1 and 2 days after burn. We found four analytic methods of FLIR images that were predictive of burn progression at 1 and 2 days after burn; however, temperature minima 2 days after burn appeared to be the best predictive test for injury progression to a full-thickness burn. Although these results must be validated in clinical studies, FLIR imaging has the potential to aid clinicians in assessing burn severity and thereby assisting in burn wound management. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Chemical and Common Burns in Children.

PubMed

Yin, Shan

2017-05-01

Burns are a common cause of preventable morbidity and mortality in children. Thermal and chemical burns are the most common types of burns. Their clinical appearance can be similar and the treatment is largely similar. Thermal burns in children occur primarily after exposure to a hot surface or liquid, or contact with fire. Burns are typically classified based on the depth and total body surface area, and the severity and onset of the burn can also depend on the temperature and duration of contact. Chemical burns are caused by chemicals-most commonly acids and alkalis-that can damage the skin on contact. In children, the most common cause of chemical burns is from household products such as toilet bowl cleaners, drain cleaners, detergents, and bleaches. Mild chemical burns generally cause redness and pain and can look similar to other common rashes or skin infections, whereas severe chemical burns are more extreme and may cause redness, blistering, skin peeling, and swelling.

TSG-6 secreted by human umbilical cord-MSCs attenuates severe burn-induced excessive inflammation via inhibiting activations of P38 and JNK signaling.

PubMed

Liu, Lingying; Song, Huifeng; Duan, Hongjie; Chai, Jiake; Yang, Jing; Li, Xiao; Yu, Yonghui; Zhang, Xulong; Hu, Xiaohong; Xiao, Mengjing; Feng, Rui; Yin, Huinan; Hu, Quan; Yang, Longlong; Du, Jundong; Li, Tianran

2016-07-22

The hMSCs have become a promising approach for inflammation treatment in acute phase. Our previous study has demonstrated that human umbilical cord-MSCs could alleviate the inflammatory reaction of severely burned wound. In this study, we further investigated the potential role and mechanism of the MSCs on severe burn-induced excessive inflammation. Wistar rats were randomly divided into following groups: Sham, Burn, Burn+MSCs, Burn+MAPKs inhibitors, and Burn, Burn+MSCs, Burn+Vehicle, Burn+siTSG-6, Burn+rhTSG-6 in the both experiments. It was found that MSCs could only down-regulate P38 and JNK signaling, but had no effect on ERK in peritoneal macrophages of severe burn rats. Furthermore, suppression of P38 and JNK activations significantly reduced the excessive inflammation induced by severe burn. TSG-6 was secreted by MSCs using different inflammatory mediators. TSG-6 from MSCs and recombinant human (rh)TSG-6 all significantly reduced activations of P38 and JNK signaling induced by severe burn and then attenuated excessive inflammations. On the contrary, knockdown TSG-6 in the cells significantly increased phosphorylation of P38 and JNK signaling and reduced therapeutic effect of the MSCs on excessive inflammation. Taken together, this study suggested TSG-6 from MSCs attenuated severe burn-induced excessive inflammation via inhibiting activation of P38 and JNK signaling.

Prescribed burning consumes key forest structural components: implications for landscape heterogeneity.

PubMed

Holland, Greg J; Clarke, Michael F; Bennett, Andrew F

2017-04-01

Prescribed burning to achieve management objectives is a common practice in fire-prone regions worldwide. Structural components of habitat that are combustible and slow to develop are particularly susceptible to change associated with prescribed burning. We used an experimental, "whole-landscape" approach to investigate the effect of differing patterns of prescribed burning on key habitat components (logs, stumps, dead trees, litter cover, litter depth, and understorey vegetation). Twenty-two landscapes (each ~100 ha) were selected in a dry forest ecosystem in southeast Australia. Experimental burns were conducted in 16 landscapes (stratified by burn extent) while six served as untreated controls. We measured habitat components prior to and after burning. Landscape burn extent ranged from 22% to 89% across the 16 burn treatments. With the exception of dead standing trees (no change), all measures of habitat components declined as a consequence of burning. The degree of loss increased as the extent to which a landscape was burned also increased. Prescribed burning had complex effects on the spatial heterogeneity (beta diversity) of structural components within landscapes. Landscapes that were more heterogeneous pre-fire were homogenized by burning, while those that were more homogenous pre-fire tended to display greater differentiation post-burning. Thus, the notion that patch mosaic burning enhances heterogeneity at the landscape-scale depends on prior conditions. These findings have important management implications. Where prescribed burns must be undertaken, effects on important resources can be moderated via control of burn characteristics (e.g., burn extent). Longer-term impacts of prescribed burning will be strongly influenced by the return interval, given the slow rate at which some structural components accumulate (decades to centuries). Management of habitat structural components is important given the critical role they play in (1) provision of habitat resources for diverse organisms, (2) retention of moisture and nutrients in otherwise dry, low-productivity systems, and (3) carbon storage. © 2016 by the Ecological Society of America.

Enhancing the clinical utility of the burn specific health scale-brief: not just for major burns.

PubMed

Finlay, V; Phillips, M; Wood, F; Hendrie, D; Allison, G T; Edgar, D

2014-03-01

Like many other Western burn services, the proportion of major to minor burns managed at Royal Perth Hospital (RPH) is in the order of 1:10. The Burn Specific Health Scale-Brief (BSHS-B) is an established measure of recovery after major burn, however its performance and validity in a population with a high volume of minor burns is uncertain. Utilizing the tool across burns of all sizes would be useful in service wide clinical practice. This study was designed to examine the reliability and validity of the BSHS-B across a sample of mostly minor burn patients. BSHS-B scores of patients, obtained between January 2006 and February 2013 and stored on a secure hospital database were collated and analyzed Cronbach's alpha, factor analysis, logistic regression and longitudinal regression were used to examine reliability and validity of the BSHS-B. Data from 927 burn patients (2031 surveys) with a mean % total burn surface area (TBSA) of 6.7 (SD 10.0) were available for analysis. The BSHS-B demonstrated excellent reliability with a Cronbach's alpha of 0.95. First and second order factor analyses reduced the 40 item scale to four domains: Work; Affect and Relations; Physical Function; Skin Involvement, as per the established construct. TBSA, length of stay and burn surgery all predicted burn specific health in the first three months of injury (p<0.001, p<0.001, p=0.03). BSHS-B whole scale and domain scores showed significant improvement over 24 months from burn (p<0.001). The results from this study show that the structure and performance of the BSHS-B in a burn population consisting of 90% minor burns is consistent with that demonstrated in major burns. The BSHS-B can be employed to track and predict recovery after burns of all sizes to assist the provision of targeted burn care. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Oral Rehydration Therapy in Burn Patients

ClinicalTrials.gov

2014-04-24

Burn Any Degree Involving 20-29 Percent of Body Surface; Burn Any Degree Involving 30-39 Percent of Body Surface; Burn Any Degree Involving 40-49 Percent of Body Surface; Burn Any Degree Involving 50-59 Percent of Body Surface; Burn Any Degree Involving 60-65 Percent of Body Surface

30 CFR 250.1162 - When may I burn produced liquid hydrocarbons?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 2 2012-07-01 2012-07-01 false When may I burn produced liquid hydrocarbons... Gas Production Requirements Flaring, Venting, and Burning Hydrocarbons § 250.1162 When may I burn... burn any produced liquid hydrocarbons. The Regional Supervisor may allow you to burn liquid...

30 CFR 250.1162 - When may I burn produced liquid hydrocarbons?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 2 2014-07-01 2014-07-01 false When may I burn produced liquid hydrocarbons... Gas Production Requirements Flaring, Venting, and Burning Hydrocarbons § 250.1162 When may I burn... burn any produced liquid hydrocarbons. The Regional Supervisor may allow you to burn liquid...

30 CFR 250.1162 - When may I burn produced liquid hydrocarbons?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 2 2013-07-01 2013-07-01 false When may I burn produced liquid hydrocarbons... Gas Production Requirements Flaring, Venting, and Burning Hydrocarbons § 250.1162 When may I burn... burn any produced liquid hydrocarbons. The Regional Supervisor may allow you to burn liquid...

Burn prevention in Zambia: a targeted epidemiological approach.

PubMed

Heard, Jason P; Latenser, Barbara A; Liao, Junlin

2013-01-01

The aim of this study is to assess primary burn prevention knowledge in a rural Zambian population that is disproportionately burdened by burn injuries. A 10-question survey was completed by youths, and a 15-question survey was completed by adults. The survey was available in both English and Nyanja. The surveys were designed to test their knowledge in common causes, first aid, and emergency measures regarding burn injuries. Logistic regression analysis was used to explore relationships between burn knowledge, age, school, and socioeconomic variables. A burn prevention coloring book, based on previous local epidemiological data, was also distributed to 800 school age youths. Five hundred fifty youths and 39 adults completed the survey. The most significant results show knowledge deficits in common causes of burns, first aid treatment of a burn injury, and what to do in the event of clothing catching fire. Younger children were more likely to do worse than older children. The adults performed better than the youths, but still lack fundamental burn prevention and treatment knowledge. Primary burn prevention data from the youths and adults surveyed demonstrate a clear need for burn prevention and treatment education in this population. In a country where effective and sustainable burn care is lacking, burn prevention may be a better investment to reduce burn injury than large investments in healthcare resources.

Impact of pediatric burn camps on participants' self esteem and body image: an empirical study.

PubMed

Bakker, Anne; Van der Heijden, Peter G M; Van Son, Maarten J M; Van de Schoot, Rens; Van Loey, Nancy E E

2011-12-01

This study focuses on possible effects of specialized summer camps on young burn survivors' self esteem and body image. Quantitative as well as qualitative measures was used. To study possible effects, a pretest-posttest comparison group design with a follow-up was employed. Self-report questionnaires were used to measure self esteem and body image in a burn camp group (n=83, 8-18 years) and in a comparison group of children with burns who did not attend a burn camp during the course of the study (n=90, 8-18 years). Additionally, burn camp participants and parents completed an evaluation form about benefits derived from burn camp. A small positive short-term effect of burn camp participation was found on the 'satisfaction with appearance' component of body image. Overall, participants and parents showed high appreciation of the burn camps and reported several benefits, particularly concerning meeting other young burn survivors. Albeit statistically modest, this is the first quantitative study to document on a significant short-term impact of burn camp on young burn survivors' body image. Implications of this result for future research and burn camp organization were discussed, including the strengths of residential camps for young burn survivors. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

American Burn Association

MedlinePlus

... Quality Care Resources Prevention Prevention Resources Burn Prevention Poster Contest Burn Awareness Week Advocacy Education Annual Meeting ... Quality Care Resources Prevention Prevention Resources Burn Prevention Poster Contest Burn Awareness Week Advocacy Education Annual Meeting ...

Impact of a Newly Implemented Burn Protocol on Surgically Managed Partial Thickness Burns at a Specialized Burns Center in Singapore.

PubMed

Tay, Khwee-Soon Vincent; Chong, Si-Jack; Tan, Bien-Keem

2016-03-01

This study evaluated the impact of a newly implemented protocol for superficial to mid-dermal partial thickness burns which involves early surgery and rapid coverage with biosynthetic dressing in a specialized national burns center in Singapore. Consecutive patients with 5% or greater total body surface area (TBSA) superficial to mid-dermal partial thickness burns injury admitted to the Burns Centre at the Singapore General Hospital between August and December 2014 for surgery within 48 hours of injury were prospectively recruited into the study to form the protocol group. Comparable historical cases from the year 2013 retrieved from the burns center audit database were used to form the historical control group. Demographics (age, sex), type and depth of burns, %TBSA burnt, number of operative sessions, and length of stay were recorded for each patient of both cohorts. Thirty-nine burns patients managed under the new protocol were compared with historical control (n = 39) comparable in age and extensiveness of burns. A significantly shorter length of stay (P < 0.05) per TBSA burns was observed in the new protocol group (0.74 day/%TBSA) versus historical control (1.55 day/%TBSA). Fewer operative sessions were needed under the new protocol for burns 10% or greater TBSA burns (P < 0.05). The authors report their promising experience with a newly implemented protocol for surgically managed burns patients which involves early surgery and appropriate use of biosynthetic dressing on superficial to mid-dermal partial thickness burns. Clinically, shorter lengths of stay, fewer operative sessions, and decreased need for skin grafting of burns patient were observed.

Current concepts on burn wound conversion – a review of recent advances in understanding the secondary progressions of burns

PubMed Central

Salibian, Ara A.; Del Rosario, Angelica Tan; De Almeida Moura Severo, Lucio; Nguyen, Long; Banyard, Derek A.; Toranto, Jason D.; Evans, Gregory R.D.; Widgerow, Alan D.

2016-01-01

Burn wound conversion describes the process by which superficial partial thickness burns convert into deeper burns necessitating surgical intervention. Fully understanding and thus controlling this phenomenon continues to defy burn surgeons. However, potentially guiding burn wound progression so as to obviate the need for surgery while still bringing about healing with limited scarring is the major unmet challenge. Comprehending the pathophysiologic background contributing to deeper progression of these burns is an essential prerequisite to planning any intervention. In this study, a review of articles examining burn wound progression over the last five years was conducted to analyze trends in recent burn progression research, determine changes in understanding of the pathogenesis of burn conversion, and subsequently examine the direction for future research in developing therapies. The majority of recent research focuses on applying therapies from other disease processes to common underlying pathogenic mechanisms in burn conversion. While ischemia, inflammation, and free oxygen radicals continue to demonstrate a critical role in secondary necrosis, novel mechanisms such as autophagy have also been shown to contribute affect significantly burn progression significantly. Further research will have to determine whether multiple mechanisms should be targeted when developing clinical therapies. PMID:26787127

Car radiator burns: a prevention issue.

PubMed

Rabbitts, Angela; Alden, Nicole E; Conlin, Tara; Yurt, Roger W

2004-01-01

Scald burns continue to be the major cause of injury to patients admitted to the burn center. Scald burns occurring from car radiator fluid comprise a significant subgroup. Although manufacturer warning labels have been placed on car radiators, these burns continue to occur. This retrospective review looks at all patients admitted to our burn center who suffered scald burns from car radiator fluid to assess the extent of this problem. During the study period, 86 patients were identified as having suffered scald burns as a result of contact with car radiator fluid. Seventy-one percent of the burn injuries occurred in the summer months. The areas most commonly burned were the head and upper extremities. Burn prevention efforts have improved greatly over the years; however, this study demonstrates that scald burns from car radiator fluid continue to cause physical, emotional, and financial devastation. The current radiator warning labels alone are not effective. The National Highway Traffic Safety Administration has proposed a new federal motor vehicle safety standard to aid in decreasing the number of scald burns from car radiators. The results of this study were submitted to the United States Department of Transportation for inclusion in a docket for federal legislation supporting these safety measures.

A systematic review of the epidemiology of unintentional burn injuries in South Asia.

PubMed

Golshan, Ashkan; Patel, Cyra; Hyder, Adnan A

2013-09-01

Burns are a significant cause of mortality and morbidity in developing countries. We examined the epidemiology of unintentional burns in South Asia to identify trends and gaps in information. A MEDLINE/PUBMED search (1970-2011) was undertaken on empirical studies that focused on burns in India, Pakistan, Bangladesh and Sri Lanka. Data analyzed included demographics, injury details and risk factors. Twenty-seven studies were identified, mostly from India. Burns were more common among males at younger ages (0-12 years) and among females from adolescence onward (>14 years). Flame-related burns and scalds accounted for over 80% of burns in most cases, and were the most common types of injuries observed among children and women with most burns occurring in the home. Electrical burns occurred mostly among men. Important risk factors for burns included low socioeconomic status, being younger, wearing loose, flammable clothing and the use of kerosene. Data on care-seeking and treatment were limited. Preventing burns in the household in South Asia, particularly around kitchen activities, is essential. Children in South Asia are susceptible to burns and are an important target population. Future research should focus on filling the gaps in burn epidemiology found in this review.

Does nurses'perceived burn prevention knowledge and ability to teach burn prevention correlate with their actual burn prevention knowledge?

PubMed

Lehna, Carlee; Myers, John

2010-01-01

The purpose of this study was to explore the relationship among nurses'perceived burn prevention knowledge, their perceived ability to teach about burn prevention, and their actual burn prevention knowledge and to test if their actual burn knowledge could be predicted by these perceived measures. A two-page, anonymous survey that included a 10-item burn prevention knowledge test and an assessment of nurses'perceived knowledge of burn prevention and their perceived ability to teach burn prevention was administered to 313 nurses. Actual burn prevention knowledge was determined and the correlation among actual burn prevention knowledge, perceived knowledge, and perceived ability to teach was determined. Differences in these outcome variables based on specialty area were tested using analysis of variance techniques. Generalized linear modeling techniques were used to investigate which variables significantly predict a nurse's actual burn prevention knowledge. Test for interaction effects were performed, and significance was set at .05. Responding nurses (N = 265) described practicing in a variety of settings, such as pediatric settings (40.2%, n = 105), emergency departments (25.4%, n = 86), medical/surgical settings (8.4%, n = 22), and one pediatric burn setting (4.1%, n = 14), with all specialty areas as having similar actual burn prevention knowledge (P = .052). Seventy-seven percent of the nurses said they never taught about burn prevention (n = 177). Perceived knowledge and actual knowledge (r = .124, P = .046) as well as perceived knowledge and perceived ability were correlated (r = .799, P < .001). Significant predictors of actual knowledge were years in practice (beta = -0.063, P = .034), years in current area (beta = 0.072, P = .003), perceived knowledge (beta = 0.109, P = .042), and perceived ability (beta = 0.137, P = .019). All nurses, regardless of specialty area, have poor burn prevention knowledge, which is correlated with their perceived lack of knowledge of burn prevention. In addition, nurses'perceived burn knowledge and ability predicts their actual burn knowledge. This is a fruitful area that merits further research and exploration.

Incidence and characteristics of chemical burns.

PubMed

Koh, Dong-Hee; Lee, Sang-Gil; Kim, Hwan-Cheol

2017-05-01

Chemical burns can lead to serious health outcomes. Previous studies about chemical burns have been performed based on burn center data so these studies have provided limited information about the incidence of chemical burns at the national level. The aim of this study was to evaluate the incidence and characteristics of chemical burns using nationwide databases. A cohort representing the Korean population, which was established using a national health insurance database, and a nationwide workers' compensation database were used to evaluate the incidence and characteristics of chemical burns. Characteristics of the affected body region, depth of burns, industry, task, and causative agents were analyzed from two databases. The incidence of chemical burns was calculated according to employment status. The most common regions involving chemical burns with hospital visits were the skin followed by the eyes. For skin lesions, the hands and wrists were the most commonly affected regions. Second degree burns were the most common in terms of depth of skin lesions. The hospital visit incidence was 1.96 per 10,000 person-year in the general population. The compensated chemical burns incidence was 0.17 per 10,000 person-year. Employees and the self-employed showed a significantly increased risk of chemical burns undergoing hospital visits compared to their dependents. Chemical burns on the skin and eyes are almost equally prevalent. The working environment was associated with increased risk of chemical burns. Our results may aid in estimating the size of the problem and prioritizing prevention of chemical burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Epidemiology of U.K. Military Burns 2008-2013.

PubMed

Page, Felicity; Hamnett, Nathan; D'Asta, Federica; Jeffery, Steven

After sustaining burn injuries overseas, U.K. Armed Forces personnel are evacuated to the Royal Centre for Defence Medicine. The objective was to review the etiology of U.K. Military burns managed at the center between 2008 and 2013. Analysis will aid provision planning and assist in the prevention of burn injuries for future tours. The International Burn Injury Database database of all U.K. Armed Forces burn injured patients evacuated to the Queen Elizabeth University Hospital Birmingham between 2008 and 2013 were reviewed retrospectively. Analysis included patient demographics, injury mechanism, burn severity, management, and mortality. There were 65 military personnel with burn injuries requiring repatriation to the United Kingdom. Percentage of 78.5 were sustained in Afghanistan. The mean age was 25 (18-46) years. Percentage of 70.8 were considered noncombat burn injuries. Of the noncombat burns, the mechanism of injury most commonly involved burning waste and misuse of fuels and scalds. The mean TBSA for all patients was 6% (0.05-51%). Areas most commonly affected included arms, legs, and face. The length of hospital stay for combat vs noncombat burn injury patients was 10 vs 7 days. There were no fatalities. In conclusion, substantially fewer military personnel sustained combat burns between 2008 and 2013 than in preceding study period (19 vs 79). The number of accidental noncombat burns remained constant. The decrease in combat burns may reflect a relative decrease in military intensity and effective protective equipment and safety measures. Further education may allow for an additional decrease in preventable burn injuries.

In the media: Burns as a method of assault.

PubMed

O'Halloran, E; Duke, J; Rea, S; Wood, F

2013-09-01

The aims of this study were to determine whether a change occurred in the pattern of assault burn injury cases hospitalised to the adult state burns unit, Western Australia, from 2004 to mid-year of 2012, and to compare patient and burn characteristics of adult assault burns with those admitted for unintentional burns. Study data were obtained from the Royal Perth Hospital (RPH) Burns Minimum Dataset (BMDS). Aggregated data of unintentional burn admissions during the same period were provided by the BMDS data manager to enable comparisons with assault burn patients. Assault burn admissions during 2004-2012 accounted for approximately 1% of all adult burn hospitalisations. All assault victims were burned by either thermal or scald agents. A high rate of intubation (24%) and ICU admission (1 in 3 cases) was observed in the fire assault group. The six assault cases undergoing intubation were severe burns, median TBSA 50%, most commonly affecting the face, head and torso, half of these cases had inhalational injuries and also required escharotomies. Comparison of admissions by calendar period showed no statistically significant differences in demographic, burn cause or TBSA%. However, statistically significant differences were found for pre-morbid psychiatric history (15% vs. 58%, p=0.025) and concomitant fractures or dislocations (46% vs. 2%), p=0.011). While the proportion of assault burn admissions per total burn admissions steadily increased from 0.4% in 2009 to 1.5% in mid-2012, this proportion did not exceed that peak level observed of 2.1% for 2004. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

[Influence of three-level collaboration network of pediatric burns treatment in Anhui province on treatment effects of burn children].

PubMed

Xia, Z G; Zhou, X L; Kong, W C; Li, X Z; Song, J H; Fang, L S; Hu, D L; Cai, C; Tang, Y Z; Yu, Y X; Wang, C H; Xu, Q L

2018-03-20

Objective: To explore the influence of three-level collaboration network of pediatric burns in Anhui province on treatment effects of burn children. Methods: The data of medical records of pediatric burn children transferred from Lu'an People's Hospital and Fuyang People's Hospital to the First Affiliated Hospital of Anhui Medical University from January 2014 to December 2015 and January 2016 to September 2017 (before and after establishing three-level collaboration network of pediatric burns treatment) were analyzed: percentage of transferred burn children to hospitalized burn children in corresponding period, gender, age, burn degree, treatment method, treatment result, occurrence and treatment result of shock, and operative and non-operative treatment time and cost. Rehabilitation result of burn children transferred back to local hospitals in 2016 and 2017. Data were processed with t test, chi-square test, Mann-Whitney U test, and Fisher's exact test. Results: (1) Percentage of burn children transferred from January 2014 to December 2015 was 34.3% (291/848) of the total number of hospitalized burn children in the same period of time, which was close to 30.4% (210/691) of burn children transferred from January 2016 to September 2017 ( χ (2)=2.672, P >0.05). (2) Gender, age, burn degree, and treatment method of burn children transferred from the two periods of time were close ( χ (2)=3.382, Z =-1.917, -1.911, χ (2)=3.133, P >0.05). (3) Cure rates of children with mild, moderate, and severe burns transferred from January 2016 to September 2017 were significantly higher than those of burn children transferred from January 2014 to December 2015 ( χ (2)=11.777, 6.948, 4.310, P <0.05). Cure rates of children with extremely severe burns transferred from the two periods of time were close ( χ (2)=1.181, P >0.05). (4) Children with mild and moderate burns transferred from the two periods of time were with no shock. The incidence of shock of children with severe burns transferred from January 2014 to December 2015 was 6.0% (4/67), and 3 children among them were cured. The incidence of shock of children with severe burns transferred from January 2016 to September 2017 was 3.9% (2/51), and both children were cured. The incidences and cures of shock of children with severe burns transferred from the two periods of time were close ( χ (2)=0.006, P >0.05). Incidence of shock of children with extremely severe burns transferred from January 2014 to December 2015 was 57.1% (32/56), significantly higher than that of burn children transferred from January 2016 to September 2017 [34.5% (10/29), χ (2)=3.925, P <0.05]. Shock of 25 children with extremely severe burns transferred from January 2014 to December 2015 were cured, and shock of 9 children with extremely severe burns transferred from January 2016 to September 2017 were cured. The cures of shock of children with extremely severe burns transferred from the two periods of time were close ( χ (2)=0.139, P >0.05). (5) Time of operative treatment of children with moderate, severe, and extremely severe burns transferred from January 2014 to December 2015 was obviously longer than that of burn children transferred from January 2016 to September 2017 ( t =2.335, 2.065, 2.310, P <0.05). Time of operative treatment of children with mild burns transferred from the two periods of time was close ( Z =-0.417, P >0.05). Costs of operative treatment of children with moderate and severe burns transferred from January 2014 to December 2015 were significantly more than those of burn children transferred from January 2016 to September 2017 ( Z =-3.324, t =2.167, P <0.05). Costs of operative treatment of children with mild and extremely severe burns transferred from the two periods of time were close ( t =0.627, 0.808, P >0.05). (6)Time of non-operative treatment of children with mild, moderate, and severe burns transferred from January 2014 to December 2015 was obviously longer than that of burn children transferred from January 2016 to September 2017 ( t =2.335, Z =-2.095, t =2.152, P <0.05). Time of non-operative treatment of children with extremely severe burns transferred from the two periods of time was close ( t =0.450, P >0.05). Costs of non-operative treatment of children with moderate and severe burns transferred from January 2014 to December 2015 were obviously higher than those of burn children transferred from January 2016 to September 2017 ( Z =-2.164, t =2.040, P <0.05). Costs of non-operative treatment of children with mild and extremely severe burns transferred from the two periods of time were close ( t =0.146, 1.235, P >0.05). (7) Sixty-seven burn children transferred from January 2016 to September 2017 were transferred back to local hospitals for rehabilitation under the guidance of experts of the First Affiliated Hospital of Anhui Medical University, with 25 patients in 2016 and 42 patients in 2017. Effective rehabilitation rates of burn children transferred back to local hospitals for rehabilitation in 2016 and 2017 were both 100%. Conclusions: The three-level collaboration network of pediatric burns treatment in Anhui province can effectively increase cure rate of children with mild, moderate, and severe burns, reduce incidence of shock of children with extremely severe burns, shorten time of operative treatment of burn children with moderate, severe, and extremely severe burns, and time of non-operative treatment of children with mild, moderate, and severe burns, reduce treatment costs of children with moderate and severe burns, and improve rehabilitation effectiveness of children transferred from Lu'an People's Hospital and Fuyang People's Hospital to the the First Affiliated Hospital of Anhui Medical University.

The burn surgeon: an endangered species. Can exposure in medical school increase interest in burn surgery?

PubMed

Kahn, Steven Alexander; Goldman, Matthew; Daul, Matthew; Lentz, Christopher W

2011-01-01

The nation is faced with a shortage of subspecialty physicians, including burn surgeons. Exposure to a specialty in medical school has been shown to influence students' career choices. The authors postulate that exposure to burn surgery increases their interest in the field. Students from a medical school with an American Burn Association-verified burn center and from a school without a burn center were anonymously surveyed and asked to report their interest and knowledge regarding burn surgery using a 5-point Likert scale. They were asked about their current year in school, gender, overall interest in surgery, and any prior exposure to burn surgery (eg, preceptorship or rotation). Students were asked whether exposure to burn surgery or to a strong mentor might increase their interest in the field. Finally, they were asked to pick the most important factor in a list of deterrents to pursuing a career in burn surgery. Predictors of interest in burn surgery were determined with regression analyses. A total of 380 of 662 students responded to the survey (57.4%). Significant predictors of interest in burn surgery were an interest in surgery (P < .001, odds ratio [OR] = 56.3), prior exposure to burn surgery (P = .02, OR = 5.7), and year in school (P = .006, OR = 1.7). First- and second-year students were more likely to report interest in burn surgery (P < .001). Gender and medical school attended were not significant predictors. Prior exposure to burn surgery became a stronger predictor in subgroup analysis of the fourth-year students (P < .001, OR = 24.5). The majority of students reported that exposure to burn surgery (76%) and a strong mentor (87%) would make them more likely to consider burn surgery as a career. "Not interested in surgery" was the most important deterrent to pursuing a career in burn surgery, which was selected by 33% of students. However, 25% of students chose "I don't know anything about burn surgery" as the most important deterrent. Factors specific to burn surgery were less frequently selected (eg, wound care and hot operating room). The majority of students reported ignorance of the field of burns: 64% disagreed that they understood what a burn surgeon does on a daily basis, and 74% agreed they did not know enough about the field to consider it as a career. Exposure to burn surgery in the form of a clinical rotation fosters medical student interest. However, the majority of medical students lack knowledge about the field of burn surgery. Many consider this a deterrent to selecting it as a career. More exposure during medical school and strong mentorship may influence more students to become burn surgeons. Mentorship and recruiting efforts should be focused on students with a general interest in surgery.

Deer habitat use after prescribed burning in Northern California

Treesearch

John G. Kie

1984-01-01

Prescribed burning was used to improve blacktailed deer (Odocoileus hemionus columbianus) habitat in Trinity County, northern California. Deer response was measured by comparing pellet group deposition on one burned and three unburned areas. Pellet group counts were highest on the burned area for 3 years after burning. One year after burning, pellet...

Emissions from open burning of simulated military waste from forward operating bases.

PubMed

Aurell, Johanna; Gullett, Brian K; Yamamoto, Dirk

2012-10-16

Emissions from open burning of simulated military waste from forward operating bases (FOBs) were extensively characterized as an initial step in assessing potential inhalation exposure of FOB personnel and future disposal alternatives. Emissions from two different burning scenarios, so-called "burn piles/pits" and an air curtain burner/"burn box", were compared using simulated FOB waste from municipal and commercial sources. A comprehensive array of emissions was quantified, including CO(2), PM(2.5), volatile organic compounds (VOCs), polyaromatic hydrocarbons (PAHs), polychlorinated dibenzodioxins and -furans (PCDDs/PCDFs), polybrominated dibenzodioxins and -furans (PBDDs/PBDFs), and metals. In general, smoldering conditions in the burn box and the burn pile led to similar emissions. However, when the burn box underwent periodic waste charging to maintain sustained combustion, PM(2.5), VOCs, and PAH emissions dropped considerably compared to smoldering conditions and the overall burn pile results. The PCDD/PCDF and PBDD/PBDF emission factors for the burn piles were 50 times higher than those from the burn box likely due to the dominance of smoldering combustion in the burn piles.

Burning Issue: Handling Household Burns

MedlinePlus

... hot objects or liquid, fire, friction, the sun, electricity, or certain chemicals. Each year, about a half- ... infant or elderly. the burn was caused by electricity, which can lead to “invisible” burns. Links Burns ...

Initial fuel temperature effects on burning rate of pool fire.

PubMed

Chen, Bing; Lu, Shou-Xiang; Li, Chang-Hai; Kang, Quan-Sheng; Lecoustre, Vivien

2011-04-15

The influence of the initial fuel temperature on the burning behavior of n-heptane pool fire was experimentally studied at the State Key Laboratory of Fire Science (SKLFS) large test hall. Circular pool fires with diameters of 100mm, 141 mm, and 200 mm were considered with initial fuel temperatures ranging from 290 K to 363 K. Burning rate and temperature distributions in fuel and vessel wall were recorded during the combustion. The burning rate exhibited five typical stages: initial development, steady burning, transition, bulk boiling burning, and decay. The burning rate during the steady burning stage was observed to be relatively independent of the initial fuel temperature. In contrast, the burning rate of the bulk boiling burning stage increases with increased initial fuel temperature. It was also observed that increased initial fuel temperature decreases the duration of steady burning stage. When the initial temperature approaches the boiling point, the steady burning stage nearly disappears and the burning rate moves directly from the initial development stage to the transition stage. The fuel surface temperature increases to its boiling point at the steady burning stage, shortly after ignition, and the bulk liquid reaches boiling temperature at the bulk boiling burning stage. No distinguished cold zone is formed in the fuel bed. However, boiling zone is observed and the thickness increases to its maximum value when the bulk boiling phenomena occurs. Copyright © 2011 Elsevier B.V. All rights reserved.

Burns in South Korea: An analysis of nationwide data from the Health Insurance Review and Assessment Service.

PubMed

Oh, Hyunjin; Boo, Sunjoo

2016-05-01

The purpose of the study was to identify and describe the incidence of burn injuries in patients seen and treated in South Korea. Characteristics of inpatients and outpatients with burns were analyzed according to gender, age, burn site, and burn severity. This retrospective study examined the characteristics of a stratified sample of burn patients seen and treated in South Korea during the calendar year 2011. The sample was drawn from the national patient database Health Insurance Review and Assessment (HIRA). Approximately 1.71% of the total patients in the Patient Sample of HIRA for 2011 were burn-injured patients. The numbers of patients treated for burns were 913/10(5) males (n=8009) and 1454/10(5) females (n=11,881). Nearly all of these patients (94.1%) were covered by national health insurance and the majority of these patients (80.6%) were treated as outpatients. Nearly half of the burn injuries were of the upper extremities (43.5%), and most of these injuries (71.5%) were rated as second-degree burns. A review of the national data on patients seen and treated for burns in 2011 revealed that people in South Korea may experience higher numbers and more severe cases of burns and burn-related injuries than found in other countries. General burn prevention programs as well as gender- and age-specific prevention strategies are needed to reduce the risk of burns in this population. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Improved Survival of Patients With Extensive Burns: Trends in Patient Characteristics and Mortality Among Burn Patients in a Tertiary Care Burn Facility, 2004-2013.

PubMed

Strassle, Paula D; Williams, Felicia N; Napravnik, Sonia; van Duin, David; Weber, David J; Charles, Anthony; Cairns, Bruce A; Jones, Samuel W

Classic determinants of burn mortality are age, burn size, and the presence of inhalation injury. Our objective was to describe temporal trends in patient and burn characteristics, inpatient mortality, and the relationship between these characteristics and inpatient mortality over time. All patients aged 18 years or older and admitted with burn injury, including inhalation injury only, between 2004 and 2013 were included. Adjusted Cox proportional hazards regression models were used to estimate the relationship between admit year and inpatient mortality. A total of 5540 patients were admitted between 2004 and 2013. Significant differences in sex, race/ethnicity, burn mechanisms, TBSA, inhalation injury, and inpatient mortality were observed across calendar years. Patients admitted between 2011 and 2013 were more likely to be women, non-Hispanic Caucasian, with smaller burn size, and less likely to have an inhalation injury, in comparison with patients admitted from 2004 to 2010. After controlling for patient demographics, burn mechanisms, and differential lengths of stay, no calendar year trends in inpatient mortality were detected. However, a significant decrease in inpatient mortality was observed among patients with extensive burns (≥75% TBSA) in more recent calendar years. This large, tertiary care referral burn center has maintained low inpatient mortality rates among burn patients over the past 10 years. While observed decreases in mortality during this time are largely due to changes in patient and burn characteristics, survival among patients with extensive burns has improved.

Epidemiology and outcome of burns at the Saud Al Babtain Burns, Plastic Surgery and Reconstructive Center, Kuwait: our experience over five years (from 2006 to 2010)

PubMed Central

Khashaba, H.A.; Al-Fadhli, A.N.; Al-Tarrah, K.S.; Wilson, Y.T.; Moiemen, N.

2012-01-01

Summary Aim To determine the epidemiology and clinical presentation, and any contributing factors responsible for burns and outcome of care in Kuwait over the 5-yr period January 2006 to December 2010. Patients and methods. The study reviewed 1702 burn patients admitted over the study period to the Saud Al Babtain Burns, Plastic and Reconstructive Surgery Center, Kuwait. Patient characteristics, including age, sex, type of burn, nationality, total body surface area (TBSA) burn, hospital stay in days, and mortality were recorded. Results. Seventy-one per cent of the 1702 burn patients admitted were males; 540 were children. The majority of patients (64%) had less than 15% TBSA burns and only 14% had more than 50% TBSA burns. Flame burns were the most common cause of burn injuries (60%), followed by scalds (29%). Scalds were most common in children. The mortality rate was 5.75%. Flame burn was the leading cause of mortality. Lethal dose 50 (% TBSA at which a certain group has a 50% chance of survival) for adults (16-40 yr) and for the elderly (>65 yr) was 76.5% and 41.8% TBSA respectively. Conclusion. Burn injury is an important public health concern and is associated with high morbidity and mortality. Flame and scald burns are commonly a result of domestic and occupational accidents and they are preventable. Effective initial resuscitation, infection control, and adequate surgical treatment improve outcomes. PMID:23766750

Economic burden of burn injuries in the Netherlands: A 3 months follow-up study.

PubMed

Hop, M Jenda; Wijnen, Ben F M; Nieuwenhuis, Marianne K; Dokter, Jan; Middelkoop, Esther; Polinder, Suzanne; van Baar, Margriet E

2016-01-01

Burn care has rapidly improved in the past decades. However, healthcare innovations can be expensive, demanding careful choices on their implementation. Obtaining knowledge on the extent of the costs of burn injuries is an essential first step for economic evaluations within burn care. The objective of this study was to determine the economic burden of patients with burns admitted to a burn centre and to identify important cost categories until 3 months post-burn. A prospective cohort study was conducted in the burn centre of Maasstad Hospital Rotterdam, the Netherlands, including all patients with acute burn related injuries from August 2011 until July 2012. Total costs were calculated from a societal perspective, until 3 months post injury. Subgroup analyses were performed to examine whether the mean total costs per patient differed by age, aetiology or percentage total body surface area (TBSA) burned. In our population, with a mean burn size of 8%, mean total costs were €26,540 per patient varying from €742 to €235,557. Most important cost categories were burn centre days (62%), surgical interventions (5%) and work absence (20%). Flame burns were significantly more costly than other types of burns, adult patients were significantly more costly than children and adolescents and a higher percentage TBSA burned also corresponded to significantly higher costs. Mean total costs of burn care in the first 3 months post injury were estimated at €26,540 and depended on age, aetiology and TBSA. Mean total costs in our population probably apply to other high-income countries as well, although we should realise that patients with burn injuries are diverse and represent a broad range of total costs. To reduce costs of burn care, future intervention studies should focus on a timely wound healing, reducing length of stay and enabling an early return to work. Copyright © 2015 Elsevier Ltd. All rights reserved.

Landsat-Based Detection and Severity Analysis of Burned Sugarcane Plots in Tarlac, Philippines Using Differenced Normalized Burn Ratio (dNBR)

NASA Astrophysics Data System (ADS)

Baloloy, A. B.; Blanco, A. C.; Gana, B. S.; Sta. Ana, R. C.; Olalia, L. C.

2016-09-01

The Philippines has a booming sugarcane industry contributing about PHP 70 billion annually to the local economy through raw sugar, molasses and bioethanol production (SRA, 2012). Sugarcane planters adapt different farm practices in cultivating sugarcane, one of which is cane burning to eliminate unwanted plant material and facilitate easier harvest. Information on burned sugarcane extent is significant in yield estimation models to calculate total sugar lost during harvest. Pre-harvest burning can lessen sucrose by 2.7% - 5% of the potential yield (Gomez, et al 2006; Hiranyavasit, 2016). This study employs a method for detecting burn sugarcane area and determining burn severity through Differenced Normalized Burn Ratio (dNBR) using Landsat 8 Images acquired during the late milling season in Tarlac, Philippines. Total burned area was computed per burn severity based on pre-fire and post-fire images. Results show that 75.38% of the total sugarcane fields in Tarlac were burned with post-fire regrowth; 16.61% were recently burned; and only 8.01% were unburned. The monthly dNBR for February to March generated the largest area with low severity burn (1,436 ha) and high severity burn (31.14 ha) due to pre-harvest burning. Post-fire regrowth is highest in April to May when previously burned areas were already replanted with sugarcane. The maximum dNBR of the entire late milling season (February to May) recorded larger extent of areas with high and low post-fire regrowth compared to areas with low, moderate and high burn severity. Normalized Difference Vegetation Index (NDVI) was used to analyse vegetation dynamics between the burn severity classes. Significant positive correlation, rho = 0.99, was observed between dNBR and dNDVI at 5% level (p = 0.004). An accuracy of 89.03% was calculated for the Landsat-derived NBR validated using actual mill data for crop year 2015-2016.

A mobile app for measuring the surface area of a burn in three dimensions: comparison to the Lund and Browder assessment.

PubMed

Goldberg, Harry; Klaff, Justin; Spjut, Aaron; Milner, Stephen

2014-01-01

The aim of this study was to compare the ease and accuracy of measuring the surface area of a severe burn through the use of a mobile software application (BurnMed) to the traditional method of assessment, the Lund and Browder chart. BurnMed calculates the surface area of a burn by enabling the user to first manipulate a three-dimensional model on a mobile device and then by touching the model at the locations representing the patient's injury. The surface area of the burn is calculated in real time. Using a cohort of 18 first-year medical students with no experience in burn care, the surface area of a simulated burn on a mannequin was made using BurnMed and compared to estimates derived from the Lund and Browder chart. At the completion of this study, students were asked to complete a questionnaire designed to assess the ease of use of BurnMed. Users were able to easily and accurately measure the surface area of a simulated burn using the BurnMed application. In addition, there was less variability in surface area measurements with the application compared to the results obtained using the Lund and Browder chart. Users also reported that BurnMed was easier to use than the Lund and Browder chart. A software application, BurnMed, has been developed for a mobile device that easily and accurately determines the surface area of a burn. This system uses a three-dimensional model that can be rotated, enlarged, and transposed by the health care provider to easily determine the extent of a burn. Results show that the variability of measurements using BurnMed is lower than the measurements obtained using the Lund and Browder chart. BurnMed is available at no charge in the Apple™ Store.

Burns in Baghdad from 2003 to 2014: Results of a randomized household cluster survey.

PubMed

Stewart, Barclay T; Lafta, Riyadh; Esa Al Shatari, Sahar A; Cherewick, Megan; Burnham, Gilbert; Hagopian, Amy; Galway, Lindsay P; Kushner, Adam L

2016-02-01

Civilians living amid conflict are at high-risk of burns. However, the epidemiology of burns among this vulnerable group is poorly understood, yet vital for health policy and relief planning. To address this gap, we aimed to determine the death and disability, healthcare needs and household financial consequences of burns in post-invasion Baghdad. A two-stage, cluster randomized, community-based household survey was performed in May 2014 to determine the civilian burden of injury from 2003 to 2014 in Baghdad. In addition to questions about cause of household member death, households were interviewed regarding burn specifics, healthcare required, disability, relationship to conflict and resultant financial hardship. Nine-hundred households, totaling 5148 individuals, were interviewed. There were 55 burns, which were 10% of all injuries reported. There were an estimated 2340 serious burns (39 per 100,000 persons) in Baghdad in 2003. The frequency of serious burns generally increased post-invasion to 8780 burns in 2013 (117 per 100,000 persons). Eight burns (15%) were the direct result of conflict. Individuals aged over 45 years had more than twice the odds of burn than children aged less than 13 years (aOR 2.42; 95%CI 1.08-5.44). Nineteen burns (35%) involved ≥ 20% body surface area. Death (16% of burns), disability (40%), household financial hardship (48%) and food insecurity (50%) were common after burn. Civilian burn in Baghdad is epidemic, increasing in frequency and associated with household financial hardship. Challenges of healthcare provision during prolonged conflict were evidenced by a high mortality rate and likelihood of disability after burn. Ongoing conflict will directly and indirectly generates more burns, which mandates planning for burn prevention and care within local capacity development initiatives, as well as humanitarian assistance. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Burns in Baghdad from 2003–2014: results of a randomized household cluster survey

PubMed Central

Stewart, Barclay T; Lafta, Riyadh; Shatari, Sahar A Esa Al; Cherewick, Megan; Burnham, Gilbert; Hagopian, Amy; Galway, Lindsay P; Kushner, Adam L

2015-01-01

Purpose Civilians living amid conflict are at high-risk of burns. However, the epidemiology of burns among this vulnerable group is poorly understood, yet vital for health policy and relief planning. To address this gap, we aimed to determine the death and disability, healthcare needs and household financial consequences of burns in post-invasion Baghdad. Methods A two-stage, cluster randomized, community-based household survey was performed in May of 2014 to determine the civilian burden of injury from 2003 to 2014 in Baghdad. In addition to questions about cause of household member death, households were interviewed regarding burn specifics, healthcare required, disability, relationship to conflict and resultant financial hardship. Results Nine-hundred households, totaling 5,148 individuals, were interviewed. There were 55 burns, which were 10% of all injuries reported. There were an estimated 2,340 serious burn injures (39 per 100,000 persons) in Baghdad in 2003. The frequency of serious burn injuries generally increased post-invasion to 8,780 burns in 2013 (117 per 100,000 persons). Eight burns (15%) were the direct result of conflict. Individuals aged over 45 years had more than twice the odds of burn injury than children aged less than 13 years (aOR 2.42; 95%CI 1.08 – 5.44). Nineteen burns (35%) involved ≥20% body surface area. Death (16% of burn injuries), disability (40%), household financial hardship (48%) and food insecurity (50%) were common after burn injury. Conclusion Civilian burn injury in Baghdad is epidemic, increasing in frequency and associated with household financial hardship. Challenges of healthcare provision during prolonged conflict were evidenced by a high mortality rate and likelihood of disability after burn injury. Ongoing conflict will directly and indirectly generate more burns, which mandates planning for burn prevention and care within local capacity development initiatives, as well as humanitarian assistance. PMID:26526376

Burning mouth syndrome.

PubMed

Crow, Heidi C; Gonzalez, Yoly

2013-02-01

Pain in the tongue or oral tissues described as "burning" has been referred to by many terms including burning mouth syndrome. When a burning sensation in the mouth is caused by local or systemic factors, it is called secondary burning mouth syndrome and when these factors are treated the pain will resolve. When burning mouth syndrome occurs in the absence of identified risk indicators, the term primary burning mouth syndrome is utilized. This article focuses on descriptions, etiologic theories, and management of primary burning mouth syndrome, a condition for which underlying causative agents have been ruled out. Copyright © 2013. Published by Elsevier Inc.

A rare case of failed healing in previously burned skin after a secondary burns.

PubMed

Goldie, Stephen J; Parsons, Shaun; Menezes, Hana; Ives, Andrew; Cleland, Heather

2017-01-01

Patients presenting with large surface area burns are common in our practice; however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. We report on an unusual case of a patient sustaining a secondary large burn to areas previously injured by a burn from a different mechanism. We discuss the potential implications when managing a case like this and suggest potential biological reasons why the skin may behave differently. Our patient was a 33-year-old man who presented with a 5% TBSA burn on skin scarred by a previous 40% total body surface area (TBSA) burn and skin grafts. Initially assessed as superficial partial thickness in depth, the wounds were treated conservatively with dressings; however, they failed to heal and became infected requiring surgical management. Burns sustained in areas of previous burn scars and grafts may behave differently to normal patterns of healing, requiring more aggressive management and surgical intervention at an early stage.

Education in burns: Lessons from the past and objectives for the future.

PubMed

Tevlin, Ruth; Dillon, Luke; Clover, A James P

2017-09-01

Burns are devastating to the individual and society, representing a huge biomedical burden. Improved education in burns has however ignited a revolution in high-income countries-burn mortality is reducing. Education in burns is far-reaching. For the purpose of this concise review, we focus on four categories: education of both (1) emergency and (2) specialist physicians, and the general population, both at a (3) societal and (4) individual level. Tragically, the global burns picture is bleak with burns representing a neglected but solvable health crisis. Ninety-five percent of burns occur in low-income countries, causing enormous suffering, death and disability. Here, we examine the literature detailing burn education with a focus on past lessons, current trends and future objectives. We have identified key educational objectives to revolutionise burn care on a global perspective. Now is the time to build on promising educational strides to reduce the global burns burden. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Burns in sub-Saharan Africa: A review.

PubMed

Nthumba, Peter M

2016-03-01

Burns are important preventable causes of morbidity and mortality, with a disproportionate incidence in sub-Saharan Africa. The management of these injuries in sub-Saharan Africa is a challenge because of multiple other competing problems such as infectious diseases (HIV/AIDS, tuberculosis and malaria), terrorist acts and political instability. There is little investment in preventive measures, pre-hospital, in-hospital and post-discharge care of burns, resulting in high numbers of burns, high morbidity and mortality. Lack of data that can be used in legislation and policy formulation is a major hindrance in highlighting the problem of burns in this sub-region. An online search of publications on burns from sub-Saharan countries was performed. A total of 54 publications with 32,862 patients from 14 countries qualified for inclusion in the study. The average age was 15.3 years. Children aged 10 years and below represented over 80% of the burn patient population. Males constituted 55% of those who suffered burns. Scalds were the commonest cause of thermal injuries, accounting for 59% of all burns, while flame burns accounted for 33%. The burn mortality averaged 17%, or the death of one of every five burn victims. These statistics indicate the need for an urgent review of burn policies and related legislation across the sub-Saharan region to help reduce burns, and provide a safe environment for children. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Educational Materials - Burn Wise

EPA Pesticide Factsheets

Burn Wise outreach material. Burn Wise is a partnership program of that emphasizes the importance of burning the right wood, the right way, in the right wood-burning appliance to protect your home, health, and the air we breathe.

Prescribed burning in the South: trends, purpose, and barriers

Treesearch

Terry K. Haines; Rodney L. Busby; David A. Cleaves

2001-01-01

The results of a survey of fire management officials concerning historical and projected prescribed burning activity in the South are reported. Prescribed burning programs on USDA Forest Service and private and State-owned lands are described in terms of area burned by ownership and State, intended resource benefits, barriers to expanded burning, and optimum burning...

Satisfaction with life after burn: A Burn Model System National Database Study.

PubMed

Goverman, J; Mathews, K; Nadler, D; Henderson, E; McMullen, K; Herndon, D; Meyer, W; Fauerbach, J A; Wiechman, S; Carrougher, G; Ryan, C M; Schneider, J C

2016-08-01

While mortality rates after burn are low, physical and psychosocial impairments are common. Clinical research is focusing on reducing morbidity and optimizing quality of life. This study examines self-reported Satisfaction With Life Scale scores in a longitudinal, multicenter cohort of survivors of major burns. Risk factors associated with Satisfaction With Life Scale scores are identified. Data from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Burn Model System (BMS) database for burn survivors greater than 9 years of age, from 1994 to 2014, were analyzed. Demographic and medical data were collected on each subject. The primary outcome measures were the individual items and total Satisfaction With Life Scale (SWLS) scores at time of hospital discharge (pre-burn recall period) and 6, 12, and 24 months after burn. The SWLS is a validated 5-item instrument with items rated on a 1-7 Likert scale. The differences in scores over time were determined and scores for burn survivors were also compared to a non-burn, healthy population. Step-wise regression analysis was performed to determine predictors of SWLS scores at different time intervals. The SWLS was completed at time of discharge (1129 patients), 6 months after burn (1231 patients), 12 months after burn (1123 patients), and 24 months after burn (959 patients). There were no statistically significant differences between these groups in terms of medical or injury demographics. The majority of the population was Caucasian (62.9%) and male (72.6%), with a mean TBSA burned of 22.3%. Mean total SWLS scores for burn survivors were unchanged and significantly below that of a non-burn population at all examined time points after burn. Although the mean SWLS score was unchanged over time, a large number of subjects demonstrated improvement or decrement of at least one SWLS category. Gender, TBSA burned, LOS, and school status were associated with SWLS scores at 6 months; scores at 12 months were associated with LOS, school status, and amputation; scores at 24 months were associated with LOS, school status, and drug abuse. In this large, longitudinal, multicenter cohort of burn survivors, satisfaction with life after burn was consistently lower than that of non-burn norms. Furthermore mean SWLS scores did not improve over the two-year follow-up period. This study demonstrates the need for continued efforts to improve patient-centered long term satisfaction with life after burn. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Mechanisms of motor vehicle crashes related to burns--an analysis of the German In depth Accident Study (GIDAS) database.

PubMed

Brand, S; Otte, D; Stübig, T; Petri, M; Ettinger, M; Mueller, C W; Krettek, C; Haasper, C; Probst, C

2013-12-01

Patients of motor vehicle crashes (MVCs) suffering burns are challenging for the rescue team and the admitting hospital. These patients often face worse outcomes than crash patients with trauma only. Our analysis of the German In-depth Accident Study (GIDAS) database researches the detailed crash mechanisms to identify potential prevention measures. We analyzed the 2011 GIDAS database comprising 14,072 MVC patients and compared individuals with (Burns) and without (NoBurns) burns. Only complete data sets were included. Patients with burns obviously resulting of air bag deployment only were not included in the Burns group. Data acquisition by an on call team of medical and technical researchers starts at the crash scene immediately after the crash and comprises technical data as well as medical information until discharge from the hospital. Statistical analysis was done by Mann-Whitney-U-test. Level of significance was p < 0.05. 14,072 MVC patients with complete data sets were included in the analysis. 99 individuals suffered burns (0.7%; group "Burns"). Demographic data and injury severity showed no statistical significant difference between the two groups of Burns and NoBurns. Injury severity was measured using the Injury Severity Score (ISS). Direct frontal impact (Burns: 48.5% vs. NoBurns: 33%; p < 0.05) and high-energy impacts as represented by delta-v (m/s) (Burns: 33.5 ± 21.4 vs. NoBurns: 25.2 ± 15.9; p < 0.05) were significantly different between groups as was mortality (Burns: 12.5% vs. NoBurns: 2.1%; p < 0.05). Type of patients' motor vehicles and type of crash opponent showed no differences. Our results show, that frontal and high-energy impacts are associated with a frequency of burns. This may serve automobile construction companies to improve the burn safety to prevent flames spreading from the motor compartment to the passenger compartment. Communities may impose speed limits in local crash hot spots. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

MORBIDITY AND SURVIVAL PROBABILITY IN BURN PATIENTS IN MODERN BURN CARE

PubMed Central

Jeschke, Marc G.; Pinto, Ruxandra; Kraft, Robert; Nathens, Avery B.; Finnerty, Celeste C.; Gamelli, Richard L.; Gibran, Nicole S.; Klein, Matthew B.; Arnoldo, Brett D.; Tompkins, Ronald G.; Herndon, David N.

2014-01-01

Objective Characterizing burn sizes that are associated with an increased risk of mortality and morbidity is critical because it would allow identifying patients who might derive the greatest benefit from individualized, experimental, or innovative therapies. Although scores have been established to predict mortality, few data addressing other outcomes exist. The objective of this study was to determine burn sizes that are associated with increased mortality and morbidity after burn. Design and Patients Burn patients were prospectively enrolled as part of the multicenter prospective cohort study, Inflammation and the Host Response to Injury Glue Grant, with the following inclusion criteria: 0–99 years of age, admission within 96 hours after injury, and >20% total body surface area burns requiring at least one surgical intervention. Setting Six major burn centers in North America. Measurements and Main Results Burn size cutoff values were determined for mortality, burn wound infection (at least two infections), sepsis (as defined by ABA sepsis criteria), pneumonia, acute respiratory distress syndrome, and multiple organ failure (DENVER2 score >3) for both children (<16 years) and adults (16–65 years). Five-hundred seventy-three patients were enrolled, of which 226 patients were children. Twenty-three patients were older than 65 years and were excluded from the cutoff analysis. In children, the cutoff burn size for mortality, sepsis, infection, and multiple organ failure was approximately 60% total body surface area burned. In adults, the cutoff for these outcomes was lower, at approximately 40% total body surface area burned. Conclusions In the modern burn care setting, adults with over 40% total body surface area burned and children with over 60% total body surface area burned are at high risk for morbidity and mortality, even in highly specialized centers. PMID:25559438

Epidemiology of pediatric burns in southwest China from 2011 to 2015.

PubMed

Li, Haisheng; Wang, Song; Tan, Jianglin; Zhou, Junyi; Wu, Jun; Luo, Gaoxing

2017-09-01

Burns are a major form of injury in children worldwide. This study aimed to investigate the epidemiology, outcome, cost and risk factors of pediatric burns in southwest China. This retrospective study was performed at the Institute of Burn Research of the Third Military Medical University from 2011 to 2015. Data, including demographic, injury-related, and clinical data and patient outcome, were collected from medical records. A total of 2478 children with burns (58.03% boys), accounting for 39.2% of total burn patients, were included. The average age of the burn patients was 2.86±2.86years, and most patients (85.55%) were under five years old. The incidence of burns peaked in January, February and May. Scald burns were the most frequent (79.06%), followed by flame burns (14.0%) and electrical burns (3.35%). Limbs were the most common burn sites (69.73%), and the average total body surface area (TBSA) was 11.57±11.61%. The percentage of children who underwent operations and the number of operations were significantly increased in cases of electrical burns, the older-age group, a larger TBSA and full-thickness burns. Six deaths were recorded, yielding a mortality of 0.24%. The median length of stay and cost were 14days and 9541 CNY, respectively, and the major risk factors for length of stay and cost were the TBSA, number of operations, full-thickness burns and outcome. In southwest China, among children under five years old, scald and flame burns should become the key prevention target, and future prevention strategies should be based on related risk factors. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Is there a threshold age and burn size associated with poor outcomes in the elderly after burn injury?

PubMed Central

Jeschke, Marc G; Pinto, Ruxandra; Costford, Sheila R.; Amini-Nik, Saeid

2016-01-01

Elderly burn care represents a vast challenge. The elderly are one of the most susceptible populations to burn injuries, but also one of the fastest growing demographics, indicating a substantial increase in patient numbers in the near future. Despite the need and importance of elderly burn care, survival of elderly burn patients is poor. Additionally, little is known about the responses of elderly patients after burn. One central question that has not been answered is what age defines an elderly patient. The current study was conducted to determine whether there is a cut-off age for elderly burn patients that is correlated with an increased risk for mortality and to determine the burn size in modern burn care that is associated with increased mortality. To answer these questions, we applied appropriate statistical analyses to the Ross Tilley Burn Centre and the Inflammatory and Host Response to Injury databases. We could not find a clear cut-off age that differentiates or predicts between survival and death. Risk of death increased linearly with increasing age. Additionally, we found that the LD50 decreases from 45% total body surface area (TBSA) to 25% TBSA from the age of 55 years to the age of 70 years, indicating that even small burns lead to poor outcome in the elderly. We therefore concluded that age is not an ideal to predictor of burn outcome, but we strongly suggest that burn care providers be aware that if an elderly patient sustains even a 25% TBSA burn, the risk of mortality is 50% despite the implementation of modern protocolized burn care. PMID:26803373

The Protective Effects of Epigallocatechin Gallate Against Distant Organ Damage After Severe Skin Burns--Experimental Study Using a Rat Model of Thermal Trauma.

PubMed

Hosnuter, Mubin; Melikoglu, Cenk; Aslan, Cem; Saglam, Gulcan; Sutcu, Recep

2015-01-01

Epigallocatechin gallate (EGCG), a green tea polyphenol, has potent antioxidant properties. The purpose of the present study was to examine the possible preventative effects of EGCG against internal organ injury due to large-surface skin burns in a rat model. The study design involved three groups of rats: a sham group and two groups with 25-30% full-thickness burns: (a) the sham group without burns or treatment (n=18); (b) the control burn group (burns+sterile saline, n=18); and (c) the burn treatment group (burns+treatment with EGCG, n=18). EGCG was administered intraperitoneally immediately after the thermal injury, and daily in 100 μmol/kg doses. Kidney and lung tissue samples were taken to determine the levels of malondialdehyde (MDA), superoxide dismutase (SOD), tumor necrosis factor-α (TNF-α), and glutathione peroxidase (GPX) after the first, third and seventh post-burn days. In the EGCG-treated burn group, SOD and GPX activity were significantly higher than in the burn control group. Additionally, MDA and TNF-α levels were significantly lower in the EGCG-treated burn group. Based on this study, it might be anticipated that EGCG treatment may be beneficial in burn injury cases.

Economics of pediatric burns.

PubMed

Bass, Michael J; Phillips, Linda G

2008-07-01

Sustaining a burn injury sets in motion a cycle of pain, disfigurement, and a search for survival. In pediatric burns, the injury extends to the parents where fear, ignorance, and helplessness forever change their lives. Pediatric burn injuries are caused by fire, hot liquids, clothing irons, hair curlers, caustic substances like drain cleaner, the grounding of an electrical source, and exposure to radiation. Efficiency in the delivery of pediatric burn care is critical. Maximizing resource utilization means continual self-evaluation and economic analysis of therapeutic modalities. Griffiths et al found that most childhood burns are due to scalds, which can be treated for $1061 per percent burn. Paddock et al reduced the cost of treating superficial pediatric burns and reduced the length of stay in hospital using silver-impregnated gauze over traditional methods. Barrett et al found improved cosmesis of skin grafts using cultured epithelial autografts but at a substantially increased cost. Corpron et al showed that pediatric burn units that treat burns >10% total body surface area and operative treatment of pediatric burns regardless of size generate positive revenue. There is a paucity of evidentiary pediatric burn economic data. More research is needed to address areas of pediatric burn care inefficiency. Improving knowledge of cost in all health care endeavors will create competition and drive down expenditures.

A review of campfire burns in children: The QLD experience.

PubMed

Okon, O; Zhu, L; Kimble, R M; Stockton, K A

2018-03-27

Campfire burns in children are a significant health issue. It is imperative that the extent of the problem is examined and strategies discussed to inform future prevention campaigns. A retrospective review of data from the Queensland Paediatric Burns Registry for all children presenting with campfire burns between January 2013 and December 2014 (inclusive). Information collected included patient demographics, detail regarding mechanism of injury, first aid, Total Body Surface Area (TBSA), burn depth, and treatment. Seventy-five children with campfire burns were seen in our paediatric burns centre during this 2-year period. The median age of patients was 3 years (range 10 days-14 years). The hands and feet were the areas most commonly affected. Eleven percent of patients suffered flame burns, whilst 89% suffered contact burns from the hot coals or ashes. Of the latter group, approximately half experienced burns from campfires that had been extinguished for at least one night. Thirteen percent of patients underwent split thickness skin grafting. The incidence of burns was increased during school holiday months. We have previously demonstrated the effectiveness of targeted campaigns in reducing the incidence of campfire burns. A significant portion of patients sustained burns from incorrectly extinguished campfires. These injuries are likely to be preventable with ongoing public awareness campaigns. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

Outpatient presentations to burn centers: data from the Burns Registry of Australia and New Zealand outpatient pilot project.

PubMed

Gabbe, Belinda J; Watterson, Dina M; Singer, Yvonne; Darton, Anne

2015-05-01

Most studies about burn injury focus on admitted cases. To compare outpatient and inpatient presentations at burn centers in Australia to inform the establishment of a repository for outpatient burn injury. Data for sequential outpatient presentations were collected at seven burn centers in Australia between December 2010 and May 2011 and compared with inpatient admissions from these centers recorded by the Burns Registry of Australia and New Zealand for the corresponding period. There were 788 outpatient and 360 inpatient presentations. Pediatric outpatients included more children <3 years of age (64% vs 33%), scald (52% vs 35%) and contact burns (39% vs 24%). Adult outpatients included fewer males (58% vs 73%) and intentional injuries (3.3% vs 10%), and more scald (46% vs 30%) and contact burns (24% vs 13%). All pediatric, and 98% of adult, outpatient presentations involved a %TBSA<10. The pattern of outpatient presentations was consistent between centers. Outpatient presentations outnumbered inpatient admissions by 2.2:1. The pattern of outpatient burns presenting to burn centers differed to inpatient admission data, particularly with respect to etiology and burn severity, highlighting the importance of the need for outpatient data to enhance burn injury surveillance and inform prevention. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Current concepts on burn wound conversion-A review of recent advances in understanding the secondary progressions of burns.

PubMed

Salibian, Ara A; Rosario, Angelica Tan Del; Severo, Lucio De Almeida Moura; Nguyen, Long; Banyard, Derek A; Toranto, Jason D; Evans, Gregory R D; Widgerow, Alan D

2016-08-01

Burn wound conversion describes the process by which superficial partial thickness burns convert into deeper burns necessitating surgical intervention. Fully understanding and thus controlling this phenomenon continues to defy burn surgeons. However, potentially guiding burn wound progression so as to obviate the need for surgery while still bringing about healing with limited scarring is the major unmet challenge. Comprehending the pathophysiologic background contributing to deeper progression of these burns is an essential prerequisite to planning any intervention. In this study, a review of articles examining burn wound progression over the last five years was conducted to analyze trends in recent burn progression research, determine changes in understanding of the pathogenesis of burn conversion, and subsequently examine the direction for future research in developing therapies. The majority of recent research focuses on applying therapies from other disease processes to common underlying pathogenic mechanisms in burn conversion. While ischemia, inflammation, and free oxygen radicals continue to demonstrate a critical role in secondary necrosis, novel mechanisms such as autophagy have also been shown to contribute affect significantly burn progression significantly. Further research will have to determine whether multiple mechanisms should be targeted when developing clinical therapies. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Burn Wise Educational Materials for Businesses

EPA Pesticide Factsheets

Burn Wise outreach material. Burn Wise is a partnership program of that emphasizes the importance of burning the right wood, the right way, in the right wood-burning appliance to protect your home, health, and the air we breathe.

Burn-related peripheral neuropathy: A systematic review.

PubMed

Tu, Yiji; Lineaweaver, William C; Zheng, Xianyou; Chen, Zenggan; Mullins, Fred; Zhang, Feng

2017-06-01

Peripheral neuropathy is the most frequent disabling neuromuscular complication of burns. However, the insidious and progressive onset of burn neuropathy makes it often undiagnosed or overlooked. In our study, we reviewed the current studies on the burn-related peripheral neuropathy to summarize the morbidity, mechanism, detecting method and management of peripheral neuropathy in burn patients. Of the 1533 burn patients included in our study, 98 cases (6.39%) were presented with peripheral neuropathy. Thermal and electrical burns were the most common etiologies. Surgical procedures, especially nerve decompression, showed good effect on functional recovery of both acute and delayed peripheral neuropathy in burn patients. It is noteworthy that, for early detection and prevention of peripheral neuropathy, electrodiagnostic examinations should be performed on burn patients independent of symptoms. Still, the underlying mechanisms of burn-related peripheral neuropathy remain to be clarified. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

[Advances in the research of pressure therapy for pediatric burn patients with facial scar].

PubMed

Wei, Y T; Fu, J F; Li-Tsang, Z H P

2017-05-20

Facial scar and deformation caused by burn injury severely affect physical and psychological well-being of pediatric burn patients, which needs medical workers and pediatric burn patients' family members to pay much attention to and to perform early rehabilitation treatment. Pressure therapy is an important rehabilitative strategy for pediatric burn patients with facial scar, mainly including wearing headgears and transparent pressure facemasks, which have their own features. To achieve better treatment results, pressure therapy should be chosen according to specific condition of pediatric burn patients and combined with other assistant therapies. Successful rehabilitation for pediatric burn patients relies on cooperation of both family members of pediatric burn patients and society. Rehabilitation knowledge should be provided to parents of pediatric burn patients to acquire their full support and cooperation in order to achieve best therapeutic effects and ultimately to rebuild physical and psychological well-being of pediatric burn patients.

Burns from illegal drug manufacture: case series and management.

PubMed

Porter, C J W; Armstrong, J R

2004-01-01

This case series presents our experience with burns sustained while manufacturing illegal drugs. All adult burn admissions in an 18-month period were retrospectively reviewed. All patients suspected of sustaining burns from illegal drug manufacture were contacted. Information regarding the burn mechanism was sought. Nine of the 64 adult burn admissions were caused by explosions during the manufacture of cannabis oil. Young males with hand and face burns were heavily represented. First-aid treatment was often ignored in favor of hiding incriminating evidence. Only two patients gave honest admission histories. Illegal drug manufacture is becoming more common as synthetic drugs become more consumer desirable. Burns sustained may be thermal and/or chemical. Dishonest patient histories negatively influence burn management. A high level of suspicion is required for diagnosing and treating burns from illegal drug manufacture. Public education is unlikely to be effective as the financial rewards outweigh the perceived risks.

Civilian blast-related burn injuries

PubMed Central

Patel, J.N.; Tan, A.; Dziewulski, P.

2016-01-01

Summary There is limited English literature describing the experience of a civilian hospital managing blast-related burn injuries. As the largest regional burn unit, we reviewed our cases with the aim of identifying means to improve current management. A 6-year retrospective analysis of all patients coded as sustaining blast-related burns was conducted through the unit’s burns database. Medical case notes were reviewed for information on burn demographics, management and outcomes. 42 patients were identified. Male to female ratio was 37:5. Age range was 12-84 years, (mean=33 years). Total body surface area (%TBSA) burn ranged from 0.25% to 60%, (median=1%). The most common burn injury was flame (31/42, 73.8%). Gas explosions were the most common mechanism of injury (19 cases; 45.2%). 7/42 cases (16.7%) had full ATLS management pre-transfer to the burns unit. The Injury Severity Score (ISS) ranged from 0-43 (median=2). 17/42 (40.4%) patients required admission. 37/36 (88.1%) patients were managed conservatively of which 1 patient later required surgery due to deeper burns. 5/42 (11.9%) patients required surgical management at presentation and these were noted to be burns with >15% TBSA requiring resuscitation. One case required emergency escharotomies and finger amputations. All patients survived their burn injuries. Blast-related burn injuries are generally uncommon in the civilian setting. Following proper assessment, most of these cases can be deemed as minor injuries and managed conservatively. Improvement in burns management education and training at local emergency departments would provide efficient patient care and avoid unnecessary referrals to a burns unit. PMID:27857651

Patient experiences of burn scars in adults and children and development of a health-related quality of life conceptual model: A qualitative study.

PubMed

Simons, Megan; Price, Nathaniel; Kimble, Roy; Tyack, Zephanie

2016-05-01

The aim of this study was to understand the impact of burn scars on health-related quality of life (HRQOL) from the perspective of adults and children with burn scars, and caregivers to inform the development of a conceptual model of burn scar HRQOL. Twenty-one participants (adults and children) with burn scars and nine caregivers participated in semi-structured, face-to-face interviews between 2012 and 2013. During the interviews, participants were asked to describe features about their (or their child's) burn scars and its impact on everyday life. Two coders conducted thematic analysis, with consensus achieved through discussion and review with a third coder. The literature on HRQOL models was then reviewed to further inform the development of a conceptual model of burn scar HRQOL. Five themes emerged from the qualitative data: 'physical and sensory symptoms', 'impact of burn scar interventions', 'impact of burn scar symptoms', 'personal factors' and 'change over time'. Caregivers offered further insights into family functioning after burn, and the impacts of burn scars and burn scar interventions on family life. In the conceptual model, symptoms (sensory and physical) of burn scars are considered proximal to HRQOL, with distal indicators including functioning (physical, emotional, social, cognitive), individual factors and the environment. Overall quality of life was affected by HRQOL. Understanding the impact of burn scars on HRQOL and the development of a conceptual model will inform future burn scar research and clinical practice. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

The trends of burns epidemiology in a tropical regional burns centre.

PubMed

Hwee, Jolie; Song, Christopher; Tan, Kok Chai; Tan, Bien Keem; Chong, Si Jack

2016-05-01

Singapore General Hospital (SGH) is a regional burns centre in Southeast Asia and is the only dedicated burns facility providing specialized burns care in Singapore. A cohort study was performed for burns patients admitted to SGH from 2011 to 2013. We compared our data with earlier studies and observed the trends of burns epidemiology in Singapore. Results were analyzed using the SPSS programme. 655 patients were admitted during this study period, a 35.9% increase from 2003 to 2005. Scalding by water and flame injury remain the top causes of burns and the mean extent of burn is 9.5%. TBSA correlates with the incidence of burn infection, bacteremia and mortality. Patients with ≥20% TBSA are at a higher risk of bacteremia, and ≥ 34% TBSA is a predictor of mortality. 4.9% (n=32) of our patients developed bacteremia. Bacteremia was associated with a surgical duration of ≥80min. Patients with bacteremia incurred longer hospitalization, and had higher mortality rates. Overall mortality rate of our burns patients has decreased from 4.5% to 2.7% (n=18). Key factors of mortality include inhalational injury, bacteremia and ≥20% TBSA. This is a large epidemiology study of a tropical region burns centre. A total of 655 burns cases over a 3-year period were analyzed. We analysed the key factors associated with adverse outcomes including burns infection, bacteremia and mortality, factors associated with mortality, and discussed strategies on the optimization of burns care. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Pediatric Treadmill Burns: Assessing the effectiveness of prevention strategies.

PubMed

Goltsman, David; Li, Zhe; Connolly, Siobhan; Meyerowitz-Katz, Daniel; Allan, James; Maitz, Peter K M

2016-11-01

Legislative changes in 2008 in Australia mandated that all new treadmills display a warning sticker about the risk of friction burns in children. This was accompanied by a health promotion campaign advising of the risks of treadmills to children. Analyses of pediatric burns data identified all cases of treadmill burns occurring between 2005 and 2014. The incidence of treadmill burns, associations with age and gender, characteristics of the burns and the adequacy of first aid provided immediately after the burn was examined. There were 298 cases of treadmill burns over the 10-year period (3.5% of all pediatric burns). The incidence rose until the introduction of legislation and health promotion in 2008, and then declined over the remaining study period. The majority of treadmill burns in children were inflicted on the upper limbs (91%), and 93% involved the hands. Most burns were full thickness (62%, n=182) and 49% (n=148) required skin grafts. Approximately one-third of treadmill burns (35%, n=105) occurred while someone else was using the treadmill. In the vast majority of treadmill burn injuries (74%, n=223), there was either no first aid or inadequate first aid provided immediately after the injury. A significant number of treadmill burns occur in children, and these often result in serious injuries that are not treated with appropriate first aid. A reduction in the incidence of these burns was associated with the introduction of legislation and health promotion targeted at child safety around treadmills. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Pattern and profile of electric burn injury cases at a Burn centre.

PubMed

Cheema, Saeed Ashraf

2016-01-01

Electrical burns are quite different from thermal and chemical burns. This study is from a centre which deals with job related electric burn injuries alone and thus can give a pure account of the electric burns and discuss the related peculiarities. Study aims to highlight the differences in the mechanism of electric burn injury, its mode of presentation, morbidity, complications and thus the treatment strategies as compared to rest of the burn injuries. This is a descriptive case series study of first consecutive 61 electric burn victims treated at a Burn Unit and Plastic Surgery centre. Cases were admitted and resuscitated at the emergency, and further treated at burn unit. Thorough history, examination findings and operative procedures were recorded. Patients were photographed for record as well. Emergency operative procedures, wound management, soft tissue coverage procedures and complications during the hospital stay were recorded and studied. Twenty cases (33%) were in the fifth decade of life. High voltage electric burn injury was seen in 42 (69%) of the cases. Whereas only 9 cases were treated conservatively, other 52 cases had 24 fasciotomies and 71 debridements. Series witnessed 10 expiries, and 22 amputations and all these were result of high voltage electric burns. Twenty eight soft tissue coverage procedures were carried out. Electric burn injuries are altogether different from rest of the burn injuries and must be treated accordingly. These injuries are peculiar for ongoing damage, extensive trauma, complications and prolonged morbidity. Treatment requires a high degree of suspicion, more aggressive management to unfold and minimize the deep seated insult.

Development of a Consistent and Reproducible Porcine Scald Burn Model

PubMed Central

Kempf, Margit; Kimble, Roy; Cuttle, Leila

2016-01-01

There are very few porcine burn models that replicate scald injuries similar to those encountered by children. We have developed a robust porcine burn model capable of creating reproducible scald burns for a wide range of burn conditions. The study was conducted with juvenile Large White pigs, creating replicates of burn combinations; 50°C for 1, 2, 5 and 10 minutes and 60°C, 70°C, 80°C and 90°C for 5 seconds. Visual wound examination, biopsies and Laser Doppler Imaging were performed at 1, 24 hours and at 3 and 7 days post-burn. A consistent water temperature was maintained within the scald device for long durations (49.8 ± 0.1°C when set at 50°C). The macroscopic and histologic appearance was consistent between replicates of burn conditions. For 50°C water, 10 minute duration burns showed significantly deeper tissue injury than all shorter durations at 24 hours post-burn (p ≤ 0.0001), with damage seen to increase until day 3 post-burn. For 5 second duration burns, by day 7 post-burn the 80°C and 90°C scalds had damage detected significantly deeper in the tissue than the 70°C scalds (p ≤ 0.001). A reliable and safe model of porcine scald burn injury has been successfully developed. The novel apparatus with continually refreshed water improves consistency of scald creation for long exposure times. This model allows the pathophysiology of scald burn wound creation and progression to be examined. PMID:27612153

Ecological Consequences of Shifting the Timing of Burning Tallgrass Prairie

PubMed Central

Towne, E. Gene; Craine, Joseph M.

2014-01-01

In the Kansas Flint Hills, grassland burning is conducted during a relatively narrow window because management recommendations for the past 40 years have been to burn only in late spring. Widespread prescribed burning within this restricted time frame frequently creates smoke management issues downwind. A potential remedy for the concentrated smoke production in late spring is to expand burning to times earlier in the year. Yet, previous research suggested that burning in winter or early spring reduces plant productivity and cattle weight gain while increasing the proportion of undesirable plant species. In order to better understand the ecological consequences of burning at different times of the year, plant production and species abundance were measured for 20 years on ungrazed watersheds burned annually in autumn, winter, or spring. We found that there were no significant differences in total grass production among the burns on either upland or lowland topographic positions, although spring burned watersheds had higher grass culm production and lower forb biomass than autumn and winter burned watersheds. Burning in autumn or winter broadened the window of grass productivity response to precipitation, which reduces susceptibility to mid-season drought. Burning in autumn or winter also increased the phenological range of species by promoting cool-season graminoids without a concomitant decrease in warm-season grasses, potentially widening the seasonal window of high-quality forage. Incorporating autumn and winter burns into the overall portfolio of tallgrass prairie management should increase the flexibility in managing grasslands, promote biodiversity, and minimize air quality issues caused by en masse late-spring burning with little negative consequences for cattle production. PMID:25077487

Ecological consequences of shifting the timing of burning tallgrass prairie.

PubMed

Towne, E Gene; Craine, Joseph M

2014-01-01

In the Kansas Flint Hills, grassland burning is conducted during a relatively narrow window because management recommendations for the past 40 years have been to burn only in late spring. Widespread prescribed burning within this restricted time frame frequently creates smoke management issues downwind. A potential remedy for the concentrated smoke production in late spring is to expand burning to times earlier in the year. Yet, previous research suggested that burning in winter or early spring reduces plant productivity and cattle weight gain while increasing the proportion of undesirable plant species. In order to better understand the ecological consequences of burning at different times of the year, plant production and species abundance were measured for 20 years on ungrazed watersheds burned annually in autumn, winter, or spring. We found that there were no significant differences in total grass production among the burns on either upland or lowland topographic positions, although spring burned watersheds had higher grass culm production and lower forb biomass than autumn and winter burned watersheds. Burning in autumn or winter broadened the window of grass productivity response to precipitation, which reduces susceptibility to mid-season drought. Burning in autumn or winter also increased the phenological range of species by promoting cool-season graminoids without a concomitant decrease in warm-season grasses, potentially widening the seasonal window of high-quality forage. Incorporating autumn and winter burns into the overall portfolio of tallgrass prairie management should increase the flexibility in managing grasslands, promote biodiversity, and minimize air quality issues caused by en masse late-spring burning with little negative consequences for cattle production.

Caring for burn patients at the United States Institute of Surgical Research: the nurses' multifaceted roles.

PubMed

Serio-Melvin, Maria; Yoder, Linda H; Gaylord, Kathryn M

2010-06-01

Nursing plays a critical role in the comprehensive burn care delivered at the US Army Institute of Surgical Research, otherwise known as the US Army's Burn Center serving the Department of Defense. This center serves as a model for burn units nationally and internationally. It also provides a challenging and innovative work environment for military and civilian nurses. Nurses in the Burn Center contribute to innovations in acute, rehabilitative, and psychological care for patients with burns. This article provides an overview of the complex nursing care provided to burn patients treated at the Burn Center. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Burns teaching in UK medical schools: Is it enough?

PubMed

Zinchenko, Ruslan; Perry, Fiona M; Dheansa, Baljit S

2016-02-01

Burns are frequently seen and managed in non-specialist settings. The crowding of the UK medical undergraduate curriculum may have resulted in the reduction of teaching on burns. To determine the burns education experience and the level of competence among UK final year medical students in assessing and acutely managing patients with burns. An online questionnaire was circulated among UK final year medical students. There was a total of 348 respondents. The majority of the respondents (70%) have not received any specific teaching on how to manage patients with burns. Nearly two-thirds of the students (66%) have never seen a patient being managed for burns throughout their training. Over 90% of respondents stated that they would not feel confident in initially managing a burn in the emergency department. The majority of the respondents (57%) have not heard of the criteria for referring a burns patient for further specialist management. There was almost universal agreement about the importance of knowing how to manage a burn initially. There seems to be a lack of consistent undergraduate training in burns management and final year students lack the experience and knowledge to initially manage burns. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Epidemiological data and costs of burn injuries in workers in Switzerland: an argument for immediate treatment in burn centres.

PubMed

de Roche, R; Lüscher, N J; Debrunner, H U; Fischer, R

1994-02-01

A complete statistical evaluation of epidemiological data and costs of burn injuries in 1984 with a follow-up for 5 years is presented, considering a collective of 1.77 million workers in Switzerland. The majority of burns are minor injuries; only about 5 per cent of the burn victims are admitted to a hospital, 0.2 per cent died. Burn injuries at work are rare, mainly owing to strict safety measures. Only one-fifth of the costs caused by burns are due to medical treatment. All other expenses result from continuation of payments of salaries and annuities. The treatment of the few severely burned patients in burn units produces effective costs which are higher than the tariff paid by the insurance. Even so, the predominant portion of the enormous costs is taken up by wages while off work and annuities. As our conclusion we stress the importance of primary care for all severe burns including all burns of the hands in a specialized centre. Any economic effort for primary burn treatment, however high it may be, is justified if the duration of rehabilitation and invalidity can be reduced.

Impact of Early Inpatient Rehabilitation on Adult Burn Survivors' Functional Outcomes and Resource Utilization.

PubMed

Gomez, Manuel; Tushinski, Morris; Jeschke, Marc G

On July 2012, a rehabilitation hospital merged with a trauma center where the regional burn center is located. That rehabilitation center provides the only burn rehabilitation program in our region. The objective of this study was to determine if earlier initiation of inpatient rehabilitation after merger had an effect on burn survivors' functional outcomes and resource utilization. A retrospective review of electronic data of burn survivors' functional outcomes (functional independence measure [FIM] ratings on admission, at discharge, and percent change), and resource utilization (waiting time for rehab, burn center length of stay [LOS], rehab LOS, physiotherapy and occupational therapy rehabilitation workload [RehabWorkload], and discharge destination) was undertaken. Adult burn survivors who required inpatient rehabilitation and were transferred from the burn center to the inpatient rehabilitation service before the merger (July 2010-June 2012) were compared with those transferred after the merger (July 2012-June 2014). One hundred thirty-eight burn survivors were transferred from the burn center to the inpatient rehabilitation service during the study period. Sixty (43.5%) were transferred before and 78 (56.5%) were transferred after the merger. There were 97 (70.3%) men and 41 (29.7%) women with a mean age of 47.9 ± 17.9 years. TBSA burn was 24.2 ± 16.9%, and full thickness burn was 13.1 ± 16.4%. The etiology of these burns were flame (72.5%), scald (19.6%), electrical (5.1%), chemical (2.2%), and contact (0.7%). Patients in both groups had similar age, inhalation injury, TBSA, full thickness burn, FIM ratings, RehabWorkload, and burn etiology. Patients transferred before the merger had significantly more chemical burns (5% vs 0%, P = .046), and more work-related burns (26.7% vs 7.7%, P = .004). Patients transferred after the merger had significantly shorter burn center LOS (28.5 ± 20.9 days vs 38.8 ± 34.2 days, P = .043), and shorter waiting time for rehab (0.7 ± 1.1 days vs 1.5 ± 2.3 days, P = .010) than patients transferred before the merger. Early initiation of inpatient rehabilitation, after the burn center and the inpatient rehabilitation service were located in the same hospital, improved burn survivors' resource utilization.

The validation study on a three-dimensional burn estimation smart-phone application: accurate, free and fast?

PubMed

Cheah, A K W; Kangkorn, T; Tan, E H; Loo, M L; Chong, S J

2018-01-01

Accurate total body surface area burned (TBSAB) estimation is a crucial aspect of early burn management. It helps guide resuscitation and is essential in the calculation of fluid requirements. Conventional methods of estimation can often lead to large discrepancies in burn percentage estimation. We aim to compare a new method of TBSAB estimation using a three-dimensional smart-phone application named 3D Burn Resuscitation (3D Burn) against conventional methods of estimation-Rule of Palm, Rule of Nines and the Lund and Browder chart. Three volunteer subjects were moulaged with simulated burn injuries of 25%, 30% and 35% total body surface area (TBSA), respectively. Various healthcare workers were invited to use both the 3D Burn application as well as the conventional methods stated above to estimate the volunteer subjects' burn percentages. Collective relative estimations across the groups showed that when used, the Rule of Palm, Rule of Nines and the Lund and Browder chart all over-estimated burns area by an average of 10.6%, 19.7%, and 8.3% TBSA, respectively, while the 3D Burn application under-estimated burns by an average of 1.9%. There was a statistically significant difference between the 3D Burn application estimations versus all three other modalities ( p  < 0.05). Time of using the application was found to be significantly longer than traditional methods of estimation. The 3D Burn application, although slower, allowed more accurate TBSAB measurements when compared to conventional methods. The validation study has shown that the 3D Burn application is useful in improving the accuracy of TBSAB measurement. Further studies are warranted, and there are plans to repeat the above study in a different centre overseas as part of a multi-centre study, with a view of progressing to a prospective study that compares the accuracy of the 3D Burn application against conventional methods on actual burn patients.

Burn injury pain: the continuing challenge.

PubMed

Summer, Gretchen J; Puntillo, Kathleen A; Miaskowski, Christine; Green, Paul G; Levine, Jon D

2007-07-01

The development of more effective methods of relieving pain associated with burn injury is a major unmet medical need. Not only is acute burn injury pain a source of immense suffering, but it has been linked to debilitating chronic pain and stress-related disorders. Although pain management guidelines and protocols have been developed and implemented, unrelieved moderate-to-severe pain continues to be reported after burn injury. One reason for this is that the intensity of pain associated with wound care and rehabilitation therapy, the major source of severe pain in this patient population, varies widely over the 3 phases of burn recovery, making it difficult to estimate analgesic requirements. The effects of opioids, the most commonly administered analgesics for burn injury procedural pain, are difficult to gauge over the course of burn recovery because the need for an opioid may change rapidly, resulting in the overmedication or undermedication of burn-injured patients. Understanding the mechanisms that contribute to the intensity and variability of burn injury pain over time is crucial to its proper management. We provide an overview of the types of pain associated with a burn injury, describe how these different types of pain interfere with the phases of burn recovery, and summarize pharmacologic pain management strategies across the continuum of burn care. We conclude with a discussion and suggestions for improvement. Rational management, based on the underlying mechanisms that contribute to the intensity and variability of burn injury pain, is in its infancy. The paucity of information highlights the need for research that explores and advances the identification of mechanisms of acute and chronic burn injury pain. Researchers continue to report that burn pain is undertreated. This review examines burn injury pain management across the phases of burn recovery, emphasizing 3 types of pain that require separate assessment and management. It provides insights and suggestions for future research directions to address this significant clinical problem.

Accelerant-related burns and drug abuse: Challenging combination.

PubMed

Leung, Leslie T F; Papp, Anthony

2018-05-01

Accelerants are flammable substances that may cause explosion when added to existing fires. The relationships between drug abuse and accelerant-related burns are not well elucidated in the literature. Of these burns, a portion is related to drug manufacturing, which have been shown to be associated with increased burn complications. 1) To evaluate the demographics and clinical outcomes of accelerant-related burns in a Provincial Burn Centre. 2) To compare the clinical outcomes with a control group of non-accelerant related burns. 3) To analyze a subgroup of patients with history of drug abuse and drug manufacturing. Retrospective case control study. Patient data associated with accelerant-related burns from 2009 to 2014 were obtained from the British Columbia Burn Registry. These patients were compared with a control group of non-accelerant related burns. Clinical outcomes that were evaluated include inhalational injury, ICU length of stay, ventilator support, surgeries needed, and burn complications. Chi-square test was used to evaluate categorical data and Student's t-test was used to evaluate mean quantitative data with the p value set at 0.05. A logistic regression model was used to evaluate factors affecting burn complications. Accelerant-related burns represented 28.2% of all burn admissions (N=532) from 2009 to 2014. The accelerant group had higher percentage of patients with history of drug abuse and was associated with higher TBSA burns, ventilator support, ICU stay and pneumonia rates compared to the non-accelerant group. Within the accelerant group, there was no difference in clinical outcomes amongst people with or without history of drug abuse. Four cases were associated with methamphetamine manufacturing, all of which underwent ICU stay and ventilator support. Accelerant-related burns cause significant burden to the burn center. A significant proportion of these patients have history of drug abuse. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Reliability enhancement through optimal burn-in

NASA Astrophysics Data System (ADS)

Kuo, W.

1984-06-01

A numerical reliability and cost model is defined for production line burn-in tests of electronic components. The necessity of burn-in is governed by upper and lower bounds: burn-in is mandatory for operation-critical or nonreparable component; no burn-in is needed when failure effects are insignificant or easily repairable. The model considers electronic systems in terms of a series of components connected by a single black box. The infant mortality rate is described with a Weibull distribution. Performance reaches a steady state after burn-in, and the cost of burn-in is a linear function for each component. A minimum cost is calculated among the costs and total time of burn-in, shop repair, and field repair, with attention given to possible losses in future sales from inadequate burn-in testing.

The organisation of critical care for burn patients in the UK: epidemiology and comparison of mortality prediction models.

PubMed

Toft-Petersen, A P; Ferrando-Vivas, P; Harrison, D A; Dunn, K; Rowan, K M

2018-05-15

In the UK, a network of specialist centres has been set up to provide critical care for burn patients. However, some burn patients are admitted to general intensive care units. Little is known about the casemix of these patients and how it compares with patients in specialist burn centres. It is not known whether burn-specific or generic risk prediction models perform better when applied to patients managed in intensive care units. We examined admissions for burns in the Case Mix Programme Database from April 2010 to March 2016. The casemix, activity and outcome in general and specialist burn intensive care units were compared and the fit of two burn-specific risk prediction models (revised Baux and Belgian Outcome in Burn Injury models) and one generic model (Intensive Care National Audit and Research Centre model) were compared. Patients in burn intensive care units had more extensive injuries compared with patients in general intensive care units (median (IQR [range]) burn surface area 16 (7-32 [0-98])% vs. 8 (1-18 [0-100])%, respectively) but in-hospital mortality was similar (22.8% vs. 19.0%, respectively). The discrimination and calibration of the generic Intensive Care National Audit and Research Centre model was superior to the revised Baux and Belgian Outcome in Burn Injury burn-specific models for patients managed on both specialist burn and general intensive care units. © 2018 The Association of Anaesthetists of Great Britain and Ireland.

Burn-center quality improvement: are burn outcomes dependent on admitting facilities and is there a volume-outcome "sweet-spot"?

PubMed

Hranjec, Tjasa; Turrentine, Florence E; Stukenborg, George; Young, Jeffrey S; Sawyer, Robert G; Calland, James F

2012-05-01

Risk factors of mortality in burn patients such as inhalation injury, patient age, and percent of total body surface area (%TBSA) burned have been identified in previous publications. However, little is known about the variability of mortality outcomes between burn centers and whether the admitting facilities or facility volumes can be recognized as predictors of mortality. De-identified data from 87,665 acute burn observations obtained from the National Burn Repository between 2003 and 2007 were used to estimate a multivariable logistic regression model that could predict patient mortality with reference to the admitting burn facility/facility volume, adjusted for differences in age, inhalation injury, %TBSA burned, and an additional factor, percent full thickness burn (%FTB). As previously reported, all three covariates (%TBSA burned, inhalation injury, and age) were found to be highly statistically significant risk factors of mortality in burn patients (P value < 0.0001). The additional variable, %FTB, was also found to be a statistically significant determinant, although it did not greatly improve the multivariable model. The treatment/admitting facility was found to be an independent mortality predictor, with certain hospitals having increased odds of death and others showing a protective effect (decreased odds ratio). Hospitals with high burn volumes had the highest risk of mortality. Mortality outcomes of patients with similar risk factors (%TBSA burned, inhalation injury, age, and %FTB) are significantly affected by the treating facility and their admission volumes.

Local Burn Injury Promotes Defects in the Epidermal Lipid and Antimicrobial Peptide Barriers in Human Autograft Skin and Burn Margin: Implications for Burn Wound Healing and Graft Survival

PubMed Central

Plichta, Jennifer K.; Holmes, Casey J.; Gamelli, Richard L.; Radek, Katherine A.

2016-01-01

Burn injury increases the risk of morbidity and mortality by promoting severe hemodynamic shock and risk for local or systemic infection. Graft failure due to poor wound healing or infection remains a significant problem for burn subjects. The mechanisms by which local burn injury compromises the epithelial antimicrobial barrier function in the burn margin, containing the elements necessary for healing of the burn site, and in distal unburned skin, which serves as potential donor tissue, are largely unknown. The objective of this study was to establish defects in epidermal barrier function in human donor skin and burn margin, in order to identify potential mechanisms that may lead to graft failure and/or impaired burn wound healing. In the present study, we established that epidermal lipids and respective lipid synthesis enzymes were significantly reduced in both donor skin and burn margin. We further identified diverse changes in the gene expression and protein production of several candidate skin antimicrobial peptides (AMPs) in both donor skin and burn margin. These results also parallel changes in cutaneous AMP activity against common burn wound pathogens, aberrant production of epidermal proteases known to regulate barrier permeability and AMP activity, and greater production of pro-inflammatory cytokines known to be induced by AMPs. These findings suggest that impaired epidermal lipid and AMP regulation could contribute to graft failure and infectious complications in subjects with burn or other traumatic injury. PMID:27183442

Epidemiology and financial implications of self-inflicted burns.

PubMed

George, S; Javed, M; Hemington-Gorse, S; Wilson-Jones, N

2016-02-01

The cost of the treatment of burns is high especially in self-inflicted burns with prolonged treatment. We performed a retrospective review of the self-inflicted burns at our regional burns centre to determine the costs incurred in their management and to identify factors which could reduce the financial burden in the future. The data was collected retrospectively of all the inpatient and outpatient self-inflicted burns presenting to our regional burns centre in the year 2011. Twenty one patients (out of a total of 870 patients) presented with self-inflicted burns to our centre in 2011. Five (23.8%) were major burns with an average of 53.2% Total Body Surface Area (TBSA) and 16 (76.2%) were minor burns with an average of 0.5% TBSA. 11 (52.4%) patients had flame burns including 4 self-immolation burns. The mortality rate was 4.8% (n=1). Five (23.8%) patients underwent surgical treatment. Seven (33.3%) patients were treated in intensive care and with average stay of 46.85 days. Critical care and theatre attendances made up most of the costs with average ICU stay per patient calculated at £313,131/day. The total cost of all 21 patients was £1,581,856. Burns are preventable injuries, early detection and intervention in patients with propensity to self-inflict burns can possibly reduce the costs of treatment in the future. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Etiology, incidence and gender-specific patterns of severe burns in a German Burn Center - Insights of 25 years.

PubMed

Schiefer, Jennifer Lynn; Perbix, Walter; Grigutsch, Daniel; Zinser, Max; Demir, Erhan; Fuchs, Paul Christian; Schulz, Alexandra

2016-05-01

Burns often require special treatment in specialized burn centers. One of the specialized German burn centers is located in Cologne-Merheim. Only little is known about the etiology of burns in Germany, their monthly distribution and changes over the past 25 years. We therefore retrospectively analyzed the etiology for all patients treated at the burn intensive care unit (BICU) of Cologne in the last 25 years and categorized them into groups. Thereafter all groups were analyzed according to distribution of age, gender and occurrence. In this way we were able to show that the number of severe burns did not decrease over the time under evaluation and that it did not show seasonal variation. Injured females were older than males but fewer in number. The highest numbers of burns were related to fire, followed by electricity, hot liquids, chemicals and heat contact. Work-related burns occurred mostly with males. However, most of the burns were not work-related for either gender. The number of burns in Germany and in the world is still high, and prevention strategies do not always have the desired effect. This study aims to fill the gap in published burn knowledge in Germany by way of describing the gender differences and etiology characteristics. It can therefore help to identify risks and expand effective burn prevention strategies. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Poverty, population density, and the epidemiology of burns in young children from Mexico treated at a U.S. pediatric burn facility.

PubMed

Patel, Dipen D; Rosenberg, Marta; Rosenberg, Laura; Foncerrada, Guillermo; Andersen, Clark R; Capek, Karel D; Leal, Jesus; Lee, Jong O; Jimenez, Carlos; Branski, Ludwik; Meyer, Walter J; Herndon, David N

2018-08-01

Children 5 and younger are at risk for sustaining serious burn injuries. The causes of burns vary depending on demographic, cultural and socioeconomic variables. At this pediatric burn center we provided medical care to children from Mexico with severe injuries. The purpose of this study was to understand the impact of demographic distribution and modifiable risk factors of burns in young children to help guide prevention. A retrospective chart review was performed with children 5 and younger from Mexico who were injured from 2000-2013. The medical records of 447 acute patients were reviewed. Frequency counts and percentages were used to identify geographic distribution and calculate incidence of burns. Microsoft Powermap software was used to create a geographical map of Mexico based on types of burns. A binomial logistic regression was used to model the incidence of flame burns as opposed to scald burns in each state with relation to population density and poverty percentage. In all statistical tests, alpha=0.05 for a 95% level of confidence. Burns were primarily caused by flame and scald injuries. Admissions from flame injuries were mainly from explosions of propane tanks and gas lines and house fires. Flame injuries were predominantly from the states of Jalisco, Chihuahua, and Distrito Federal. Scalds were attributed to falling in large containers of hot water or food on the ground, and spills of hot liquids. Scald injuries were largely from the states of Oaxaca, Distrito Federal, and Hidalgo. The odds of a patient having flame burns were significantly associated with poverty percentage (p<0.0001) and population density (p=0.0085). Increasing levels of poverty led to decrease in odds of a flame burn, but an increase in the odds of scald burns. Similarly, we found that increasing population density led to a decrease in the odds of a flame burn, but an increase in the odds of a scald burn. Burns in young children from Mexico who received medical care at this pediatric burn center were attributed to flame and scalds. Potential demographic associations have been identified. Different states in Mexico have diverse cultural and socioeconomic variables that may influence the etiology of burns in young children and this information may help efficiently tailor burn prevention campaigns for burn prevention efforts in each region. This information will be used to develop and help modify existing prevention campaigns. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

In vivo imaging of human burn injuries with polarization-sensitive optical coherence tomography

NASA Astrophysics Data System (ADS)

Kim, Ki Hean; Pierce, Mark C.; Maguluri, Gopi; Park, B. Hyle; Yoon, Sang June; Lydon, Martha; Sheridan, Robert; de Boer, Johannes F.

2012-06-01

The accurate determination of burn depth is critical in the clinical management of burn wounds. Polarization-sensitive optical coherence tomography (PS-OCT) has been proposed as a potentially non-invasive method for determining burn depth by measuring thermally induced changes in the structure and birefringence of skin, and has been investigated in pre-clinical burn studies with animal models and ex vivo human skin. In this study, we applied PS-OCT to the in-vivo imaging of two pediatric burn patients. Deep and superficial burned skins along with contralateral controls were imaged in 3D. The imaging size was 8 mm×6 mm×2 mm in width, length, and depth in the air respectively, and the imaging time was approximately 6 s per volume. Superficially burned skins exhibited the same layered structure as the contralateral controls, but more visible vasculature and reduced birefringence compared to the contralateral controls. In contrast, a deeply burned skin showed loss of the layered structure, almost absent vasculature, and smaller birefringence compared to superficial burns. This study suggested the vasculature and birefringence as parameters for characterizing burn wounds.

Spatial frequency domain imaging of burn wounds in a preclinical model of graded burn severity

NASA Astrophysics Data System (ADS)

Nguyen, John Quan; Crouzet, Christian; Mai, Tuan; Riola, Kathleen; Uchitel, Daniel; Liaw, Lih-Huei; Bernal, Nicole; Ponticorvo, Adrien; Choi, Bernard; Durkin, Anthony J.

2013-06-01

Frequent monitoring of early-stage burns is necessary for deciding optimal treatment and management. Both superficial and full thickness burns are relatively easy to diagnose based on clinical observation. In between these two extremes are superficial-partial thickness and deep-partial thickness burns. These burns, while visually similar, differ dramatically in terms of clinical treatment and are known to progress in severity over time. The objective of this study was to determine the potential of spatial frequency domain imaging (SFDI) for noninvasively mapping quantitative changes in chromophore and optical properties that may be an indicative of burn wound severity. A controlled protocol of graded burn severity was developed and applied to 17 rats. SFDI data was acquired at multiple near-infrared wavelengths over a course of 3 h. Burn severity was verified using hematoxylin and eosin histology. From this study, we found that changes in water concentration (edema), deoxygenated hemoglobin concentration, and optical scattering (tissue denaturation) to be statistically significant at differentiating superficial partial-thickness burns from deep-partial thickness burns.

Photoacoustic diagnosis of burns in rats: two-dimensional photo-acoustic imaging of burned tissue

NASA Astrophysics Data System (ADS)

Yamazaki, Mutsuo; Sato, Shunichi; Saito, Daizo; Okada, Yoshiaki; Kurita, Akira; Kikuchi, Makoto; Ashida, Hiroshi; Obara, Minoru

2003-06-01

We previously reported that for rat burn models, deep dermal burns and deep burns can be well differentiated by measuring the propagation time of the photoacoustic signals originated from the blood in the healthy skin tissue under the damaged tissue layer. However, the diagnosis was based on point measurement in the wound, and therefore site-dependent information on the injuries was not obtained; such information is very important for diagnosis of extended burns. In the present study, we scanned a photoacoustic detector on the wound and constructed two-dimensional (2-D) images of the blood-originated photoacoustic signals for superficial dermal burns (SDB), deep dermal burns (DDB), deep burns (DB), and healthy skins (control) in rats. For each burn model, site-dependent variation of the signal was observed; the variation probably reflects the distribution of blood vessels in the skin tissue. In spite of the variation, clear differentiation was obtained between SDB, DDB, and DB from the 2D images. The images were constructed as a function of post burn time. Temporal signal variation will be also presented.

Paediatric electrical burn injuries: experience from a tertiary care burns unit in North India

PubMed Central

Srivastava, S.; Patil, A.N.; Bedi, M.; Tawar, R.S.

2017-01-01

Summary Electrical burn injuries in the paediatric age group constitute a small proportion of all burn cases and cause significant morbidity and long-term psychosocial impact. The objective of this study was to evaluate various aspects of electrical burn injuries in the paediatric age group in our region. A retrospective review was done of all paediatric electrical burns admitted to a tertiary care burns unit over a period of 12 months (January 2016 to December 2016). There were 77 cases of electrical burns under the age of 16 years. High voltage burns predominated and older age groups were more frequently affected. Male:female ratio was 4.1:1. Amputations were required in 18 (23%), skin grafting in 52 (67%) and flap cover in 29 (37%) patients. There were unfavourable outcomes in 32% patients with a mortality rate of 7.8%. Significant association was found between unfavourable outcomes and high voltage burn injuries and length of hospital stay. The impact of electrical burn injuries is substantial and can be reduced by simple preventive measures such as educating parents, improving health infrastructure and adherence to safety regulations.

Multidecadal trends in area burned with high severity in the Selway-Bitterroot Wilderness Area 1880-2012

Treesearch

Penelope Morgan; Andrew T. Hudak; Ashley Wells; Sean A. Parks; L. Scott Baggett; Benjamin C. Bright; Patricia Green

2017-01-01

Multidecadal trends in areas burned with high severity shape ecological effects of fires, but most assessments are limited to ~30 years of satellite data. We analysed the proportion of area burned with high severity, the annual area burned with high severity, the probability areas burned with high severity and also the area reburned (all severities and high burn...

How to manage burns in primary care.

PubMed Central

Waitzman, A. A.; Neligan, P. C.

1993-01-01

Burns are common injuries; more than 200,000 occur in Canada annually. Nearly all burn injuries can be managed on on outpatient basis. Appropriate treatment depends on burn depth, extent, and location. Special types of burns, such as chemical, tar, and electrical injuries, need specific management strategies. Prevention through education is important to reduce the incidence of burns. Images Figure 2 Figure 3 PMID:8268745

Predicting the proportion of full-thickness involvement for any given burn size based on burn resuscitation volumes.

PubMed

Liu, Nehemiah T; Salinas, José; Fenrich, Craig A; Serio-Melvin, Maria L; Kramer, George C; Driscoll, Ian R; Schreiber, Martin A; Cancio, Leopoldo C; Chung, Kevin K

2016-11-01

The depth of burn has been an important factor often overlooked when estimating the total resuscitation fluid needed for early burn care. The goal of this study was to determine the degree to which full-thickness (FT) involvement affected overall 24-hour burn resuscitation volumes. We performed a retrospective review of patients admitted to our burn intensive care unit from December 2007 to April 2013, with significant burns that required resuscitation using our computerized decision support system for burn fluid resuscitation. We defined the degree of FT involvement as FT Index (FTI; percentage of FT injury/percentage of total body surface area (TBSA) burned [%FT / %TBSA]) and compared variables on actual 24-hour fluid resuscitation volumes overall as well as for any given burn size. A total of 203 patients admitted to our burn center during the study period were included in the analysis. Mean age and weight were 47 ± 19 years and 87 ± 18 kg, respectively. Mean %TBSA was 41 ± 20 with a mean %FT of 18 ± 24. As %TBSA, %FT, and FTI increased, so did actual 24-hour fluid resuscitation volumes (mL/kg). However, increase in FTI did not result in increased volume indexed to burn size (mL/kg per %TBSA). This was true even when patients with inhalation injury were excluded. Further investigation revealed that as %TBSA increased, %FT increased nonlinearly (quadratic polynomial) (R = 0.994). Total burn size and FT burn size were both highly correlated with increased 24-hour fluid resuscitation volumes. However, FTI did not correlate with a corresponding increase in resuscitation volumes for any given burn size, even when patients with inhalation injury were excluded. Thus, there are insufficient data to presume that those who receive more volume at any given burn size are likely to be mostly full thickness or vice versa. This was influenced by a relatively low sample size at each 10%TBSA increment and larger burn sizes disproportionately having more FT burns. A more robust sample size may elucidate this relationship better. Therapeutic/care management study, level IV.

Topical local anaesthetics (EMLA) inhibit burn-induced plasma extravasation as measured by digital image colour analysis.

PubMed

Jönsson, A; Mattsson, U; Tarnow, P; Nellgård, P; Cassuto, J

1998-06-01

Amide local anaesthetics have previously been shown to reduce oedema and improve dermal perfusion following experimental burns. Previous studies have used invasive techniques for burn oedema quantification which do not allow continuous monitoring in the same animal. The present study used digital image colour analysis to investigate the effect of topical local anaesthetics on burn-induced extravasation of Evans blue albumin. A standardised full-thickness burn injury (1 x 1 cm) was induced in the abdominal skin of anaesthetised rats. The burn area was subsequently covered with 0.5 g of lidocaine-prilocaine cream 5% (25 mg of each in 1 g; EMLA, ASTRA, Sweden) or placebo cream during the first hour post-burn. One hour after the burn trauma, animals received Evans blue dye intravenously. Skin colour appearances were recorded by macrophotography before the burn and 5, 60. 65, 90, 120, 150, and 180 min post-burn. Colour slides were digitised and colour changes were analysed using the normalised red-green-blue (n-rgb) colour system. Results showed a significant inhibition of Evans blue extravasation between 60 and 180 min post-burn in EMLA-treated animals versus controls. Topical local anaesthetics are potent inhibitors of burn-induced plasma albumin extravasation, probably by direct action on vascular permeability and by inhibition of various steps of the pathophysiological response after burn injury.

Human beta defensin-4 and keratinocyte growth factor gene expression in cultured keratinocyte and fibroblasts of burned patients.

PubMed

Noronha, Silvana Aparecida Alves Corrêa de; Noronha, Samuel Marcos Ribeiro de; Lanziani, Larissa Elias; Ipolito, Michele Zampieri; Ferreira, Lydia Masako; Gragnani, Alfredo

2014-01-01

To evaluate KGF and human beta defensin-4 (HBD-4) levels produced by dermic fibroblasts and keratinocytes cultivated from burned patients' skin samples. Keratinocytes and fibroblasts of 10 patients (four major burns, four minor burns and two controls) were primarily cultivated according to standard methods. HBD-4 and KGF genes were analyzed by quantitative PCR. In fibroblasts, KGF gene expression was 220±80 and 33.33±6.67 (M±SD; N=4), respectively for major and minor burn groups. In keratinocytes, KGF gene expression was 11.2±1.9 and 3.45±0.37 (M±SD; N=4), respectively for major and minor burn groups. In fibroblasts, HBD-4 gene expression was 15.0±4.0 and 11.5±0.5 (M±SD; N=4), respectively for major and minor burn. In keratinocyte, HBD-4 gene expression was 0.0±0.0 and 13.4±4.8 (M±SD; N=4), respectively for major and minor burn. KGF expression was increased in burn patient fibroblasts compared to control group. In keratinocytes culture, KGF suppression is inversely proportional to burn extension; it is active and increased in major burn but decreased in minor burn. HBD-4 expression was increased in fibroblasts and decreased in keratinocytes from all burned patients.

Tailorable Burning Behavior of Ti14 Alloy by Controlling Semi-Solid Forging Temperature.

PubMed

Chen, Yongnan; Yang, Wenqing; Zhan, Haifei; Zhang, Fengying; Huo, Yazhou; Zhao, Yongqing; Song, Xuding; Gu, Yuantong

2016-08-16

Semi-solid processing (SSP) is a popular near-net-shape forming technology for metals, while its application is still limited in titanium alloy mainly due to its low formability. Recent works showed that SSP could effectively enhance the formability and mechanical properties of titanium alloys. The processing parameters such as temperature and forging rate/ratio, are directly correlated with the microstructure, which endow the alloy with different chemical and physical properties. Specifically, as a key structural material for the advanced aero-engine, the burn resistant performance is a crucial requirement for the burn resistant titanium alloy. Thus, this work aims to assess the burning behavior of Ti14, a kind of burn resistant alloy, as forged at different semi-solid forging temperatures. The burning characteristics of the alloy are analyzed by a series of burning tests with different burning durations, velocities, and microstructures of burned sample. The results showed that the burning process is highly dependent on the forging temperature, due to the fact that higher temperatures would result in more Ti₂Cu precipitate within grain and along grain boundaries. Such a microstructure hinders the transport of oxygen in the stable burning stage through the formation of a kind of oxygen isolation Cu-enriched layer under the burn product zone. This work suggests that the burning resistance of the alloy can be effectively tuned by controlling the temperature during the semi-solid forging process.

[Epidemiological investigation on 2 133 hospitalized patients with electrical burns].

PubMed

Jiang, M J; Li, Z; Xie, W G

2017-12-20

Objective: To analyze the epidemiological characteristics of the hospitalized patients with electrical burns in Institute of Burns of Tongren Hospital of Wuhan University & Wuhan Third Hospital (hereinafter referred to as Institute of Burns of Wuhan Third Hospital), so as to provide reference for the prevention and treatment of electrical burns. Methods: Medical records of all hospitalized burn patients in Institute of Burns of Wuhan Third Hospital from January 2004 to December 2016 were collected. Genders, ages, social categories, seasons of injury, total burn areas, depths of wounds, electrical voltages of injury, sites of wound, treatment methods, amputation rates, lengths of hospital stay, operation costs, hospitalization costs, and treatment outcomes of the electrical burn patients were collected. Treatment methods, lengths of hospital stay, operation costs, and hospitalization costs of the thermal burn patients were collected and compared with those of the electrical burn patients. Electrical voltages of injury, amputation rates, operation costs, hospitalization costs, and treatment outcomes were compared and analyzed between the electrical contact burn patients and the electrical arc burn patients. Data were processed with Chi-square test and Wilcoxon rank-sum test. Results: During the 13 years, 23 534 burn patients were admitted to Institute of Burns of Wuhan Third Hospital, among whom 2 133 (9.1%) were with electrical burns, without obvious variation in admission number of electrical burn patients every year. There were 1 418 patients (66.5%) with electrical contact burns and 715 patients (33.5%) with electrical arc burns. The ratio of male to female was 11.2∶1.0 among the electrical burn patients with known genders. The proportions of three age groups of more than 20 years old and less than or equal to 30 years old, more than 30 years old and less than or equal to 40 years old, and more than 40 years old and less than or equal to 50 years old were relatively higher, which were 18.3% (391/2 133), 22.1% (471/2 133), and 24.6% (525/2 133), respectively. The first three social category groups in proportions were workers, peasants, and preschool children, which were 57.9% (1 235/2 133), 14.6% (311/2 133), and 6.0% (128/2 133), respectively. Among the electrical burn patients with known seasons of injury, most cases were injured in summer (659 cases, accounting for 34.1%), obviously more than the proportions in autumn (537 cases, accounting for 27.8%), spring (455 cases, accounting for 23.5%), and winter (283 cases, accounting for 14.6%), with χ (2) values from 8.414 to 149.573, P values below 0.01. The group of patients with total burn areas less than 10% total body surface area (TBSA) occupied the highest proportion (1 603 cases, accounting for 75.15%), among whom 229 (10.74%) were with scattered small wounds which were less than 1% TBSA. The percentage of electrical contact burn patients with deep wounds was 79.1% (1 122/1 418), which was obviously higher than 2.5% (18/715) of the electrical arc burn patients ( χ (2)=381.741, P <0.001). Among the patients with known electrical voltages of injury, patients injured by high voltage among the electrical contact burn patients accounted for 78.4% (469/598), which was obviously higher than 8.7% (11/127) of the electrical arc burn patients ( χ (2)=227.893, P <0.001). The most common wound site of the electrical burn patients was upper limbs (1 650 cases, accounting for 63.2%), followed by lower limbs (382 cases, accounting for 14.6%), head and neck (292 cases, accounting for 11.2%), trunk (247 cases, accounting for 9.5%), and hip and perineum (40 cases, accounting for 1.5%). The operation rate of electrical burn patients was 32.4% (691/2 133), obviously higher than 19.1% (3 860/20 209)of the thermal burn patients during the same period ( χ (2)=210.255, P <0.001). Wounds of 116 electrical contact burn patients were repaired with free flap by vascular anastomosis, of which 9 (7.8%) failed. The length of hospital stay, the operation cost, and the hospitalization cost of electrical burn patients were (28±29) d, (9 534±16 935) and (44 258±93 012) Yuan, respectively, obviously longer or higher than those of the thermal burn patients during the same period [(17±19) d, (2 990±8 916) and (23 291±88 340) Yuan, respectively, with Z values from -21.323 to -10.996, P values below 0.001]. The amputation rate and the death rate of electrical burn patients were 3.8% (82/2 133) and 0.8% (16/2 133) respectively. Compared with those of electrical arc burn patients, the amputation rate and the operation cost of electrical contact burn patients were obviously higher ( χ (2)=36.970, Z =-11.351, P values below 0.001), and the length of hospital stay of electrical contact burn patients was obviously longer ( Z =-5.181, P <0.001). There were no significant differences in hospitalization cost and treatment outcome between the electrical contact burn patients and the electrical arc burn patients ( Z =-1.461, χ (2)=1.673, P values above 0.05). Conclusions: The number and the proportion of hospitalized electrical burn patients in Institute of Burns of Wuhan Third Hospital were relatively high, indicating a hard task of prevention for electrical burns in Wuhan area. Working-age workers and farmers, and preschool children were the key groups in prevention from electrical burns. The length of hospital stay, the operation cost, and the hospitalization cost of electrical burn patients were obviously higher than those of thermal burn patients. The amputation rate and the operation cost of electrical contact burn patients were obviously higher than those of electrical arc burn patients, but there were no obvious differences in hospitalization cost or treatment outcome between them. Actively using tissue flaps including free flap to repair of wounds may be helpful to reduce the amputation rate, improve the results, and shorten the time of treatment.

Predictors of sustaining burn injury: does the use of common prevention strategies matter?

PubMed

Taira, Breena R; Cassara, Guy; Meng, Hongdao; Salama, Michael N; Chohan, Jasmine; Sandoval, Steven; Singer, Adam J

2011-01-01

The incidence of burn injury has decreased over the past several decades. Although this has been largely attributed to increased prevention awareness, few studies evaluate the effectiveness of implementing standard burn prevention strategies in preventing burn injury. The authors hypothesized that patients who sustain burns use burn prevention strategies less frequently than those who do not. This was a case-control study composed of a prospective survey questionnaire and retrospective burn registry query, which was performed in a suburban academic medical center with a burn unit. All burn patients seen by the burn service in the year 2008 and a nonrandom sample of nonburned emergency department patients and visitors during the same time period were enrolled. Demographics included age, gender, income, education, house type, insurance status, and prevention strategy usage including smoke alarms, carbon monoxide detectors, fire extinguishers, and escape plans. The primary outcome of interest in this study was burn injury. Chi-square tests were used to compare rates, Student's t-tests were used to compare mean values of continuous variables between burn patients and others, and multivariate logistic regression was used to determine the strongest predictors of sustaining burn injury. One hundred ninety-four burn patients and 348 nonburned emergency department patients and visitors were surveyed. Burn patients reported the same rates of smoke alarm usage (96.9 vs 96.3%, P = .692), carbon monoxide detectors (75.3 vs 67.2%, P = .05), and higher rates of fire extinguisher ownership (80.4 vs 72.7%, P = .045) when compared with others. In multivariable analysis, the strongest predictor of sustaining burn injury was less than high school education (odds ratio [OR] 3.61, 95% confidence interval [CI] 1.27-10.27), whereas English as a primary language (OR 0.48, 95% CI 0.26-0.89), a graduate degree (OR 0.10, 95% CI 0.02-0.42), income >$50,000 (OR 0.46, 95% CI 0.29-0.72), and keeping flammable liquids in a locked place (OR 0.59, 95% CI 0.44-0.80) were protective against burn injury. Smoke alarms (OR 0.75, 95% CI 0.22-2.61), fire extinguishers (OR 1.34, 95% CI 0.80-2.32), and having an escape plan (OR 0.85, 95% CI 0.56-1.29) were not protective. Patients who sustain burn injury use burn prevention strategies at similar rates when compared with those who do not. When holding demographic characteristics constant, utilization of most burn prevention strategies is not protective of sustaining burn injury. Those with lower levels of education and income remain more susceptible to burn injury.

A population-based study of the epidemiology of acute adult burns in Ecuador from 2005 to 2014.

PubMed

Ortiz-Prado, Esteban; Armijos, Luciana; Iturralde, Ana Lucia

2015-05-01

To describe the demographic, risk factor, occupational, and morbidity and mortality characteristics of burns in adults in Ecuador using national data. These data are from the only specialized public hospital in Ecuador that has a 12-bed burn unit. The National Institute of Statistics and Census provided data from the burn unit of the Hospital Eugenio Espejo, in Quito. Three different datasets pertaining to burn deaths, burn unit inpatient admissions, and hospital discharge were analyzed. Patients who died or were discharged before entering the burn unit were not included in this analysis. During the 10-year period, 1106 patients were admitted to the burn unit, men represent 69.37% with 768 cases and women represent 30.62% with 337 patients; the number of patients per year was on average 123 cases; the average age was 33-34 years old, with a range between 16 and 96 years old. Heat (thermal) burns represent 65.78% followed by electrical with 30.53%, friction burns with 2.06%, and chemical burns with 1.62%. Domestic methane gas was the most frequent agent causing thermal burns and the most affected occupational groups are construction workers and people who stay at home. The overall mortality is 10.2% and the average length of stay was 23 days. Thermal burns are more frequent than any other cause of burns. Electrical burns are more frequent in Ecuador than anywhere else according to our research, meaning that control and prevention of workplace safety, urban planning, and home safety are scarce. The most affected groups are those dedicated to labor work. Finally, mortality in hospitalized patient is higher when compared with developed countries. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Healthcare resource utilization and epidemiology of pediatric burn-associated hospitalizations, United States, 2000.

PubMed

Shields, Brenda J; Comstock, R Dawn; Fernandez, Soledad A; Xiang, Huiyun; Smith, Gary A

2007-01-01

The objective of this study was to describe the epidemiology and financial burden of burn-associated hospitalizations for children younger than 18 years in the United States. Retrospective data analysis of pediatric burn-associated hospitalizations was done using the Healthcare Cost and Utilization Project Kids' Inpatient Database for 2000. An estimated 10,000 children younger than 18 years were hospitalized for burn-associated injuries in the United States in 2000. These children spent an estimated 66,200 days in the hospital with associated hospital charges equal to USD 211,772,700. Total charges and length of stay for pediatric burn-associated hospitalizations in the United States during 2000 were associated with degree of burn, percentage of total body surface area burned, child's age, region of the United States, hospital location, and hospital type. Children 2 years old or younger were more likely to be nonwhite, be hospitalized for burns, and burn their hands/wrists, compared with children 3 to 17 years of age. Male children in both age groups were more likely to be hospitalized for burns than female children. Children 2 years old or younger were more likely to be burned by hot liquids/vapors and contact with hot substances/objects, while children 3 to 17 years were more likely to be burned by fire/flames. This study is the first national study on healthcare resource utilization for pediatric burn-associated hospitalizations to utilize the KID database. Burns are a major source of pediatric morbidity and are associated with significant national healthcare resource utilization annually. Future burn prevention efforts should emphasize implementing passive injury prevention strategies, especially for young children who are nonwhite and live in low-income communities.

IL-6 Signal From the Bone Marrow is Required for the Browning of White Adipose Tissue Post Burn Injury.

PubMed

Abdullahi, Abdikarim; Chen, Peter; Stanojcic, Mile; Sadri, Ali-Reza; Coburn, Natalie; Jeschke, Marc G

2017-01-01

The hypermetabolic stress response after burn contributes to multi-organ failure, sepsis, morbidity, and mortality. The cytokine interleukin 6 (IL-6) has been hypothesized to mediate not only white adipose tissue (WAT) browning in burns, but also other hypermetabolic conditions. In addition to its inflammatory effects, IL-6 also acts as a metabolic mediator that affects metabolic tissues. Therefore, we sought to uncover the origin of circulating IL-6 post burn injury that regulates WAT browning. WAT and sera samples were collected from both adult burn patients admitted to the Ross Tilley Burn Centre at Sunnybrook Hospital and mice subjected to a burn injury. Collected tissues were analyzed for browning markers and metabolic state via histology, gene expression, and resting energy expenditure. Increased WAT browning was observed in burn patients as well as mice subjected to burn injury. Circulating IL-6 levels were significantly elevated post burn injury in mice (<0.05) and in burn patients (<0.05), the latter of which was positively correlated with elevated REE. Genetic loss of whole body IL-6 in mice prevented burn-induced WAT browning. Transplanting IL-6 knockout (KO) mice with bone marrow (BM) from wild-type (WT) mice, recovered the browning phenotype in these mice, as evaluated by increased uncoupling protein 1 (UCP1) expression (<0.05). Conversely, transplanting irradiated WT mice with BM from IL-6 KO mice impaired burn induced browning with no significant expression of UCP1. Together, our findings implicate BM derived IL-6 as the source controlling browning of WAT post burn injury. Thus, targeting IL-6 is a promising target for hypermetabolism in burns.

ER stress and subsequent activated calpain play a pivotal role in skeletal muscle wasting after severe burn injury

PubMed Central

Shen, Chuanan; Li, Dawei; Wang, Xiaoteng

2017-01-01

Severe burns are typically followed by hypermetabolism characterized by significant muscle wasting, which causes considerable morbidity and mortality. The aim of the present study was to explore the underlying mechanisms of skeletal muscle damage/wasting post-burn. Rats were randomized to the sham, sham+4-phenylbutyrate (4-PBA, a pharmacological chaperone promoting endoplasmic reticulum (ER) folding/trafficking, commonly considered as an inhibitor of ER), burn (30% total body surface area), and burn+4-PBA groups; and sacrificed at 1, 4, 7, 14 days after the burn injury. Tibial anterior muscle was harvested for transmission electron microscopy, calcium imaging, gene expression and protein analysis of ER stress / ubiquitin-proteasome system / autophagy, and calpain activity measurement. The results showed that ER stress markers were increased in the burn group compared with the sham group, especially at post-burn days 4 and 7, which might consequently elevate cytoplasmic calcium concentration, promote calpain production as well as activation, and cause skeletal muscle damage/wasting of TA muscle after severe burn injury. Interestingly, treatment with 4-PBA prevented burn-induced ER swelling and altered protein expression of ER stress markers and calcium release, attenuating calpain activation and skeletal muscle damage/wasting after severe burn injury. Atrogin-1 and LC3-II/LC3-I ratio were also increased in the burn group compared with the sham group, while MuRF-1 remained unchanged; 4-PBA decreased atrogin-1 in the burn group. Taken together, these findings suggested that severe burn injury induces ER stress, which in turns causes calpain activation. ER stress and subsequent activated calpain play a critical role in skeletal muscle damage/wasting in burned rats. PMID:29028830

Imaging Techniques for Clinical Burn Assessment with a Focus on Multispectral Imaging

PubMed Central

Thatcher, Jeffrey E.; Squiers, John J.; Kanick, Stephen C.; King, Darlene R.; Lu, Yang; Wang, Yulin; Mohan, Rachit; Sellke, Eric W.; DiMaio, J. Michael

2016-01-01

Significance: Burn assessments, including extent and severity, are some of the most critical diagnoses in burn care, and many recently developed imaging techniques may have the potential to improve the accuracy of these evaluations. Recent Advances: Optical devices, telemedicine, and high-frequency ultrasound are among the highlights in recent burn imaging advancements. We present another promising technology, multispectral imaging (MSI), which also has the potential to impact current medical practice in burn care, among a variety of other specialties. Critical Issues: At this time, it is still a matter of debate as to why there is no consensus on the use of technology to assist burn assessments in the United States. Fortunately, the availability of techniques does not appear to be a limitation. However, the selection of appropriate imaging technology to augment the provision of burn care can be difficult for clinicians to navigate. There are many technologies available, but a comprehensive review summarizing the tissue characteristics measured by each technology in light of aiding clinicians in selecting the proper device is missing. This would be especially valuable for the nonburn specialists who encounter burn injuries. Future Directions: The questions of when burn assessment devices are useful to the burn team, how the various imaging devices work, and where the various burn imaging technologies fit into the spectrum of burn care will continue to be addressed. Technologies that can image a large surface area quickly, such as thermography or laser speckle imaging, may be suitable for initial burn assessment and triage. In the setting of presurgical planning, ultrasound or optical microscopy techniques, including optical coherence tomography, may prove useful. MSI, which actually has origins in burn care, may ultimately meet a high number of requirements for burn assessment in routine clinical use. PMID:27602255

Report From the California Burn Registry—The Causes of Major Burns

PubMed Central

Bongard, Frederic S.; Ostrow, Louis B.; Sacks, Susan T.; McGuire, Andrew; Trunkey, Donald D.

1985-01-01

In its first four years of operation, the California Burn Registry recorded 3,332 cases of burns, of which 73.1% were in male and 26.9% were in female patients of all ages. The average total body surface area burned was 15.4±0.3%. Flame burns were the most common (31.4%). Other common sources included scalds (24.5%) and flammable liquids (12.9%). Several other causes were cited with less frequency. Burns taking place at home occurred more commonly than at all other locations combined. In all, 221 deaths (6.6%) were reported, most (66.1%) of which were due to flame burns. PMID:4013280

Improving global fire carbon emissions estimates by combining moderate resolution burned area and active fire observations

NASA Astrophysics Data System (ADS)

Randerson, J. T.; Chen, Y.; Giglio, L.; Rogers, B. M.; van der Werf, G.

2011-12-01

In several important biomes, including croplands and tropical forests, many small fires exist that have sizes that are well below the detection limit for the current generation of burned area products derived from moderate resolution spectroradiometers. These fires likely have important effects on greenhouse gas and aerosol emissions and regional air quality. Here we developed an approach for combining 1km thermal anomalies (active fires; MOD14A2) and 500m burned area observations (MCD64A1) to estimate the prevalence of these fires and their likely contribution to burned area and carbon emissions. We first estimated active fires within and outside of 500m burn scars in 0.5 degree grid cells during 2001-2010 for which MCD64A1 burned area observations were available. For these two sets of active fires we then examined mean fire radiative power (FRP) and changes in enhanced vegetation index (EVI) derived from 16-day intervals immediately before and after each active fire observation. To estimate the burned area associated with sub-500m fires, we first applied burned area to active fire ratios derived solely from within burned area perimeters to active fires outside of burn perimeters. In a second step, we further modified our sub-500m burned area estimates using EVI changes from active fires outside and within of burned areas (after subtracting EVI changes derived from control regions). We found that in northern and southern Africa savanna regions and in Central and South America dry forest regions, the number of active fires outside of MCD64A1 burned areas increased considerably towards the end of the fire season. EVI changes for active fires outside of burn perimeters were, on average, considerably smaller than EVI changes associated with active fires inside burn scars, providing evidence for burn scars that were substantially smaller than the 25 ha area of a single 500m pixel. FRP estimates also were lower for active fires outside of burn perimeters. In our analysis we quantified how including sub-500m burned area influenced global burned area, carbon emissions, and net ecosystem exchange (NEE) in different continental regions using the Global Fire Emissions Database (GFED) biogeochemical model. We conclude by discussing validation needs using higher resolution visible and thermal imagery.

Fuel reduction and coarse woody debris dynamics with early season and late season prescribed fire in a Sierra Nevada mixed conifer forest

USGS Publications Warehouse

Knapp, E.E.; Keeley, J.E.; Ballenger, E.A.; Brennan, T.J.

2005-01-01

Fire exclusion has led to an unnatural accumulation and greater spatial continuity of organic material on the ground in many forests. This material serves both as potential fuel for forest fires and habitat for a large array of forest species. Managers must balance fuel reduction to reduce wildfire hazard with fuel retention targets to maintain other forest functions. This study reports fuel consumption and changes to coarse woody debris attributes with prescribed burns ignited under different fuel moisture conditions. Replicated early season burn, late season burn, and unburned control plots were established in old-growth mixed conifer forest in Sequoia National Park that had not experienced fire for more than 120 years. Early season burns were ignited during June 2002 when fuels were relatively moist, and late season burns were ignited during September/October 2001 when fuels were dry. Fuel loading and coarse woody debris abundance, cover, volume, and mass were evaluated prior to and after the burns. While both types of burns reduced fuel loading, early season burns consumed significantly less of the total dead and down organic matter than late season burns (67% versus 88%). This difference in fuel consumption between burning treatments was significant for most all woody fuel components evaluated, plus the litter and duff layers. Many logs were not entirely consumed - therefore the number of logs was not significantly changed by fire - but burning did reduce log length, cover, volume, and mass. Log cover, volume, and mass were reduced to a lesser extent by early season burns than late season burns, as a result of higher wood moisture levels. Early season burns also spread over less of the ground surface within the burn perimeter (73%) than late season burns (88%), and were significantly patchier. Organic material remaining after a fire can dam sediments and reduce erosion, while unburned patches may help mitigate the impact of fire on fire-sensitive species by creating refugia from which these species can recolonize burned areas. Early season burns may be an effective means of moderating potential ecosystem damage when treating heavy and/or continuous fuels resulting from long periods of fire exclusion, if burning during this season is not detrimental to other forest functions. ?? 2005 Elsevier B.V. All rights reserved.

In vivo burn diagnosis by camera-phone diffuse reflectance laser speckle detection.

PubMed

Ragol, S; Remer, I; Shoham, Y; Hazan, S; Willenz, U; Sinelnikov, I; Dronov, V; Rosenberg, L; Bilenca, A

2016-01-01

Burn diagnosis using laser speckle light typically employs widefield illumination of the burn region to produce two-dimensional speckle patterns from light backscattered from the entire irradiated tissue volume. Analysis of speckle contrast in these time-integrated patterns can then provide information on burn severity. Here, by contrast, we use point illumination to generate diffuse reflectance laser speckle patterns of the burn. By examining spatiotemporal fluctuations in these time-integrated patterns along the radial direction from the incident point beam, we show the ability to distinguish partial-thickness burns in a porcine model in vivo within the first 24 hours post-burn. Furthermore, our findings suggest that time-integrated diffuse reflectance laser speckle can be useful for monitoring burn healing over time post-burn. Unlike conventional diffuse reflectance laser speckle detection systems that utilize scientific or industrial-grade cameras, our system is designed with a camera-phone, demonstrating the potential for burn diagnosis with a simple imager.

Burn Wound Infections

PubMed Central

Church, Deirdre; Elsayed, Sameer; Reid, Owen; Winston, Brent; Lindsay, Robert

2006-01-01

Burns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. Significant thermal injuries induce a state of immunosuppression that predisposes burn patients to infectious complications. A current summary of the classifications of burn wound infections, including their diagnosis, treatment, and prevention, is given. Early excision of the eschar has substantially decreased the incidence of invasive burn wound infection and secondary sepsis, but most deaths in severely burn-injured patients are still due to burn wound sepsis or complications due to inhalation injury. Burn patients are also at risk for developing sepsis secondary to pneumonia, catheter-related infections, and suppurative thrombophlebitis. The introduction of silver-impregnated devices (e.g., central lines and Foley urinary catheters) may reduce the incidence of nosocomial infections due to prolonged placement of these devices. Improved outcomes for severely burned patients have been attributed to medical advances in fluid resuscitation, nutritional support, pulmonary and burn wound care, and infection control practices. PMID:16614255

In vivo burn diagnosis by camera-phone diffuse reflectance laser speckle detection

PubMed Central

Ragol, S.; Remer, I.; Shoham, Y.; Hazan, S.; Willenz, U.; Sinelnikov, I.; Dronov, V.; Rosenberg, L.; Bilenca, A.

2015-01-01

Burn diagnosis using laser speckle light typically employs widefield illumination of the burn region to produce two-dimensional speckle patterns from light backscattered from the entire irradiated tissue volume. Analysis of speckle contrast in these time-integrated patterns can then provide information on burn severity. Here, by contrast, we use point illumination to generate diffuse reflectance laser speckle patterns of the burn. By examining spatiotemporal fluctuations in these time-integrated patterns along the radial direction from the incident point beam, we show the ability to distinguish partial-thickness burns in a porcine model in vivo within the first 24 hours post-burn. Furthermore, our findings suggest that time-integrated diffuse reflectance laser speckle can be useful for monitoring burn healing over time post-burn. Unlike conventional diffuse reflectance laser speckle detection systems that utilize scientific or industrial-grade cameras, our system is designed with a camera-phone, demonstrating the potential for burn diagnosis with a simple imager. PMID:26819831

The determination of total burn surface area: How much difference?

PubMed

Giretzlehner, M; Dirnberger, J; Owen, R; Haller, H L; Lumenta, D B; Kamolz, L-P

2013-09-01

Burn depth and burn size are crucial determinants for assessing patients suffering from burns. Therefore, a correct evaluation of these factors is optimal for adapting the appropriate treatment in modern burn care. Burn surface assessment is subject to considerable differences among clinicians. This work investigated the accuracy among experts based on conventional surface estimation methods (e.g. "Rule of Palm", "Rule of Nines" or "Lund-Browder Chart"). The estimation results were compared to a computer-based evaluation method. Survey data was collected during one national and one international burn conference. The poll confirmed deviations of burn depth/size estimates of up to 62% in relation to the mean value of all participants. In comparison to the computer-based method, overestimation of up to 161% was found. We suggest introducing improved methods for burn depth/size assessment in clinical routine in order to efficiently allocate and distribute the available resources for practicing burn care. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Influence of rice straw burning on the levels of polycyclic aromatic hydrocarbons in agricultural county of Taiwan.

PubMed

Lai, Chia-Hsiang; Chen, Kang-Shin; Wang, Hsin-Kai

2009-01-01

Atmospheric particulate and polycyclic aromatic hydrocarbons (PAHs) size distribution were measured at Jhu-Shan (a rural site) and Sin-Gang (a town site) in central Taiwan during the rice straw burning and non-burning periods. The concentrations of total PAHs accounting for a roughly 58% (34%) increment in the concentrations of total PAHs due to rice-straw burning. Combustion-related PAHs during burning periods were 1.54-2.57 times higher than those during non-burning periods. The mass median diameter (MMD) of 0.88-1.21 microm in the particulate phase suggested that rice-straw burning generated the increase in coarse particle number. Chemical mass balance (CMB) receptor model analyses showed that the primary pollution sources at the two sites were similar. However, rice-straw burning emission was specifically identified as a significant source of PAH during burning periods at the two sites. Open burning of rice straws was estimated to contribute approximately 6.3%-24.6% to total atmospheric PAHs at the two sites.

Installation for burning-out scrap metal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gutschmidt, P.

1982-08-24

Disclosed is an installation for burning-out scrap metal goods for the purpose of reclaiming scrap metal, comprising at least one furnace wagon, which is capable of being loaded with the scrap metal goods to be burned out; at least one burning-out chamber into which the furnace wagon is movable for burning-out the scrap metal goods to produce scrap steel; means for heating the burning-out chamber to a temperature of at least about 600* C.; at least one afterburning chamber communicating with the burning-out chamber for afterburning flue gases produced in the burning-out chamber at a temperature from about 1100* tomore » 1200* C.; a waste gas purifying plant communicating with the afterburning chamber for eliminating the flue gas impurities and for the scrubbing of the flue-gases originating from the afterburning chamber; and at least one cooling chamber arranged adjacent to and in selective communication with the burning-out chamber for cooling the burned-out material.« less

The wound/burn guidelines - 6: Guidelines for the management of burns.

PubMed

Yoshino, Yuichiro; Ohtsuka, Mikio; Kawaguchi, Masakazu; Sakai, Keisuke; Hashimoto, Akira; Hayashi, Masahiro; Madokoro, Naoki; Asano, Yoshihide; Abe, Masatoshi; Ishii, Takayuki; Isei, Taiki; Ito, Takaaki; Inoue, Yuji; Imafuku, Shinichi; Irisawa, Ryokichi; Ohtsuka, Masaki; Ogawa, Fumihide; Kadono, Takafumi; Kawakami, Tamihiro; Kukino, Ryuichi; Kono, Takeshi; Kodera, Masanari; Takahara, Masakazu; Tanioka, Miki; Nakanishi, Takeshi; Nakamura, Yasuhiro; Hasegawa, Minoru; Fujimoto, Manabu; Fujiwara, Hiroshi; Maekawa, Takeo; Matsuo, Koma; Yamasaki, Osamu; Le Pavoux, Andres; Tachibana, Takao; Ihn, Hironobu

2016-09-01

Burns are a common type of skin injury encountered at all levels of medical facilities from private clinics to core hospitals. Minor burns heal by topical treatment alone, but moderate to severe burns require systemic management, and skin grafting is often necessary also for topical treatment. Inappropriate initial treatment or delay of initial treatment may exert adverse effects on the subsequent treatment and course. Therefore, accurate evaluation of the severity and initiation of appropriate treatment are necessary. The Guidelines for the Management of Burn Injuries were issued in March 2009 from the Japanese Society for Burn Injuries as guidelines concerning burns, but they were focused on the treatment for extensive and severe burns in the acute period. Therefore, we prepared guidelines intended to support the appropriate diagnosis and initial treatment for patients with burns that are commonly encountered including minor as well as moderate and severe cases. Because of this intention of the present guidelines, there is no recommendation of individual surgical procedures. © 2016 Japanese Dermatological Association.

Turbulent Burning Velocities of Two-Component Fuel Mixtures of Methane, Propane and Hydrogen

NASA Astrophysics Data System (ADS)

Kido, Hiroyuki; Nakahara, Masaya; Hashimoto, Jun; Barat, Dilmurat

In order to clarify the turbulent burning velocity of multi-component fuel mixtures, both lean and rich two-component fuel mixtures, in which methane, propane and hydrogen were used as fuels, were prepared while maintaining the laminar burning velocity approximately constant. A distinct difference in the measured turbulent burning velocity at the same turbulence intensity is observed for two-component fuel mixtures having different addition rates of fuel, even the laminar burning velocities are approximately the same. The burning velocities of lean mixtures change almost constantly as the rate of addition changes, whereas the burning velocities of the rich mixtures show no such tendency. This trend can be explained qualitatively based on the mean local burning velocity, which is estimated by taking into account the preferential diffusion effect for each fuel component. In addition, a model of turbulent burning velocity proposed for single-component fuel mixtures may be applied to two-component fuel mixtures by considering the estimated mean local burning velocity of each fuel.

Novel burn device for rapid, reproducible burn wound generation.

PubMed

Kim, J Y; Dunham, D M; Supp, D M; Sen, C K; Powell, H M

2016-03-01

Scarring following full thickness burns leads to significant reductions in range of motion and quality of life for burn patients. To effectively study scar development and the efficacy of anti-scarring treatments in a large animal model (female red Duroc pigs), reproducible, uniform, full-thickness, burn wounds are needed to reduce variability in observed results that occur with burn depth. Prior studies have proposed that initial temperature of the burner, contact time with skin, thermal capacity of burner material, and the amount of pressure applied to the skin need to be strictly controlled to ensure reproducibility. The purpose of this study was to develop a new burner that enables temperature and pressure to be digitally controlled and monitored in real-time throughout burn wound creation and compare it to a standard burn device. A custom burn device was manufactured with an electrically heated burn stylus and a temperature control feedback loop via an electronic microstat. Pressure monitoring was controlled by incorporation of a digital scale into the device, which measured downward force. The standard device was comprised of a heat resistant handle with a long rod connected to the burn stylus, which was heated using a hot plate. To quantify skin surface temperature and internal stylus temperature as a function of contact time, the burners were heated to the target temperature (200±5°C) and pressed into the skin for 40s to create the thermal injuries. Time to reach target temperature and elapsed time between burns were recorded. In addition, each unit was evaluated for reproducibility within and across three independent users by generating burn wounds at contact times spanning from 5 to 40s at a constant pressure and at pressures of 1 or 3lbs with a constant contact time of 40s. Biopsies were collected for histological analysis and burn depth quantification using digital image analysis (ImageJ). The custom burn device maintained both its internal temperature and the skin surface temperature near target temperature throughout contact time. In contrast, the standard burner required more than 20s of contact time to raise the skin surface temperature to target due to its quickly decreasing internal temperature. The custom burner was able to create four consecutive burns in less than half the time of the standard burner. Average burn depth scaled positively with time and pressure in both burn units. However, the distribution of burn depth within each time-pressure combination in the custom device was significantly smaller than with the standard device and independent of user. The custom burn device's ability to continually heat the burn stylus and actively control pressure and temperature allowed for more rapid and reproducible burn wounds. Burns of tailored and repeatable depths, independent of user, provide a platform for the study of anti-scar and other wound healing therapies without the added variable of non-uniform starting injury. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Novel burn device for rapid, reproducible burn wound generation

PubMed Central

Kim, J.Y.; Dunham, D.M.; Supp, D.M.; Sen, C.K.; Powell, H.M.

2016-01-01

Introduction Scarring following full thickness burns leads to significant reductions in range of motion and quality of life for burn patients. To effectively study scar development and the efficacy of anti-scarring treatments in a large animal model (female red Duroc pigs), reproducible, uniform, full-thickness, burn wounds are needed to reduce variability in observed results that occur with burn depth. Prior studies have proposed that initial temperature of the burner, contact time with skin, thermal capacity of burner material, and the amount of pressure applied to the skin need to be strictly controlled to ensure reproducibility. The purpose of this study was to develop a new burner that enables temperature and pressure to be digitally controlled and monitored in real-time throughout burn wound creation and compare it to a standard burn device. Methods A custom burn device was manufactured with an electrically heated burn stylus and a temperature control feedback loop via an electronic microstat. Pressure monitoring was controlled by incorporation of a digital scale into the device, which measured downward force. The standard device was comprised of a heat resistant handle with a long rod connected to the burn stylus, which was heated using a hot plate. To quantify skin surface temperature and internal stylus temperature as a function of contact time, the burners were heated to the target temperature (200 ± 5 °C) and pressed into the skin for 40 s to create the thermal injuries. Time to reach target temperature and elapsed time between burns were recorded. In addition, each unit was evaluated for reproducibility within and across three independent users by generating burn wounds at contact times spanning from 5 to 40 s at a constant pressure and at pressures of 1 or 3 lbs with a constant contact time of 40 s. Biopsies were collected for histological analysis and burn depth quantification using digital image analysis (ImageJ). Results The custom burn device maintained both its internal temperature and the skin surface temperature near target temperature throughout contact time. In contrast, the standard burner required more than 20 s of contact time to raise the skin surface temperature to target due to its quickly decreasing internal temperature. The custom burner was able to create four consecutive burns in less than half the time of the standard burner. Average burn depth scaled positively with time and pressure in both burn units. However, the distribution of burn depth within each time-pressure combination in the custom device was significantly smaller than with the standard device and independent of user. Conclusions The custom burn device's ability to continually heat the burn stylus and actively control pressure and temperature allowed for more rapid and reproducible burn wounds. Burns of tailored and repeatable depths, independent of user, provide a platform for the study of anti-scar and other wound healing therapies without the added variable of non-uniform starting injury. PMID:26803369

Methylated spirit burns: an ongoing problem.

PubMed

Jansbeken, J R H; Vloemans, A F P M; Tempelman, F R H; Breederveld, R S

2012-09-01

Despite many educational campaigns we still see burns caused by methylated spirit every year. We undertook a retrospective study to analyse the impact of this problem. We retrospectively collected data of all patients with burns caused by methylated spirit over twelve years from 1996 to 2008. Our main endpoints were: incidence, age, mechanism of injury, total body surface area (TBSA) burned, burn depth, need for surgery and length of hospital stay. Ninety-seven patients with methylated spirit burns were included. During the study period there was no decrease in the number of patients annually admitted to the burn unit with methylated spirit burns. 28% of the patients (n=27) were younger than eighteen years old, 15% (n=15) were ten years old or younger. The most common cause of burns was carelessness in activities involving barbecues, campfires and fondues. Mean TBSA burned was 16% (SD 12.4). 70% (n=68) had full thickness burns. 66% (n=64) needed grafting. Mean length of hospital stay was 23 days (SD 24.7). The use of methylated spirit is an ongoing problem, which continues to cause severe burns in adults and children. Therefore methylated spirit should be banned in households. We suggest sale only in specialised shops, clear labelling and mandatory warnings. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Epidemiologic characteristics, knowledge and risk factors of unintentional burns in rural children in Zunyi, Southwest China

PubMed Central

Shi, Shangpeng; Yang, Huajun; Hui, Ya; Zhou, Xiang; Wang, Tao; Luo, Ya; Xiang, Huiyun; Shi, Xiuquan

2016-01-01

We investigated the knowledge level and risk factors for pediatric unintentional burns in rural Southwest China with an aim to provide basic evidence for the prevention strategies. A stratified sampling method was used to recruit 1842 rural children from 9 schools. Self-reported burns during the past 12 months and relevant risk factors were collected by questionnaires. The burn incidence of all surveyed children was 12.7% (95% confidence interval [95% CI] 11.2–14.2%). We found that burn incidence had a trend to increase with the increasing school grade level and a trend to decrease with increasing knowledge scores on burns. The top two causes of burns were hot liquids (36.3%) and hot object (29.5%). More than 30% of children had little knowledge about preventive measures and how to give first-aid after burns. The main risk factors for burns included female gender, left-behind children by parents who were working in cities, and poor mother school education level. As the incidence of pediatric unintentional burns was high in rural southwest China, schools, families, and local public health agencies should put efforts into health education targeting burn prevention and first-aid measures after burns, particularly in “left-behind” children and those with mothers with poor education. PMID:27748426

Epidemiology of burns caused by moxibustion in Korea.

PubMed

Yoon, Cheonjae; Cho, Young Soon; Park, Seungchoon; Chung, Sung Phil; Choi, Young Hwan

2016-11-01

Moxibustion, a traditional Chinese treatment that uses dried Artemisia argyi, is a common cause of burns treated in Korean hospitals. We aimed to examine the characteristics of moxibustion-induced burns. This retrospective study examined the records of 59 patients who were treated for moxibustion-induced burns (April 2014-October 2015). All patients completed a questionnaire regarding their general characteristics and moxibustion use. The patients included 16 men and 43 women (average age: 49.1 years, 68 burn sites). Superficial second-degree burns were present at 21 sites, deep second- or third-degree burns at 44 sites, and unknown burns at 3 sites. The most common sites were the lower extremities, abdomen, and upper extremities. The most common practitioners were the patients (27/59, 45.7%) and Oriental medicine practitioners (23/59, 38.9%). The most common locations were the patient's home, Oriental medicine clinic, and moxibustion clinic. The most common reason for moxibustion was pain. Only the burn site was significantly associated with burn depth, and non-abdominal sites were 9.37-fold more likely to involve deep burns (vs. abdominal sites). Korean patients routinely undergo moxibustion, and care must be taken when using moxibustion at non-abdominal sites, due to the risk of deep burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Role of burning season on initial understory vegetation response to prescribed fire in a mixed conifer forest

USGS Publications Warehouse

Knapp, E.E.; Schwilk, D.W.; Kane, J.M.; Keeley, J.E.

2007-01-01

Although the majority of fires in the western United States historically occurred during the late summer or early fall when fuels were dry and plants were dormant or nearly so, early-season prescribed burns are often ignited when fuels are still moist and plants are actively growing. The purpose of this study was to determine if burn season influences postfire vegetation recovery. Replicated early-season burn, late-season burn, and unburned control units were established in a mixed conifer forest, and understory vegetation was evaluated before and after treatment. Vegetation generally recovered rapidly after prescribed burning. However, late-season burns resulted in a temporary but significant drop in cover and a decline in species richness at the 1 m 2 scale in the following year. For two of the several taxa that were negatively affected by burning, the reduction in frequency was greater after late-season than early-season burns. Early-season burns may have moderated the effect of fire by consuming less fuel and lessening the amount of soil heating. Our results suggest that, when burned under high fuel loading conditions, many plant species respond more strongly to differences in fire intensity and severity than to timing of the burn relative to stage of plant growth. ?? 2007 NRC.

Differences between intentional and non-intentional burns in India: implications for prevention.

PubMed

Natarajan, Mangai

2014-08-01

Non-intentional and deliberate burns in India and other developing countries present particular challenges of prevention and treatment. This exploratory study sought improved understanding of burns in order to inform treatment and prevention. It gathered data in 2011/2012 on burns from the hospital registry (N=768) of a government hospital in India and from interviews with women patients (N=60) admitted to the burns ward. Analysis indicated that: (1) the conditions that facilitate intentional and non-intentional burns are similar, but intentional burns involve additional contributory factors; (2) a high proportion of patients subjected to burns are young women in domestic situations; and (3) a higher proportion of their TBSA was burned, with consequent higher mortality than for men. It was concluded that: (1) Haddon's matrix and the situational crime prevention framework of criminology assist in understanding the etiology of intentional burns and in identifying preventive measures; (2) social service and criminal justice agencies have important roles in dealing with victims of intentional burns during and after treatment; (3) full account should be taken of gender-related physical, psychological and family factors in planning treatment; and (4) maintaining careful records of burns cases is vital for estimating the prevalence and incidence of intentional injuries. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

A review of burns patients admitted to the Burns Unit of Hospital Universiti Kebangsaan Malaysia.

PubMed

Chan, K Y; Hairol, O; Imtiaz, H; Zailani, M; Kumar, S; Somasundaram, S; Nasir-Zahari, M

2002-12-01

This is a retrospective review of 110 patients admitted to the Burns Units between October 1999 and November 2001. The aim was to determine the burns pattern of patients admitted to hospital UKM. There was an increasing trend for patients admitted. Female to male ratio was 1:2. Children consisted 34% of the total admission. Children had significant higher number of scald burns as compare to adult (p < 0.01). Domestic burns were consist of 75% overall admission. Mean percentage of TBSA (total body surface area) burns was 19%. Thirty percent of patients sustained more than 20% of TBSA. Sixty percent of patients had scald burns. Ninety percents of patients with second degree burns that were treated with biologic membrane dressing or split skin graft. Mean duration of hospital stay was 10 days. Over 70% of patients were discharged within 15 days. Overall mortality rate was 6.3%. The patients who died had significantly larger area of burns of more than 20% TBSA (p < 0.05) and a higher incidence of inhalation injury (p < 0.02). Hence, this study suggests a need for better preventive measures by the authority to prevent burns related accident and the expansion of the service provided by the Burns Unit.

Burn-related factors affecting anxiety, depression and self-esteem in burn patients: an exploratory study.

PubMed

Jain, M; Khadilkar, N; De Sousa, A

2017-03-31

Burns are physically, psychologically and economically challenging injuries, and the factors leading to them are many and under-studied. The aim of the current study was to assess level of anxiety, depression and self-esteem in burn patients, and look at various burn-related variables that affect them. This cross-sectional study included 100 patients with burn injuries admitted to a tertiary care private hospital in an urban metropolis in India. The patients were assessed for anxiety, depression and self-esteem using the Hamilton anxiety rating scale, Hamilton depression rating scale and Rosenberg self-esteem scale respectively. Assessment was carried out within 2-8 weeks of injury following medical stabilization. The data was tabulated and statistically analyzed. The study sample was predominantly male (54%), married (69%), with a mean age of 34.1 ± 10.8 years. Accidental burns (94%) were the most common modality of injury. The majority (46%) suffered burns involving 20-59% total body surface area (TBSA), and facial burns were present (57%). No significant association was found between TBSA and anxiety, depression or self-esteem, and the same was true for facial burns. Deep burns, however, were significantly associated with anxiety (p=0.03) and depression (p=0.0002). High rates of anxiety and depression are associated with burn injuries and related to burn depth. Adjustment and recovery in these patients depends on various other factors like the patient's psychological status, nature/extent of the injury and ensuing medical care. Further research is warranted to reveal the magnitude and predictors of psychological problems in burn patients.

Short-term effects of burn season on flowering phenology of savanna plants

USGS Publications Warehouse

Pavlovic, N.B.; Leicht-Young, S. A.; Grundel, R.

2011-01-01

We examined the effect of season of burn on flowering phenology of groundlayer species, in the year following burns, in a mesic-sand Midwestern oak savanna. Burn treatments were fall, early-season, growing-season, late-season, and 1 or 5 years after a prior early-season wildfire. For these treatments, we compared the number of flowering stems and of flowers for species overall, for the 20 most prolifically flowering species, as well as for species grouped by flowering phenoperiods, and by growth form. Growing-season burn had a significant negative effect on number of flowering stems and total number of flowers. This effect occurred when either the burn occurred during the flowering season or during the season prior to the flowering phenoperiod. Tradescantia ohiensis showed expedited flowering and Phlox pilosa showed delayed flowering in response to early-season burning. Flowering of early shrubs was reduced by the previous fall and early-spring fires, while flowering of mid-season blooming shrubs was reduced by the early- and growing-season burns. Vaccinium and Gaylussacia, early-flowering shrubs, produced fewer flowers 1 year after than 5 years after an early-season burn. Arabis lyrata showed reduced flowering from the early-season burn. We also found four instances where the early-spring burn effect on flowering was more severe than the fall burn effect, suggesting that many frequent early-season burns may be deleterious to flowering and reproduction of some species. Burns occurring too frequently in the same season could negatively affect future flowering and reproduction of these plant species.

Cost analysis of acute burn patients treated in a burn centre: the Gulhane experience

PubMed Central

Sahin, I.; Ozturk, S.; Alhan, D.; Açikel, C.; Isik, S.

2011-01-01

Summary Even if calculating the exact cost of burn treatment is a very hard task, the study of cost analysis provides financial perspective. We performed a cost analysis study in our burn centre to respond to questions about total patient treatment cost and the length of hospital stay. We reviewed all patients admitted to the Gulhane Military Medical Academy Burn Centre in Ankara, Turkey, between March 2005 and August 2008. Forty-three patients with major burns were identified on the basis of the study criteria. The data regarding total treatment cost and the length of hospital stay for each type of burn (flame, scald, electric) were collected at the end of the study. The average total body surface area burned was 36 ± 7%.. The average duration of hospital stay was 73 ± 33 days. Patients with electrical burns stayed longer in hospital than patients with other types of burn injuries. Each one per cent of burn corresponded to a mean hospital stay of two days. The overall mean total cost was $US 15,250. The mean total cost of electrical burns was the highest, with $US 22,501 ± 24,039. Even if the costs associated with burn injury are higher than some other well-known health-related problems, they have not been much studied. Reports have produced different results, but it should be kept in mind that although the results of cost analysis studies may vary they must be performed in all newly established burn centres in order to form a financial overview. PMID:21991233

Care of the Critically Ill Burn Patient. An Overview from the Perspective of Optimizing Palliative Care.

PubMed

Ray, Daniel E; Karlekar, Mohana B; Crouse, Donnelle L; Campbell, Margaret; Curtis, J Randall; Edwards, Jeffrey; Frontera, Jennifer; Lustbader, Dana R; Mosenthal, Anne C; Mulkerin, Colleen; Puntillo, Kathleen A; Weissman, David E; Boss, Renee D; Brasel, Karen J; Nelson, Judith E

2017-07-01

Burn specialists have long recognized the need for and have role modeled a comprehensive approach incorporating relief of distress as part of care during critical illness. More recently, palliative care specialists have become part of the healthcare team in many U.S. hospitals, especially larger academic institutions that are more likely to have designated burn centers. No current literature describes the intersection of palliative care and burn care or integration of primary and specialist palliative care in this unique context. This Perspective gives an overview of burn care; focuses on pain and other symptoms in burn intensive care unit settings; addresses special needs of critically ill burned patients, their families, and clinicians for high-quality palliative care; and highlights potential benefits of integrating primary and specialist palliative care in burn critical care. MEDLINE and the Cumulative Index to Nursing and Allied Health Literature were searched, and an e-mail survey was used to obtain information from U.S. Burn Fellowship Program directors about palliative medicine training. The Improving Palliative Care in the Intensive Care Unit Project Advisory Board synthesized published evidence with their own research and clinical experience in preparing this article. Mortality and severe morbidity for critically ill burned patients remains high. American Burn Association guidelines lay the foundation for a robust system of palliative care delivery, embedding palliative care principles and processes in intensive care by burn providers. Understanding basic burn care, challenges for symptom management and communication, and the culture of the particular burn unit, can optimize quality and integration of primary and specialist palliative care in this distinctive setting.

Comparison of combat and non-combat burns from ongoing U.S. military operations.

PubMed

Kauvar, David S; Cancio, Leopoldo C; Wolf, Steven E; Wade, Charles E; Holcomb, John B

2006-05-15

Military burns result from either combat or non-combat causes. We compared these etiologies from patients involved in ongoing conflicts to evaluate their impact and provide prevention recommendations. All military patients with significant burns treated at the United States Army Institute of Surgical Research from April 2003 to May 2005 were reviewed. Injuries were categorized as having resulted from combat or non-combat causes. Demographics, burn severity and pattern, mortality, and early outcomes were compared. There were 273 burn patients seen with 63% injured in combat. A high early rate of non-combat injuries was noted. Feedback on non-combat burn prevention was provided to the combat theater, and the incidence of non-combat burns decreased. Mean age and time from injury to admission did not differ. The majority of combat injuries resulted from explosive device detonation. Waste burning, ammunition handling, and gasoline caused most non-combat injuries. Combat casualties had more associated and inhalation injuries and greater full-thickness burn size; total body surface area burned was equivalent. The hands and the face were the most frequently burned body areas. Mortality was 5% in combat and 2% in non-combat patients. The majority of survivors in both groups returned to military duty. The disparity in full-thickness burn size and incidence of inhalation and associated injuries resulted from differing mechanisms of injury, with explosions and penetrating trauma more common in combat wounds. Despite the severity of combat burns, mortality was low and outcomes generally good. Non-combat burns are preventable and have decreased in incidence.

NASA Electronic Parts and Packaging (NEPP) Program

NASA Technical Reports Server (NTRS)

Agarwal, Shri

2012-01-01

Recent Findings from Audits, New Technology Data Reviews a) Disabled Chip Burn-ins A recent audit for a QML device discovered that the chip was disabled during the static burn-in, thus it was not drawing any current. Recommendation: For new SMDs add a statement within the burn-in paragraphs stating that the parts shall be kept in their enabled state during the burn-in. b) Class Q 160-hr/125oC Burn-in This is being interpreted as a static burn-in (even for CMOS technology). Recommendation: Provide clarification in MIL-STD-883, Test Method 5004. c) At Frequency (Dynamic) Burn-ins Test equipment limitation is being cited for not doing burn-ins at the application frequency. Recommendation: The burn-in task group to discuss and provide guidance. When the SMD says that the part can be used at 200 MHz, then doing burn-in at 6 MHz (cited as burn-in equipment limitation frequency) is not going to be meaningful! d) Two Static Burn-ins Some manufacturers are doing electrical testing between the two static burn-ins, whereas others do electricals after completing both static burn-ins. Recommendation: Provide clarification in MIL-STD-883, Test Method 5004. e) Thermal Imaging For a device with hot spots, the thermal resistance, junction-to-case, would be much higher than the guidelines given in MIL-STD-1835. One of the suppliers used thermal imaging to find hot spots on the die. Recommendation: Assign a task group to evaluate the effectiveness of thermal imaging at the product development stage.

A survey of burn professionals regarding the mental health services available to burn survivors in the United States and United Kingdom.

PubMed

Lawrence, John W; Qadri, Ali; Cadogan, Julia; Harcourt, Diana

2016-06-01

This investigation surveyed burn health professionals in the UK and US to investigate the psychosocial issues facing burn survivors and the psychological services available to them through their burns service. One hundred and sixty six burn care professionals (132 from the United States and 34 from the United Kingdom) from 76 different hospitals (60 in the US and 16 in the UK) completed an online survey. Mental health practitioners (MHPs) answered questions regarding their psychotherapy practice with burn survivors. Respondents reported that psychosocial issues are common among burn survivors. Burn teams in the UK were more likely than those in the US to include psychologists, but social workers were more common in the US. Participants reported that routine screening for psychosocial issues was more common in the UK than the US, and indicated it was easier for burn survivors to access mental health care after discharge in the UK. Burn services in both countries routinely referred burn survivors to support organizations such as the Phoenix Society or Changing Faces. The preferred mental health treatment modality in the UK was psychotherapy without medications. Reported psychotropic medications use was more common in the US. MHPs had two primary orientations - eclectic and cognitive behavioral therapy. Among MHPs there was a modest tendency to favor evidence-based interventions. The provision of mental health services varies between these two countries. Creating international standards for assessing and treating psychosocial complications of burns could facilitate the improvement of burn mental health services. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Evaluating the socioeconomic and cultural factors associated with pediatric burn injuries in Maputo, Mozambique.

PubMed

Karan, Abraar; Amado, Vanda; Vitorino, Pio; Kulber, David; Taela, Atanasio; DeUgarte, Daniel A

2015-11-01

Pediatric burn injuries are one of the leading causes of preventable morbidity and mortality in Sub-Saharan Africa. Research on the complex system of social, economic and cultural factors contributing to burn injuries in this setting is much needed. We conducted a prospective questionnaire-based analysis of pediatric burn patients presenting to the Hospital Central de Maputo. A total of 39 patients were included in the study. Interviews were conducted with the children's caretakers by two trained medical students at the Eduardo Mondlane Medical School in Maputo with the aid of local nursing staff. Most burns occurred from scald wounds (26/39) particularly from bathwater, followed by fire burns (11/39). Burns occurred more frequently in the afternoon (16/39) and evening (16/39). Over one quarter of burns (9/33) occurred in the absence of a caretaker. One-third (12/36) of participants attempted to treat the burn at home prior to bringing the child into the hospital, and roughly two-thirds (24/37) reported using traditional remedies for burn care. The average household had just 2 rooms for an average of 5 family members. Most burns were second degree (25/37). Prevention efforts in this setting are much needed and can be implemented taking complex cultural and social factors into account. Education regarding regulation of water temperature for baths is important, given the prevalence of scald burns. Moreover, the introduction of low-cost, safer cooking technology can help mitigate inhalation injury and reduce fire burns. Additionally, burn care systems must be integrated with local traditional medical interventions to respect local cultural medicinal practices.

Health-related quality of life (EQ-5D) early after injury predicts long-term pain after burn.

PubMed

Gauffin, Emelie; Öster, Caisa; Sjöberg, Folke; Gerdin, Bengt; Ekselius, Lisa

2016-12-01

Chronic pain after burn can have severe physical and psychological effects on former patients years after the initial injury. Although the issue of pain after burn has gained increased attention over the past years, prospective, longitudinal studies are scarce. Our aim was to prospectively investigate consecutive burn patients for pain severity over time and to evaluate the prevalence and characteristics of post-burn pain to 2-7 years after the burn. As an additional aim, the effects of burn and individual-related factors, especially health-related Quality of Life (HRQoL), were investigated. Sixty-seven consecutive burn patients were assessed during acute care at 3, 6, 12 and 24 months, as well as at 2-7 years post-burn. HRQoL, symptoms of post-traumatic stress disorder (PTSD) and other psychiatric disorders were investigated. During the interviews that took place 2-7 years after the injury (mean 4.6±1.9 years), current chronic post-burn pain was assessed using the Brief Pain Inventory-Short Form (BPI-SF). One-third of the patients still reported pain 2-7 years after the injury. Pain severity and interference with daily life were mainly mild to moderate though they were found to be associated with significantly lower HRQoL. Chronic pain after burn was associated with both burn- and individual-related factors. In logistic regression analysis HRQoL at 3 and 12 months and symptoms of PTSD at 12 months were independent factors in predicting chronic pain after burn. Pain after burn becomes a chronic burden for many former burn patients and decreases HRQoL. A novel finding in this study was that HRQoL assessed early after burn was a predictor for the development of chronic pain. This finding may help to predict future pain problems and serve as an indicator for pain preventive measures. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Differential acute and chronic effects of burn trauma on murine skeletal muscle bioenergetics

PubMed Central

Porter, Craig; Herndon, David N.; Bhattarai, Nisha; Ogunbileje, John O.; Szczesny, Bartosz; Szabo, Csaba; Toliver-Kinsky, Tracy; Sidossis, Labros S.

2015-01-01

Altered skeletal muscle mitochondrial function contributes to the pathophysiological stress response to burns. However, the acute and chronic impact of burn trauma on skeletal muscle bioenergetics remains poorly understood. Here, we determined the temporal relationship between burn trauma and mitochondrial function in murine skeletal muscle local to and distal from burn wounds. Male BALB/c mice (8–10 weeks old) were burned by submersion of the dorsum in water (~95°C) to create a full thickness burn on ~30% of the body. Skeletal muscle was harvested from spinotrapezius underneath burn wounds (local) and the quadriceps (distal) of sham and burn treated mice at 3h, 24h, 4d and 10d post-injury. Mitochondrial respiration was determined in permeabilized myofiber bundles by high-resolution respirometry. Caspase 9 and caspase 3 protein concentration were determined by western blot. In muscle local to burn wounds, respiration coupled to ATP production was significantly diminished at 3h and 24h post-injury (P<0.001), as was mitochondrial coupling control (P<0.001). There was a 5- (P<0.05) and 8-fold (P<0.001) increase in respiration in response to cytochrome at 3h and 24h post burn, indicating damage to the outer mitochondrial membranes. Moreover, we also observed greater active caspase 9 and caspase 3 in muscle local to burn wounds, indicating the induction of apoptosis. Distal muscle mitochondrial function was unaltered by burn trauma until 10d post burn, where both respiratory capacity (P<0.05) and coupling control (P<0.05) was significantly lower than sham. These data highlight a differential response in muscle mitochondrial function to burn trauma, where the timing, degree and mode of dysfunction are dependent on whether the muscle is local or distal to the burn wound. PMID:26615714

A clinico-epidemiological study of rescuer burns.

PubMed

Basra, Baljeet Kumar; Suri, Manav P; Patil, Nilesh; Atha, Ravish; Patel, Natvar; Sachde, Jayesh P; Shaikh, M F

2014-08-01

Rescuer burn is a relatively newer terminology introduced to define the burns sustained by a person attempting to rescue a primary burn victim. Few studies have been published thus far on this peculiar type of burns. Due to the general neglect of the rescuer burns victim and discontinuation of treatment in most cases, once the primary victim dies, the rescuer often ends up in badly infected wounds and has a delayed return to work. A prospective study was conducted at the B J Medical College and Civil Hospital, Ahmedabad from January 2009 to December 2012 on the rescuer burns patients treated in its burns and plastic surgery department. 3074 patients of burns received treatment during the period of study. Of these, 48 patients gave the history of sustaining burns while trying to rescue a burns victim. Male to female ratio of rescuers was approximately 7:1. It was significantly higher as compared to the ratio of 1:0.8 of females to male burn victims observed at our centre (p≤0.01). Average age of the rescuers was higher in males as compared to females but the difference was not significant (p≥0.05). Of the 45 cases of female primary burns victims, male rescuer was husband of the primary victim in 41/45 cases (91.1%), mother was rescuer in three cases (6.6% cases) and sister was rescuer in one case. Though multiple people came to rescue a burns victim, in all cases, it was seen that it was the first rescuer who sustained burns himself or herself. None of the rescuers had any knowledge of the techniques and precautions to be taken while performing a rescue operation irrespective of their education status, indirectly pointing to the lack of any teaching on burns rescue in the school education curriculum. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

The effect of prescribed burning on plant rarity in a temperate forest.

PubMed

Patykowski, John; Holland, Greg J; Dell, Matt; Wevill, Tricia; Callister, Kate; Bennett, Andrew F; Gibson, Maria

2018-02-01

Rare species can play important functional roles, but human-induced changes to disturbance regimes, such as fire, can inadvertently affect these species. We examined the influence of prescribed burns on the recruitment and diversity of plant species within a temperate forest in southeastern Australia, with a focus on species that were rare prior to burning. Floristic composition was compared among plots in landscapes before and after treatment with prescribed burns differing in the extent of area burnt and season of burn (before-after, control-impact design). Floristic surveys were conducted before burns, at the end of a decade of drought, and 3 years postburn. We quantified the effect of prescribed burns on species grouped by their frequency within the landscape before burning (common, less common, and rare) and their life-form attributes (woody perennials, perennial herbs or geophytes, and annual herbs). Burn treatment influenced the response of rare species. In spring-burn plots, the recruitment of rare annual herbs was promoted, differentiating this treatment from both autumn-burn and unburnt plots. In autumn-burn plots, richness of rare species increased across all life-form groups, although composition remained statistically similar to control plots. Richness of rare woody perennials increased in control plots. For all other life-form and frequency groups, the floristic composition of landscapes changed between survey years, but there was no effect of burn treatment, suggesting a likely effect of rainfall on species recruitment. A prescribed burn can increase the occurrence of rare species in a landscape, but burn characteristics can affect the promotion of different life-form groups and thus affect functional diversity. Drought-breaking rain likely had an overarching effect on floristic composition during our study, highlighting that weather can play a greater role in influencing recruitment and diversity in plant communities than a prescribed burn.

40 CFR 265.382 - Open burning; waste explosives.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Open burning; waste explosives. 265... DISPOSAL FACILITIES Thermal Treatment § 265.382 Open burning; waste explosives. Open burning of hazardous waste is prohibited except for the open burning and detonation of waste explosives. Waste explosives...

40 CFR 265.382 - Open burning; waste explosives.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Open burning; waste explosives. 265... DISPOSAL FACILITIES Thermal Treatment § 265.382 Open burning; waste explosives. Open burning of hazardous waste is prohibited except for the open burning and detonation of waste explosives. Waste explosives...

40 CFR 265.382 - Open burning; waste explosives.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Open burning; waste explosives. 265... DISPOSAL FACILITIES Thermal Treatment § 265.382 Open burning; waste explosives. Open burning of hazardous waste is prohibited except for the open burning and detonation of waste explosives. Waste explosives...

40 CFR 265.382 - Open burning; waste explosives.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Open burning; waste explosives. 265... DISPOSAL FACILITIES Thermal Treatment § 265.382 Open burning; waste explosives. Open burning of hazardous waste is prohibited except for the open burning and detonation of waste explosives. Waste explosives...

40 CFR 265.382 - Open burning; waste explosives.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Open burning; waste explosives. 265... DISPOSAL FACILITIES Thermal Treatment § 265.382 Open burning; waste explosives. Open burning of hazardous waste is prohibited except for the open burning and detonation of waste explosives. Waste explosives...

[Estimating Biomass Burned Areas from Multispectral Dataset Detected by Multiple-Satellite].

PubMed

Yu, Chao; Chen, Liang-fu; Li, Shen-shen; Tao, Jin-hua; Su, Lin

2015-03-01

Biomass burning makes up an important part of both trace gases and particulate matter emissions, which can efficiently degrade air quality and reduce visibility, destabilize the global climate system at regional to global scales. Burned area is one of the primary parameters necessary to estimate emissions, and considered to be the largest source of error in the emission inventory. Satellite-based fire observations can offer a reliable source of fire occurrence data on regional and global scales, a variety of sensors have been used to detect and map fires in two general approaches: burn scar mapping and active fire detection. However, both of the two approaches have limitations. In this article, we explore the relationship between hotspot data and burned area for the Southeastern United States, where a significant amount of biomass burnings from both prescribed and wild fire took place. MODIS (Moderate resolution imaging spectrometer) data, which has high temporal-resolution, can be used to monitor ground biomass. burning in time and provided hot spot data in this study. However, pixel size of MODIS hot spot can't stand for the real ground burned area. Through analysis of the variation of vegetation band reflectance between pre- and post-burn, we extracted the burned area from Landsat-5 TM (Thematic Mapper) images by using the differential normalized burn ratio (dNBR) which is based on TM band4 (0.84 μm) and TM band 7(2.22 μm) data. We combined MODIS fire hot spot data and Landsat-5 TM burned scars data to build the burned area estimation model, results showed that the linear correlation coefficient is 0.63 and the relationships vary as a function of vegetation cover. Based on the National Land Cover Database (NLCD), we built burned area estimation model over different vegetation cover, and got effective burned area per fire pixel, values for forest, grassland, shrub, cropland and wetland are 0.69, 1.27, 0.86, 0.72 and 0.94 km2 respectively. We validated the burned area estimates by using the ground survey data from National interagency Fire Center (NIFC), our results are more close to the ground survey data than burned area from Global Fire Emissions Database (GFED) and MODIS burned area product (MCD45), which omitted many small prescribed fires. We concluded that our model can provide more accurate burned area parameters for developing fire emission inventory, and be better for estimating emissions from biomass burning.

Impact of managed moorland burning on peat nutrient and base cation status

NASA Astrophysics Data System (ADS)

Palmer, Sheila; Gilpin, Martin; Wearing, Catherine; Johnston, Kerrylyn; Holden, Joseph; Brown, Lee

2013-04-01

Controlled 'patch' burning of moorland vegetation has been used for decades in the UK to stimulate growth of heather (Calluna vulgaris) for game bird habitat and livestock grazing. Typically small patches (300-900 m2) are burned in rotations of 8-25 years. However, our understanding of the short-to-medium term environmental impacts of the practice on these sensitive upland areas has so far been limited by a lack of scientific data. In particular the effect of burning on concentrations of base cations and acid-base status of these highly organic soils has implications both for ecosystem nutrient status and for buffering of acidic waters. As part of the EMBER project peat chemistry data were collected in ten upland blanket peat catchments in the UK. Five catchments were subject to a history of prescribed rotational patch burning. The other five catchments acted as controls which were not subject to burning, nor confounded by other detrimental activities such as drainage or forestry. Soil solution chemistry was also monitored at two intensively studied sites (one regularly burned and one control). Fifty-centimetre soil cores, sectioned into 5-cm intervals, were collected from triplicate patches of four burn ages at each burned site, and from twelve locations at similar hillslope positions at each control site. At the two intensively monitored sites, soil solution chemistry was monitored at four depths in each patch. Across all sites, burned plots had significantly smaller cation exchange capacities, lower concentrations of exchangeable base cations and increased concentrations of exchangeable H+ and Al3+ in near-surface soil. C/N ratios were also lower in burned compared to unburned surface soils. There was no consistent trend between burn age and peat chemistry across all burned sites, possibly reflecting local controls on post-burn recovery rates or external influences on burn management decisions. At the intensively monitored site, plots burned less than two years prior to sampling had significantly smaller exchange capacities and lower concentrations of soil base cations in surface soils relative to plots burned 15-25 years previously. In contrast, surface soil solutions in recently burned plots were enriched in base cations relative to older plots and relative to the control site, possibly due to enhanced leaching at bare soil surfaces. The results offer evidence for an impact of burning on peat nutrient and acid-base status, but suggest that soils recover given time with no further burning.

Basic investigation into the present burn care system in China: burn units, doctors, nurses, beds and special treatment equipment.

PubMed

Zhanzeng, Feng; Yurong, Zheng; Chuangang, You; Yunyun, Jin; Xingang, Wang; Zhaofan, Xia; Chunmao, Han

2015-03-01

The aim of the study was to survey the current burn units in China to understand the burn care system in the country and supply basic data for the National Burn Repository of China (NBRC) and further research. A questionnaire was developed and sent to burn unit directors in China via e-mail, which was followed up with reminder text messages to obtain information for the study. Of the 405 hospitals from the 31 provinces in mainland China that responded to the questionnaire, 63.7% of the responses came from Grade 3A hospitals, and the most popular model of organisation was the Burns and Plastic Surgery arrangement (63.0%). An average of 9.43±0.351 doctors work in each burn unit with 70.4% of all units having 4-11 doctors. The ratio of chief surgeon to associate chief surgeon to attending surgeon to resident surgeon and surgeon assistant was 1:1.8:2.2:2.3. An average of 30% of all doctors in each burn unit held postgraduate degrees, and more than 90% of all surgeons held a bachelor's degree or higher. There were 16.48±0.637 nurses per burn unit, 56.5% of burn units had 8-15 nurses, and the ratio of chief nurse to associate chief nurse to supervisor nurse to nurse practitioner to junior nurse was 1:11.8:57.0:82.1:86.1. More than 80% of all nurses had received a college education or above. However, only 30% of nurses held bachelor's degrees or higher, while only 0.66% of nurses had received postgraduate degrees. A total of 39.91±1.50 beds were available in each burn unit and 45% of burn units had 20-39 beds. Up to 70% of the total beds were prepared for patients with burn, and more than 10% of the beds were specifically for patients with severe burn. The ratios of doctors to nurses, beds to doctors, beds to nurses, and beds to doctors and nurses were 0.64±0.01, 4.48±0.12, 2.67±0.09, and 1.66±0.06, respectively. The workload of each doctor and nurse was most heavy in units with 40-59 beds. In addition, we estimated that there were 0.05, 0.5, 0.8, and 1.9 burn units, burn doctors, nurses, and beds, respectively, per 100,000 members of the population in mainland China. Chinese burn units lack special burn treatments, nursing equipment, and operation apparatuses. To the best of our knowledge, this is the first survey of the present burn care system in China. These results confirm that the burn care system is not equivalent to the national power of this country and the system lacks a great number of trained burn professionals. Burn doctors and nurses bear a heavy burden of work. This report supplies basic data to spur further research. We propose creating a burn unit registration system and a special database in China. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Nitramine propellants. [gun propellant burning rate

NASA Technical Reports Server (NTRS)

Cohen, N. S.; Strand, L. D. (Inventor)

1978-01-01

Nitramine propellants without a pressure exponent shift in the burning rate curves are prepared by matching the burning rate of a selected nitramine or combination of nitramines within 10% of burning rate of a plasticized active binder so as to smooth out the break point appearance in the burning rate curve.

Prescribed burning in the North Central States.

Treesearch

Linda R. Donoghue; Von J. Johnson

1975-01-01

Describes 5 years of prescribed burning in the North Central States from 1968 through 1972. Provides information concerning participating agencies, burned-acreage, purpose-of-burn, fuels, and weather. Also examines other aspects such as ignition and burning techniques, hours-to-complete, time of fire start, and cost-per-acre.

49 CFR 195.226 - Welding: Arc burns.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Welding: Arc burns. 195.226 Section 195.226 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Construction § 195.226 Welding: Arc burns. (a) Each arc burn must be repaired. (b) An arc burn may...

50 CFR 35.10 - Controlled burning.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 9 2013-10-01 2013-10-01 false Controlled burning. 35.10 Section 35.10 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE... burning. Controlled burning will be permitted on wilderness units when such burning will contribute to the...

50 CFR 35.10 - Controlled burning.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 9 2014-10-01 2014-10-01 false Controlled burning. 35.10 Section 35.10 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE... burning. Controlled burning will be permitted on wilderness units when such burning will contribute to the...

40 CFR 266.101 - Management prior to burning.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 27 2011-07-01 2011-07-01 false Management prior to burning. 266.101... MANAGEMENT FACILITIES Hazardous Waste Burned in Boilers and Industrial Furnaces § 266.101 Management prior to burning. (a) Generators. Generators of hazardous waste that is burned in a boiler or industrial furnace...

40 CFR 266.101 - Management prior to burning.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 27 2014-07-01 2014-07-01 false Management prior to burning. 266.101... MANAGEMENT FACILITIES Hazardous Waste Burned in Boilers and Industrial Furnaces § 266.101 Management prior to burning. (a) Generators. Generators of hazardous waste that is burned in a boiler or industrial furnace...

50 CFR 35.10 - Controlled burning.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 8 2011-10-01 2011-10-01 false Controlled burning. 35.10 Section 35.10 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE... burning. Controlled burning will be permitted on wilderness units when such burning will contribute to the...

50 CFR 35.10 - Controlled burning.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 9 2012-10-01 2012-10-01 false Controlled burning. 35.10 Section 35.10 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE... burning. Controlled burning will be permitted on wilderness units when such burning will contribute to the...

50 CFR 35.10 - Controlled burning.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Controlled burning. 35.10 Section 35.10 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE... burning. Controlled burning will be permitted on wilderness units when such burning will contribute to the...

40 CFR 266.101 - Management prior to burning.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 28 2013-07-01 2013-07-01 false Management prior to burning. 266.101... MANAGEMENT FACILITIES Hazardous Waste Burned in Boilers and Industrial Furnaces § 266.101 Management prior to burning. (a) Generators. Generators of hazardous waste that is burned in a boiler or industrial furnace...

40 CFR 266.101 - Management prior to burning.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Management prior to burning. 266.101... MANAGEMENT FACILITIES Hazardous Waste Burned in Boilers and Industrial Furnaces § 266.101 Management prior to burning. (a) Generators. Generators of hazardous waste that is burned in a boiler or industrial furnace...

40 CFR 266.101 - Management prior to burning.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 28 2012-07-01 2012-07-01 false Management prior to burning. 266.101... MANAGEMENT FACILITIES Hazardous Waste Burned in Boilers and Industrial Furnaces § 266.101 Management prior to burning. (a) Generators. Generators of hazardous waste that is burned in a boiler or industrial furnace...

49 CFR 195.226 - Welding: Arc burns.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Welding: Arc burns. 195.226 Section 195.226 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Construction § 195.226 Welding: Arc burns. (a) Each arc burn must be repaired. (b) An arc burn may...

49 CFR 195.226 - Welding: Arc burns.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Welding: Arc burns. 195.226 Section 195.226 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Construction § 195.226 Welding: Arc burns. (a) Each arc burn must be repaired. (b) An arc burn may...

49 CFR 195.226 - Welding: Arc burns.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Welding: Arc burns. 195.226 Section 195.226 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Construction § 195.226 Welding: Arc burns. (a) Each arc burn must be repaired. (b) An arc burn may...

49 CFR 195.226 - Welding: Arc burns.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false Welding: Arc burns. 195.226 Section 195.226 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Construction § 195.226 Welding: Arc burns. (a) Each arc burn must be repaired. (b) An arc burn may...

Burning by prescription in chaparral

Treesearch

Lisle R. Green

1981-01-01

Prescribed burning is frequently suggested for reducing conflagration costs in chaparral. Preparation for a prescribed burn includes environmental impact reports, approval by higher levels of authority, and a burn plan. After objectives are stated, the prescription can be written. Elements of the burn prescription reflect fuel, weather, and other factors that determine...

Enhanced biogenic emissions of nitric oxide and nitrous oxide following surface biomass burning

NASA Technical Reports Server (NTRS)

Anderson, Iris C.; Levine, Joel S.; Poth, Mark A.; Riggan, Philip J.

1988-01-01

Recent measurements indicate significantly enhanced biogenic soil emissions of both nitric oxide (NO) and nitrous oxide (N2O) following surface burning. These enhanced fluxes persisted for at least six months following the burn. Simultaneous measurements indicate enhanced levels of exchangeable ammonium in the soil following the burn. Biomass burning is known to be an instantaneous source of NO and N2O resulting from high-temperature combustion. Now it is found that biomass burning also results in significantly enhanced biogenic emissions of these gases, which persist for months following the burn.

Global biomass burning - Atmospheric, climatic, and biospheric implications

NASA Technical Reports Server (NTRS)

Levine, Joel S.

1991-01-01

On a global scale, the total biomass consumed by annual burning is about 8680 million tons of dry material; the estimated total biomass consumed by the burning of savanna grasslands, at 3690 million tons/year, exceeds all other biomass burning (BMB) components. These components encompass agricultural wastes burning, forest burning, and fuel wood burning. BMB is not restricted to the tropics, and is largely anthropogenic. Satellite measurements indicate significantly increased tropospheric concentrations of CO and ozone associated with BMB. BMB significantly enhances the microbial production and emission of NO(x) from soils, and of methane from wetlands.

[REVIEW OF 30 YEARS OF RESEARCH AND DEVELOPMENT OF AN ENZYMATIC DEBRIDEMENT AGENT FOR BURNS].

PubMed

Krieger, Yuval; Shoham, Yaron; Bogdanov-Berezovsky, Alexander; Silberstein, Eldad; Sagi, Amiram; Levy, Avraham; Rosenberg, Nir; Rubin, Guy; Egozi, Dana; Ullman, Yehuda; Haik, Josef; Rosenberg, Lior

2016-05-01

Early removal of burn eschar is a cornerstone of burn care. The most commonly practiced eschar removal technique for deep burns in modern burn care is surgical debridement but this technique is associated with surgical burden and leads to unnecessary excision of viable tissue. To review 30 years of research and development of an enzymatic debridement agent for burns. Studies performed during the last 30 years are reviewed in this manuscript. Patients who underwent enzymatic debridement had a significantly shorter time to complete debridement, the surgical burden was significantly lower, hand burns did not necessitate escharotomy, and the long term results were favorable. Early enzymatic debridement leads to an efficient debridement, preservation of viable tissue, a reduction in surgical burden and favorable long term results. We believe early enzymatic debridement will lead to better care for burn victims and perhaps, even to a paradigm shift in the treatment of burns.

Pediatric thermal injury: acute care and reconstruction update.

PubMed

Armour, Alexis D; Billmire, David A

2009-07-01

The acute and reconstructive care of each pediatric burn patient presents unique challenges to the plastic surgeon and the burn care team. : The purpose of this review article is to highlight the interdependence between the acute and reconstructive needs of pediatric burn patients as it pertains to each anatomical site. Relevant principles of acute pediatric burn care and burn reconstruction are outlined, based on the authors' experience and review of the literature. The need for late reconstruction in pediatric burn survivors is significantly influenced by the acute surgical and rehabilitative treatments. With their vulnerability to airway swelling, hypothermia, pulmonary edema, and ischemia-reperfusion injury, pediatric patients with large burns require precise, life-saving treatment in the acute phase. Decision-making in pediatric burn reconstruction must take into account the patient's future growth, maturity, and often lack of suitable donor sites. Appropriately selected reconstructive techniques are essential to optimize function, appearance, and quality of life in pediatric burn survivors.

Burn Pit Emissions Exposure and Respiratory and Cardiovascular Conditions Among Airborne Hazards and Open Burn Pit Registry Participants.

PubMed

Liu, Jason; Lezama, Nicholas; Gasper, Joseph; Kawata, Jennifer; Morley, Sybil; Helmer, Drew; Ciminera, Paul

2016-07-01

The aim of this study was to determine how burn pit emissions exposure is associated with the incidence of respiratory and cardiovascular conditions. We examined the associations between assumed geographic and self-reported burn pit emissions exposure and respiratory and cardiovascular outcomes in participants of the Airborne Hazards and Open Burn Pit Registry. We found significant dose-response associations for higher risk of self-reported emphysema, chronic bronchitis, or chronic obstructive pulmonary disease with increased days of deployment within 2 miles of selected burn pits (P-trend = 0.01) and self-reported burn pit smoke exposure (P-trend = 0.0005). We found associations between burn pit emissions exposure and higher incidence of post-deployment self-reported respiratory and cardiovascular conditions, but these findings should be interpreted with caution because the surrogate measurements of burn pit emissions exposure in this analysis may not reflect individual exposure levels.

LANDSAT digital analysis of the initial recovery of the Kokolik River tundra fire area, Alaska

NASA Technical Reports Server (NTRS)

Hall, D. K.; Ormsby, J. P.; Johnson, L.; Brown, J. (Principal Investigator)

1979-01-01

The author has identified the following significant results. Considerable regrowth of vegetation was observed between August 1977 and August 1978, both in the field and through analysis of LANDSAT near infrared digital data. The spectral reflectances in the burned areas were found to increase with the age of the burn in a one year period due to vegetation regrowth. Regrowth was particularly evident in the lightly burned portions of the burned area. Image analysis techniques using the AOIPS system permitted delineation of burn severity categories. The conditions and type of ground cover prior to the fire influenced the severity of burning, as did the direction of the winds while the burning was in progress as determined from field and LANDSAT observations. More severe burning was induced by winds blowing in the northeastern and southeastern portions of the burned area.

Work-Related Burn Injuries Hospitalized in US Burn Centers: 2002 to 2011.

PubMed

Huang, Zhenna; Friedman, Lee S

2017-03-01

To develop a comprehensive definition to identify work-related burns in the National Burn Repository (NBR) based on multiple fields and describes injuries by occupation. The NBR, which is an inpatient dataset, was used to compare type and severity of burn injuries by occupation. Using the definition developed for this analysis, 22,969 burn injuries were identified as work-related. In contrast, the single work-related field intended to capture occupational injuries only captured 4696 cases. The highest numbers of burns were observed in construction/extraction, food preparation, and durable goods production occupations. Occupations with a mean total body surface area (TBSA) burned greater than 10% include transportation and material-moving, architecture and engineering, and arts/design/entertainment/sports/media occupations. The NBR dataset should be further utilized for occupational burn injury investigations and multiple fields should be considered for case ascertainment.

Aging and the Pathogenic Response to Burn

PubMed Central

Rani, Meenakshi; Schwacha, Martin G.

2012-01-01

Aging is an important and critical factor that contributes to the clinical outcome of burn patients. The very young and the elderly are more likely to succumb after major burn as compared to their adult counterparts. With the aging population, improved understanding of the mechanisms underlying age-associated complications after burns becomes even more demanding. It is widely accepted that elderly burn patients have significantly increased morbidity and mortality. Irrespective of the type of burn injury, the aged population shows slower recoveries and suffers more complications. Age-associated immune dysfunction, immunosenescence, may predispose the elderly burn patients to more infections, slower healing and/or to other complications. Furthermore, pre-existing, age-related medical conditions such as, pulmonary/cardiovascular dysfunctions and diabetes in the elderly are other important factors that contribute to their poorer outcomes after major burn. The present review describes the impact of aging on burn patients outcomes. PMID:22724078

Acute and Perioperative Care of the Burn-Injured Patient

PubMed Central

Bittner, Edward A.; Shank, Erik; Woodson, Lee; Martyn, J.A. Jeevendra

2016-01-01

Care of burn-injured patients requires knowledge of the pathophysiologic changes affecting virtually all organs from the onset of injury until wounds are healed. Massive airway and/or lung edema can occur rapidly and unpredictably after burn and/or inhalation injury. Hemodynamics in the early phase of severe burn injury are characterized by a reduction in cardiac output, increased systemic and pulmonary vascular resistance. Approximately 2–5 days after major burn injury, a hyperdynamic and hypermetabolic state develops. Electrical burns result in morbidity much higher than expected based on burn size alone. Formulae for fluid resuscitation should serve only as guideline; fluids should be titrated to physiologic end points. Burn injury is associated basal and procedural pain requiring higher than normal opioid and sedative doses. Operating room concerns for the burn-injured patient include airway abnormalities, impaired lung function, vascular access, deceptively large and rapid blood loss, hypothermia and altered pharmacology. PMID:25485468

The Impact of Media Reporting on the Emergence of Charcoal Burning Suicide in Taiwan

PubMed Central

Chen, Ying-Yeh; Chen, Feng; Gunnell, David; Yip, Paul S. F.

2013-01-01

We investigated the association of the intensity of newspaper reporting of charcoal burning suicide with the incidence of such deaths in Taiwan during 1998–2002. A counting process approach was used to estimate the incidence of suicides and intensity of news reporting. Conditional Poisson generalized linear autoregressive models were performed to assess the association of the intensity of newspaper reporting of charcoal burning and non-charcoal burning suicides with the actual number of charcoal burning and non-charcoal burning suicides the following day. We found that increases in the reporting of charcoal burning suicide were associated with increases in the incidence of charcoal burning suicide on the following day, with each reported charcoal burning news item being associated with a 16% increase in next day charcoal burning suicide (p<.0001). However, the reporting of other methods of suicide was not related to their incidence. We conclude that extensive media reporting of charcoal burning suicides appears to have contributed to the rapid rise in the incidence of the novel method in Taiwan during the initial stage of the suicide epidemic. Regulating media reporting of novel suicide methods may prevent an epidemic spread of such new methods. PMID:23383027

Pavement temperature and burns: streets of fire.

PubMed

Harrington, W Z; Strohschein, B L; Reedy, D; Harrington, J E; Schiller, W R

1995-11-01

To measure pavement temperatures over a 24-hour period to determine when patients are at risk for burns and to report cases of pavement burns with predisposing factors. Descriptive study of pavement temperatures and retrospective case series of 23 patients with pavement burns admitted to the Maricopa Medical Center during the years 1986 to 1992. Twenty-three patients with pavement burns serious enough for them to be admitted to the burn center. We measured the temperatures of asphalt, cement, and other outdoor materials hourly for one 24-hour period using a thermocouple thermometer. Asphalt pavement was hot enough to cause burns from 9 AM to 7 PM during the summer months. It was hot enough to cause a second-degree burn within 35 seconds from 10 AM to 5 PM. The group of burned patients could be divided into three categories: incapacitated, restrained, and sensory deficient. All burns involved less than 13% of the total body surface area. During summer days in the desert, pavement is often hot enough to cause burns and does so with regularity in the southwestern United States. No one should be allowed to remain in contact with hot pavement, even transiently.

Comparison of traditional burn wound mapping with a computerized program.

PubMed

Williams, James F; King, Booker T; Aden, James K; Serio-Melvin, Maria; Chung, Kevin K; Fenrich, Craig A; Salinas, José; Renz, Evan M; Wolf, Steven E; Blackbourne, Lorne H; Cancio, Leopoldo C

2013-01-01

Accurate burn estimation affects the use of burn resuscitation formulas and treatment strategies, and thus can affect patient outcomes. The objective of this process-improvement project was to compare the accuracy of a computer-based burn mapping program, WoundFlow (WF), with the widely used hand-mapped Lund-Browder (LB) diagram. Manikins with various burn representations (from 1% to more than 60% TBSA) were used for comparison of the WF system and LB diagrams. Burns were depicted on the manikins using red vinyl adhesive. Healthcare providers responsible for mapping of burn patients were asked to perform burn mapping of the manikins. Providers were randomized to either an LB or a WF group. Differences in the total map area between groups were analyzed. Also, direct measurements of the burn representations were taken and compared with LB and WF results. The results of 100 samples, compared using Bland-Altman analysis, showed no difference between the two methods. WF was as accurate as LB mapping for all burn surface areas. WF may be additionally beneficial in that it can track daily progress until complete wound closure, and can automatically calculate burn size, thus decreasing the chances of mathematical errors.

Foot burns: epidemiology and management.

PubMed

Hemington-Gorse, S; Pellard, S; Wilson-Jones, N; Potokar, T

2007-12-01

This is a retrospective study of the epidemiology and management of isolated foot burns presenting to the Welsh Centre for Burns from January 1998 to December 2002. A total of 289 were treated of which 233 were included in this study. Approximately 40% were in the paediatric age group and the gender distribution varied dramatically for adults and children. In the adult group the male:female ratio was 3.5:1, however in the paediatric group the male:female ratio was more equal (1.6:1). Scald burns (65%) formed the largest group in children and scald (35%) and chemical burns (32%) in adults. Foot burns have a complication rate of 18% and prolonged hospital stay. Complications include hypertrophic scarring, graft loss/delayed healing and wound infection. Although isolated foot burns represent a small body surface area, over half require treatment as in patients to allow for initial aggressive conservative management of elevation and regular wound cleansing to avoid complications. This study suggests a protocol for the initial acute management of foot burns. This protocol states immediate referral of all foot burns to a burn centre, admission of these burns for 24-48 h for elevation, regular wound cleansing with change of dressings and prophylactic antibiotics.

Management of facial burns with a collagen/glycosaminoglycan skin substitute-prospective experience with 12 consecutive patients with large, deep facial burns.

PubMed

Klein, Matthew B; Engrav, Loren H; Holmes, James H; Friedrich, Jeffrey B; Costa, Beth A; Honari, Shari; Gibran, Nicole S

2005-05-01

Management of deep facial burns remains one of the greatest challenges in burn care. We have developed a protocol over the past 20 years for management of facial burns that includes excision and coverage with thick autograft. However, the results were not perfect. Deformities of the eyelids, nose and mouth as well as the prominence of skin graft junctures demonstrated the need to explore novel approaches. Integra has been used with success in the management of burns of the trunk and extremities. The purpose of this study was to prospectively evaluate the aesthetic outcome of the use of Integra for deep facial burns. Twelve consecutive patients underwent excision of large, deep facial burns and placement of Integra. Integra provides excellent color and minimally visible skin graft junctures. The texture is good but not as supple as thick autograft. Integra is not well suited for use in the coverage of eyelid burns due to the need to wait 2 weeks for adequate vascularization. In summary, thick autograft remains the gold standard for deep facial burns. However, for patients with extensive burns and limited donor sites, Integra provides an acceptable alternative.

Long-term survival after burns in a Swedish population.

PubMed

Pompermaier, Laura; Steinvall, Ingrid; Fredrikson, Mats; Thorfinn, Johan; Sjöberg, Folke

2017-02-01

As widely reported, the progress in burn care during recent decades has reduced the hospital mortality. The effect of the burns on long-term outcome has not received so much attention, and more study is indicated. The aim of this retrospective study was to investigate the long-time survival among patients who had been treated for burns. We studied 1487 patients who were discharged alive from the Linköping University Hospital Burn Centre during the period 1993 until the end of December 2012. We used Cox's regression analysis to study the effect of burns on long-term survival after adjustment for different factors. Age and a full-thickness burn were significantly associated with mortality after discharge (p<0.001), whereas percentage of total body surface area burned (TBSA %), need for mechanical ventilation, and gender were not. Less than 1% of the patients with burns (13/1487) died within 30 days of discharge and a total of 176/1487 (12%) died during follow-up. Age and full-thickness burns reduce the long-time survival after discharge from the Burn Centre, whereas the effect of TBSA% and need for artificial ventilation ends with discharge. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Tailorable Burning Behavior of Ti14 Alloy by Controlling Semi-Solid Forging Temperature

PubMed Central

Chen, Yongnan; Yang, Wenqing; Zhan, Haifei; Zhang, Fengying; Huo, Yazhou; Zhao, Yongqing; Song, Xuding; Gu, Yuantong

2016-01-01

Semi-solid processing (SSP) is a popular near-net-shape forming technology for metals, while its application is still limited in titanium alloy mainly due to its low formability. Recent works showed that SSP could effectively enhance the formability and mechanical properties of titanium alloys. The processing parameters such as temperature and forging rate/ratio, are directly correlated with the microstructure, which endow the alloy with different chemical and physical properties. Specifically, as a key structural material for the advanced aero-engine, the burn resistant performance is a crucial requirement for the burn resistant titanium alloy. Thus, this work aims to assess the burning behavior of Ti14, a kind of burn resistant alloy, as forged at different semi-solid forging temperatures. The burning characteristics of the alloy are analyzed by a series of burning tests with different burning durations, velocities, and microstructures of burned sample. The results showed that the burning process is highly dependent on the forging temperature, due to the fact that higher temperatures would result in more Ti2Cu precipitate within grain and along grain boundaries. Such a microstructure hinders the transport of oxygen in the stable burning stage through the formation of a kind of oxygen isolation Cu-enriched layer under the burn product zone. This work suggests that the burning resistance of the alloy can be effectively tuned by controlling the temperature during the semi-solid forging process. PMID:28773820

The role of alternative therapy in the management of partial thickness burns of the face--experience with the use of moist exposed burn ointment (MEBO) compared with silver sulphadiazine.

PubMed

Ang, E S; Lee, S T; Gan, C S; See, P; Chan, Y H; Ng, L H; Machin, D

2000-01-01

Conventional management of partial thickness facial burn wounds includes the use of silver sulphadiazine dressings. Silver sulphadiazine forms an overlying slough that makes wound healing assessment difficult. Moist exposed burn ointment (MEBO) has been proposed as the ideal burn wound dressing both for burns of the face and other sites. Proponents of MEBO claim that it accelerates wound healing and results in scarless wound healing and at the same time reduce bacterial colonisation and the need for analgesics. We present here our experience with MEBO in the management of partial thickness burns of the face. One hundred and fifteen patients with partial thickness burns were randomly assigned to conventional treatment or MEBO. Out of this, 112 were analysed. Thirty-nine patients sustained facial burns; 17 received MEBO and 22 received silver sulphadiazine. Patients were followed up daily until the burn wounds were reduced by 75% of original body surface area (BSA). In patients with facial burns, MEBO was similar to silver sulphadiazine therapy with respect to rate of wound healing. Minimal slough was present over the wounds in MEBO-treated wounds resulting in clearer assessment of healing progression. Advantages of MEBO as compared to silver sulphadiazine in the management of partial thickness burns of the face include convenient change of dressing and easier assessment of healing progression. This suggests that MEBO is a useful alternative therapy for partial thickness burns of the face.

Fenofibrate Does Not Affect Burn-Induced Hepatic Endoplasmic Reticulum Stress

PubMed Central

Hiyama, Yaeko; Marshall, Alexandra H.; Kraft, Robert; Arno, Anna; Jeschke, Marc G.

2013-01-01

Background Burn injury causes major metabolic derangements such as hypermetabolism, hyperlipidemia, and insulin resistance and is associated with liver damage, hepatomegaly, and hepatic endoplasmic reticulum (ER) stress. Although the physiological consequences of such derangements have been delineated, the underlying molecular mechanisms remain unknown. Previously, it was shown that fenofibrate improves patient outcome by attenuating post-burn stress responses. Methods Fenofibrate, a peroxisome proliferator-activated receptor (PPAR)-α agonist, regulates liver lipid metabolism and has been used to treat hypertriglyceridemia and hypercholesterolemia for many years. The aim of the present study is to determine the effects of fenofibrate on burn-induced hepatic morphologic and metabolic changes. We randomized rats to sham, burn injury, and burn injury plus fenofibrate. Animals were sacrificed and livers were assessed at 24 or 48 hours post-burn. Results Burn injury decreased albumin and increased alanine transaminase (p = 0.1 vs. sham), indicating liver injury. Fenofibrate administration did not restore albumin or decrease alanine transaminase. In addition, ER stress was significantly increased after burn injury both with and without fenofibrate (p < 0.05 vs. sham). Burn injury increased fatty acid metabolism gene expression (p < 0.05 vs. sham), downstream of PPARα. Fenofibrate treatment increased fatty acid metabolism further, which reduced post-burn hepatic steatosis (burn vs. sham p < 0.05, burn+fenofibrate vs. sham not significant). Conclusions Fenofibrate did not alleviate thermal injury induced hepatic ER stress and dysfunction but reduced hepatic steatosis by modulating hepatic genes related to fat metabolism. PMID:23866789

Burn Survivor Quality of Life and Barriers to Support Program Participation.

PubMed

Baldwin, Stephanie; Yuan, Haimao; Liao, Junlin; Grieve, Brian; Heard, Jason; Wibbenmeyer, Lucy A

2018-03-29

After a serious burn, re-entry into family life, society, and work can be incredibly difficult. Support services such as professional counseling and peer support play a key role for recovering survivors. Herein, we sought to identify support service participation rates, barriers to participation, and quality of life (QOL) among burn survivors treated at a regional burn center. A survey of burn survivors over 18 years old treated for a burn for 5 days or greater between 2006 and 2016 were invited to participate in a survey. The three-part survey contained sections covering demographics, questions regarding support program (SP) awareness, needs and participation, and QOL surveys. Univariate and multivariate regression analyses were performed to identify factors related to SP participation and QOL scores. Nine hundred sixty-eight patients were eligible; 150 responses were received. Over one third (40, 31%) of the responding survivors wanted support, but only half of those (23, 17%) participated in SPs. Distance and awareness of the available programs were two barriers to participation. Those attending SPs were more likely to have had larger burns (OR = 3.7, P = 0.05) and visible burns (OR = 7.5, P = 0.031). Lower scores on selected QOL scales were associated with burns more than 30%, visible burns, female gender, time from burn, and age group. A sizable number of burn survivors want SPs. However, access to these services and advertising their existence are hurdles to overcome. Future burn survivor SPs should focus on psychosocial stresses identified in the QOL assessments.

The effect of Burns & Wounds (B&W)/burdock leaf therapy on burn-injured Amish patients: a pilot study measuring pain levels, infection rates, and healing times.

PubMed

Kolacz, Nicole M; Jaroch, Mark T; Bear, Monica L; Hess, Rosanna F

2014-12-01

The purposes of this pilot study were to measure pain associated with dressing changes, assess the presence of infection, and document healing times of burn-injured Amish in central Ohio using an herbal therapy consisting of Burns and Wounds™ ointment (B&W) and burdock (Arctium ssp.) leaves. B&W contains honey, lanolin, olive oil, wheat germ oil, marshmallow root, Aloe vera gel, wormwood, comfrey root, white oak bark, lobelia inflata, vegetable glycerin, bees wax, and myrrh. A prospective, case series design guided the study within a community-based participatory research framework. Amish burn dressers provided burn care. Registered nurses monitored each case and documented findings. Pain scores were noted and burns were inspected for infection during dressing changes; healing times were measured from day of burn to complete closure of the skin. All cases were photographed. Between October 2011 and May 2013, five Amish were enrolled. All had first- and second-degree burns. B&W/burdock leaf dressing changes caused minimal or no pain; none of the burns became infected, and healing times averaged less than 14 days. The use of this herbal remedy appears to be an acceptable alternative to conventional burn care for these types of burns. The trauma of dressing changes was virtually nonexistent. Nurses working in communities with Amish residents should be aware of this herbal-based method of burn care and monitor its use when feasible. © The Author(s) 2014.

Burn epidemiology and cost of medication in paediatric burn patients.

PubMed

Koç, Zeliha; Sağlam, Zeynep

2012-09-01

Burns are common injuries that cause problems to societies throughout the world. In order to reduce the cost of burn treatment in children, it is extremely important to determine the burn epidemiology and the cost of medicines used in burn treatment. The present study used a retrospective design, with data collected from medical records of 140 paediatric patients admitted to a burn centre between 1 January 2009 and 31 December 2009. Medical records were examined to determine burn epidemiology, medication administered, dosage, and duration of use. Descriptive statistical analysis was completed for all variables; chi-square was used to examine the relationship between certain variables. It was found that 62.7% of paediatric burns occur in the kitchen, with 70.7% involving boiling water; 55.7% of cases resulted in third-degree burns, 19.3% required grafting, and mean duration of hospital stay was 27.5 ± 1.2 days. Medication costs varied between $1.38 US dollars (USD) and $14,159.09, total drug cost was $46,148.03 and average cost per patient was $329.63. In this study, the medication cost for burn patients was found to be relatively high, with antibiotics comprising the vast majority of medication expenditure. Most paediatric burns are preventable, so it is vital to educate families about potential household hazards that can be addressed to reduce the risk of a burn. Programmes are also recommended to reduce costs and the inappropriate prescribing of medication. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Improved rice residue burning emissions estimates: Accounting for practice-specific emission factors in air pollution assessments of Vietnam.

PubMed

Lasko, Kristofer; Vadrevu, Krishna

2018-05-01

In Southeast Asia and Vietnam, rice residues are routinely burned after the harvest to prepare fields for the next season. Specific to Vietnam, the two prevalent burning practices include: a). piling the residues after hand harvesting; b). burning the residues without piling, after machine harvesting. In this study, we synthesized field and laboratory studies from the literature on rice residue burning emission factors for PM 2.5 . We found significant differences in the resulting burning-practice specific emission factors, with 16.9 g kg -2 (±6.9) for pile burning and 8.8 g kg -2 (±3.5) for non-pile burning. We calculated burning-practice specific emissions based on rice area data, region-specific fuel-loading factors, combined emission factors, and estimates of burning from the literature. Our results for year 2015 estimate 180 Gg of PM 2.5 result from the pile burning method and 130 Gg result from non-pile burning method, with the most-likely current emission scenario of 150 Gg PM 2.5 emissions for Vietnam. For comparison purposes, we calculated emissions using generalized agricultural emission factors employed in global biomass burning studies. These results estimate 80 Gg PM 2.5 , which is only 44% of the pile burning-based estimates, suggesting underestimation in previous studies. We compare our emissions to an existing all-combustion sources inventory, results show emissions account for 14-18% of Vietnam's total PM 2.5 depending on burning practice. Within the highly-urbanized and cloud-covered Hanoi Capital region (HCR), we use rice area from Sentinel-1A to derive spatially-explicit emissions and indirectly estimate residue burning dates. Results from HYSPLIT back-trajectory analysis stratified by season show autumn has most emission trajectories originating in the North, while spring has most originating in the South, suggesting the latter may have bigger impact on air quality. From these results, we highlight locations where emission mitigation efforts could be focused and suggest measures for pollutant mitigation. Our study demonstrates the need to account for emissions variation due to different burning practices. Copyright © 2018 Elsevier Ltd. All rights reserved.

Aetiology of adult burns treated from 2000 to 2012 in a Swiss University Hospital.

PubMed

Müller, M; Moser, E M; Pfortmueller, C A; Olariu, R; Lehmann, B; Exadaktylos, A K

2016-06-01

Burns in Switzerland are frequent and lead to high economic and social costs. However, little is known about the aetiology of burns suffered by patients seeking treatment in hospital emergency departments. This knowledge could be used to develop preventive measures. This retrospective analysis included all patients (≥16 years old) with acute thermal injuries of known cause admitted to the adult emergency department in Bern University Hospital (Switzerland, not a specialised burns unit) between 2000 and 2012. Clinical and sociodemographic data were extracted from medical records, i.e. the environment in which the burn occurred, as well as details of burn severity and aetiology. Seven hundred and one (701) patients with a mean age of 35.0±14.5 years (56% men) were included in the analysis. The winter season and the days around Christmas, turn of the year and Swiss National Day were identified as times with high risk of burns. Household (45%) and workplace (31%) were the most common locations/settings in which the burns occurred. Approximately every second burn was caused by scald, every fourth by flame and every seventh by hot objects. The analysis identified cooking, tar and electricity in workplace accidents, barbecues and the use of gasoline as aetiological factors in burns in leisure time, together with water in domestic thermal injuries. Burns occurred predominantly on non-protected skin on the hand and arms. The most severe burns were seen in electrical and flame burns. Men suffered more severe burns than women in all settings except psychopathology. The data suggest that the incidence and severity of burns in Switzerland could be reduced by preventive strategies and public campaigns, including education on fire protection systems, raising awareness about the times and locations where the risks of burns are greater, further improvement in workplace safety, particularly with cooking facilities and electrical equipment, and the development of innovative safety devices (i.e. machines, protective gloves). These findings have to be interpreted carefully, as this study includes only adult patients who presented in our ED and, in most cases, the burns covered less than 20% of the body surface. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

The effects of epidermal debridement of partial-thickness burns on infection and reepithelialization in swine.

PubMed

Singer, A J; Thode, H C; McClain, S A

2000-02-01

Early postburn debridement of burn blisters is controversial. This study was conducted to compare rates of infection and reepithelialization in debrided vs nondebrided second-degree burns in swine. This was a prospective, blinded, controlled, experimental trial using isoflurane-anesthetized swine. Standardized partial-thickness burns were inflicted by applying an aluminum bar preheated to 80 degrees C to the backs and flanks of two young pigs for 20 seconds. In half of the burns the necrotic epidermis was manually debrided. All burns were randomly treated with octylcyanoacrylate spray (OCA) or dry gauze (C). Full-thickness biopsies were taken at 7, 10, and 14 days for blinded histopathologic evaluation. The primary outcomes were the proportions of infected burns at days 7 and 10 and the proportion of completely reepithelialized burns at day 14. Burns were considered infected in the presence of intradermal neutrophils containing bacteria (intraobserver agreement, K = 1.00). A secondary outcome was the proportion of burns with the presence of scar tissue (abnormal collagen under polarized light; intraobserver correlation, K = 0.93). Chi-square tests were used for group comparisons. This study had 90% power to detect a 40-percentage-point difference in infection rates (alpha = 0.05). A total of 126 biopsies from 42 burns were available for review. Infection rates were higher in the debrided burns both at day 7 (55% vs 4.5%, p < 0.001) and at day 10 (65% vs 9%, p < 0.001) after injury. The proportion of nondebrided burns that were completely reepithelialized was higher at days 10 (68% vs 0%, p < 0.001) and 14 (100% vs 65%, p = 0.003). The presence of scar tissue was more common in debrided burns (75% vs 4.5%, p < 0.001). Burns treated with OCA had fewer infections than controls (4% vs 55%, p < 0.001). Fewer OCA-treated debrided burns were reepithelialized at 14 days than those that were not debrided (30% vs 100%, p = 0.001). Under the current study conditions, early postburn epidermal debridement of second-degree burns resulted in more infections and slower reepithelialization rates in swine. The effects of early postburn epidermal debridement in humans should be explored.

Burden of burns in Portugal, 2000-2013: A clinical and economic analysis of 26,447 hospitalisations.

PubMed

Santos, João V; Oliveira, Andreia; Costa-Pereira, Altamiro; Amarante, José; Freitas, Alberto

2016-06-01

There is a lack of recent and nation-wide epidemiological studies of burns in Europe, mainly in southern Europe. There are no recent studies describing the clinical and economic burden of burns in this European area. Hence, this research aimed to describe the clinical and economic burden of burn hospitalisations in Portugal. A retrospective observational study was performed and the Portuguese hospitalisation database of public hospitals was used; all inpatients, discharged between 2000 and 2013, with a main or secondary diagnosis of burns (ICD-9-CM: 940.xx-949.xx) were taken into account. Furthermore, admissions to hospitals with and without burn centres were compared. A total of 26,447 burn hospitalisations were registered (mean of 1889burn admissions/year). The total hospitalisation rate was of 18.9hospitalisations/100,000inhabitants/year, and there was a higher incidence of male patients. Burn hospitalisations and hospitalisation rates are significantly decreasing - mostly in 0-14-year-old patients - and children below the age of 5 years represented a fifth of all admissions. Besides the important morbidity, the in-hospital mortality rate was of 4.4%. With a total annual charge of almost 13million Euros, the average cost per burn admission is increasing, and reached 8032Euros in 2013. Additionally, more than half of the patients admitted to hospitals without burn centres were not transferred to hospitals with burn centres, not following the European Burns Association transferral criteria. As the largest southern European nation-wide epidemiological study of burn patients, this research highlights that burn admissions, as well as hospitalisation rates, are decreasing significantly. This was particularly obvious among the youngest patients despite the fact that the numbers still remain very high. Moreover, the in-hospital mortality rate is still excessively high and the burn transferral criteria are not being followed. Thus, it is important to improve preventive measures, reach out to and educate providers about the burn transferral criteria, and develop specific health care strategies for children with these injuries. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Ten-year epidemiology of chemical burns in western Zhejiang Province, China.

PubMed

Ye, Chunjiang; Wang, Xingang; Zhang, Yuanhai; Ni, Liangfang; Jiang, Ruiming; Liu, Liping; Han, Chunmao

2016-05-01

Chemical burns occur frequently in western Zhejiang Province. This study documents the epidemiology of chemical burns in the region using burn data from a local specialized hospital. Results from this analysis will assist in the planning of prevention strategies for high-risk occupations and groups. A 10-year retrospective analysis was conducted for all patients with chemical burns admitted to the Department of Burn and Plastic Surgery from January 2004 to December 2013. Information obtained for each patient included demographics (gender, age, occupation and education), location of the burn, cause of the burn, and categories of chemicals. Data regarding the season of admittance, prehospital treatment, wound site/size (area, region, and depth), accompanying injuries, operations, length of hospital stay and mortality were also assessed. A total of 690 patients (619 males, 71 females; average age: 30.6±12.4 years) were admitted to the department for chemical burns. Over the 10-year period, the incidence of chemical burns showed an increasing tendency. Chemical burns occurred most frequently in patients aged 20-59 years (94.79%). Most of the chemical burns were work-related, primarily in private enterprises (47.97%) and state-owned enterprises (24.93%). Operations (68.99%) and machine problems (17.26%) were the main causes of chemical burns in the workplace. With regard to burns caused by chemicals, most were caused by acids (72.01%), with hydrofluoric acid and sulphuric acid causing 51.45%. Most chemical burns occurred in the summer and autumn seasons (61.02%). The burn size was <10% of the total body surface area (TBSA) for 445 patients (64.49%), while only 26 patients (3.76%) had burns covering >40% TBSA. The most common burn sites were the upper extremities (31.57%), lower extremities (19.86%), and head and neck (28.83%). Most patients (581 (84.20%)) received water washing treatment on site immediately after exposure. The most common accompanying injuries included inhalation injury, ocular burns and digestive tract injury. The average hospital stay was 17.0±23.1 days (range 1-333 days). Surgery was performed in 146 patients (21.16%), and the overall mortality rate was 0.58%. Chemical burns are preventable. The high morbidity of chemical burns in western Zhejiang Province is related to the industrial structure of the area. Governmental management in the fields of production, transportation, and utilization of chemicals could be improved. Workplaces have the responsibility to provide safe work environments and equipment, as well as occupational education and safety training for high-risk work groups. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Effects of past burning frequency on plant species structure and composition in dry dipterocarp forest

NASA Astrophysics Data System (ADS)

Wanthongchai, Dr.; Bauhus, Prof.; Goldammer, Prof.

2009-04-01

Anthropogenic burning in dry dipterocarp forests (DDF) has become a common phenomenon throughout Thailand. It is feared that too frequent fires may affect vegetation structure and composition and thus impact on ecosystem productivity. The aim of this study was to quantify the effects of prescribed fires on sites with different past burning regimes on vegetation structure and composition in the Huay Kha Khaeng Wildlife Sanctuary (HKK), Thailand. Fire frequency was determined from satellite images and ranged from frequent, infrequent, rare and unburned with fire occurrences of 7, 2, 1 and 0 out of the past 10 years, respectively. The pre-burn fuel loads, the overstorey and understorey vegetation structure and composition were determined to investigate the effects of the contrasting past burning regimes. The burning experiment was carried out, applying a three-strip head-fire burning technique. The vegetation structure and composition were sampled again one year after the fire to assess the fire impacts. Aboveground fine fuel loads increased with the length of fire-free interval. The woody plant structures of the frequently burned stand differed from those of the other less frequently burned stands. The species composition of the overstorey on the frequently burned site, in particular that of small sized trees (4.5-10 cm dbh), also differed significantly from that of the other sites. Whilst the ground vegetation including shrubs and herbs did not differ between the past burning regimes, frequent burning obviously promoted the proliferation of graminoid vegetation. There was no clear evidence showing that the prescribed fires affected the mortality of trees (dbh> 4.5 cm) on the sites of the different past burning regimes. The effects of prescribed burning on the understorey vegetation structures varied between the past burning regimes and the understorey vegetation type. Therefore, it is recommended that the DDF at HKK should be subjected to a prescribed fire frequency not shorter than every 6-7 years, or 1-2 fires per decade, to maintain ecosystem structure and function. Variation in time and space in this way, the biodiversity of the landscape may be maintained for the long-term. Keywords: Prescribed burning, burning history, burning frequency, plant species, vegetation structure, dry dipterocarp forest, Huay Kha Khaeng wildlife Sanctuary

Burns to the genitalia, perineum, and buttocks increase the risk of death among U.S. service members sustaining combat-related burns in Iraq and Afghanistan.

PubMed

Clemens, Michael S; Janak, Judson C; Rizzo, Julie A; Graybill, John C; Buehner, Michelle F; Hudak, Steven J; Thompson, Charles K; Chung, Kevin K

2017-08-01

Among service members injured in Iraq and Afghanistan, to determine the risk of mortality associated with combat-related burns to the genitalia, perineum, and buttocks. The prospectively maintained burn registry from the United States Army Institute of Surgical Research was retrospectively reviewed to identify all service members with combat-related burns sustained in Iraq and Afghanistan from March 2003 to October 2013. The two primary risk factors of interest were (1) any burn to the genitals, perineum, and/or buttocks (PB) and (2) burns involving the entire perineal, genital, and buttock region (complete PB). Cox proportional hazard models were used to estimate the risk of mortality for both primary risk factors, and adjusted for severe non-burn-related trauma, percent of burn over total body surface area (TBSA), inhalational injury, time to urinary tract infection, and time to bacteremia. A post-hoc analysis was performed to explore the potential effect modification of TBSA burned on the relationship between PB and mortality. Among the 902 U.S. service members with combat-related burns sustained during the study period, 226 (25.0%) had involvement of the genitalia, perineum, and/or buttocks. Complete PB was associated with a crude risk of mortality (HR: 5.3; 2.9-9.7), but not an adjusted risk (HR=1.8; 0.8-4.0). However, TBSA burned was identified as a potential negative effect modifier. Among patients with burns <60% TBSA, sustaining a complete PB conferred an adjusted risk of death (HR=2.7; 1.1-6.8). Further, patients with a perineal burn had a five-fold increased incidence of bacteremia. In adjusted models, each event of bacteremia increased the risk of mortality by 92% (HR 1.92; 1.39-2.65). Perineal burns were associated with a two-fold increased incidence of severe non-burn related trauma that also doubled mortality risk in adjusted models (HR 2.29; 1.23-4.27). Among those with relatively survivable combat-related burns (<60% TBSA), genital/perineal/buttock involvement increases the risk of death. Bacteremia may account for part of this increased risk, but does not fully explain the independent risk associated with perineal burns. Published by Elsevier Ltd.

The Effect of Prescribed Burns and Wildfire on Vegetation in Bastrop State Park, TX

NASA Astrophysics Data System (ADS)

Justice, C. J.

2014-12-01

In 2011, central Texas had its worst drought since the 1950's. This, in conjunction with the strong winds produced by Tropical Storm Lee created conditions that made possible the Bastrop County Complex Fire in September 2011. These record-breaking wildfires burned over 95% of the 6,565-acre Bastrop State Park (BSP). Since 2003, BSP had been using prescribed burns as a management practice to reduce fuel load and prevent high severity wildfires. Although these prescribed fires did not prevent the 2011 wildfires they may have mitigated their effects. This study considered the effect of prescribed burn history and wildfire burn severity on vegetation recovery in BSP since the 2011 wildfire. The hypotheses of this study are that prescribed burn history and wildfire burn severity separately and jointly have affected post wildfire vegetation. To test these hypotheses, data were collected in 2013 from 46 plots across BSP using the Fire Effects Monitoring and Inventory (FIREMON) protocol to determine herbaceous plant density, shrub density, overstory density, and midstory tree density. Data were analyzed using analyses of variance (ANOVA) to determine the effects of prescribed fire and wildfire severity on these vegetation measurements. It was found that more severely burned plots had more herbaceous plants, fewer midstory trees, and lower shrub densities than less severely burned plots. Contrary to an initial hypotheses, there were few relationships between prescribed burn history and wildfire effects. The only significant effect detected for prescribed burning was the positive effect of prescribed fire on midstory tree density, but only for plots that were not severely burned in the wildfire. In this system, burn severity had a greater effect on post-wildfire vegetation than prescribed burns.

Desert tortoise use of burned habitat in the Eastern Mojave desert

USGS Publications Warehouse

Drake, Karla K.; Esque, Todd C.; Nussear, Kenneth E.; DeFalco, Lesley; Scoles, Sara; Modlin, Andrew T.; Medica, Philip A.

2015-01-01

Wildfires burned 24,254 ha of critical habitat designated for the recovery of the threatened Mojave desert tortoise (Gopherus agassizii) in southern Nevada during 2005. The proliferation of non-native annual grasses has increased wildfire frequency and extent in recent decades and continues to accelerate the conversion of tortoise habitat across the Mojave Desert. Immediate changes to vegetation are expected to reduce quality of critical habitat, yet whether tortoises will use burned and recovering habitat differently from intact unburned habitat is unknown. We compared movement patterns, home-range size, behavior, microhabitat use, reproduction, and survival for adult desert tortoises located in, and adjacent to, burned habitat to understand how tortoises respond to recovering burned habitat. Approximately 45% of home ranges in the post-fire environment contained burned habitat, and numerous observations (n = 12,223) corroborated tortoise use of both habitat types (52% unburned, 48% burned). Tortoises moved progressively deeper into burned habitat during the first 5 years following the fire, frequently foraging in burned habitats that had abundant annual plants, and returning to adjacent unburned habitat for cover provided by intact perennial vegetation. However, by years 6 and 7, the live cover of the short-lived herbaceous perennial desert globemallow (Sphaeralcea ambigua) that typically re-colonizes burned areas declined, resulting in a contraction of tortoise movements from the burned areas. Health and egg production were similar between burned and unburned areas indicating that tortoises were able to acquire necessary resources using both areas. This study documents that adult Mojave desert tortoises continue to use habitat burned once by wildfire. Thus, continued management of this burned habitat may contribute toward the recovery of the species in the face of many sources of habitat loss.

A modified surgical technique in the management of eyelid burns: a case series

PubMed Central

2011-01-01

Introduction Contractures, ectropion and scarring, the most common sequelae of skin grafts after eyelid burn injuries, can result in corneal exposure, corneal ulceration and even blindness. Split-thickness or full-thickness skin grafts are commonly used for the treatment of acute eyelid burns. Plasma exudation and infection are common early complications of eyelid burns, which decrease the success rate of grafts. Case presentation We present the cases of eight patients, two Chinese women and six Chinese men. The first Chinese woman was 36 years old, with 70% body surface area second or third degree flame burn injuries involving her eyelids on both sides. The other Chinese woman was 28 years old, with sulfuric acid burns on her face and third degree burn on her eyelids. The six Chinese men were aged 21, 31, 38, 42, 44, and 55 years, respectively. The 38-year-old patient was transferred from the ER with 80% body surface area second or third degree flame burn injuries and third degree burn injuries to his eyelids. The other five men were all patients with flame burn injuries, with 7% to 10% body surface area third degree burns and eyelids involved. All patients were treated with a modified surgical procedure consisting of separation and loosening of the musculus orbicularis oculi between tarsal plate and septum orbital, followed by grafting a large full-thickness skin graft in three days after burn injury. The use of our modified surgical procedure resulted in 100% successful eyelid grafting on first attempt, and all our patients were in good condition at six-month follow-up. Conclusions This new surgical technique is highly successful in treating eyelid burn injuries, especially flame burn injuries of the eyelid. PMID:21843322

β-adrenergic blockade does not impair the skin blood flow sensitivity to local heating in burned and non-burned skin under neutral and hot environments in children

PubMed Central

Rivas, Eric; McEntire, Serina J.; Herndon, David N.; Mlcak, Ronald P.; Suman, Oscar E.

2017-01-01

Objective Tested the hypothesis that propranolol, a drug given to burn patients to reduce hypermetabolism/cardiac stress, may inhibit heat dissipation by changing the sensitivity of skin blood flow (SkBF) to local heating under neutral and hot conditions. Methods In a randomized double-blind study, a placebo was given to 8 burned children while propranolol was given to 13 burned children with similar characteristics (mean ± SD: 11.9±3y, 147±20cm, 45±23kg, 56±12% TBSA). Non-burned children (n=13, 11.4±3y, 152±15cm, 52±13kg) served as healthy controls. A progressive local heating protocol characterized SkBF responses in burned and unburned skin and non-burned control skin under the two environmental conditions (23°C and 34°C) via laser-Doppler flowmetry. Results Resting SkBF was greater in burned and unburned skin compared to the non-burned control (main effect: skin, P<0.0001; 57±32 burned; 38±36 unburned vs 9±8 control %SkBFmax). No difference was found for maximal SkBF capacity to local heating between groups. Additionally, dose response curves for the sensitivity of SkBF to local heating were not different among burned or unburned skin, and non-burned control skin (EC50, P>0.05) under either condition. Conclusion Therapeutic propranolol does not negatively affect SkBF under neutral or hot environmental conditions and further compromise temperature regulation in burned children. PMID:28071840

Evaluating the Socioeconomic and Cultural Factors Associated with Pediatric Burn Injuries in Maputo, Mozambique

PubMed Central

Karan, Abraar; Amado, Vanda; Vitorino, Pio; Kulber, David; Taela, Atanasio; DeUgarte, Daniel

2015-01-01

Background Pediatric burn injuries are one of the leading causes of preventable morbidity and mortality in Sub-Saharan Africa. Research on the complex system of social, economic and cultural factors contributing to burn injuries in this setting is much needed. Methods We conducted a prospective questionnaire-based analysis of pediatric burn patients presenting to the Hospital Central de Maputo. A total of 39 patients were included in the study. Interviews were conducted with the children’s caretakers by two trained medical students at the Eduardo Mondlane Medical School in Maputo with the aid of local nursing staff. Results Most burns occurred from scald wounds (26/39) particularly from bathwater, followed by fire burns (11/39). Burns occurred more frequently in the afternoon (16/39) and evening (16/39). Over one quarter of burns (9/33) occurred in the absence of a caretaker. One third (12/36) of participants attempted to treat the burn at home prior to bringing the child in to the hospital, and roughly two-thirds (24/37) reported using traditional remedies for burn care. The average household had just 2 rooms for an average of 5 family members. Most burns were grade II (25/37). Conclusions Prevention efforts in this setting are much needed and can be implemented taking complex cultural and social factors into account. Education regarding regulation of water temperature for baths is important, given the prevalence of scald burns. Moreover, the introduction of low-cost, safer cooking technology can help mitigate inhalation injury and reduce fire burns. Additionally, burn care systems must be integrated with local traditional medical interventions to respect local cultural medicinal practices. PMID:26280740

Burns at KCMC: epidemiology, presentation, management and treatment outcome.

PubMed

Ringo, Y; Chilonga, K

2014-08-01

About 90% of the global burden of burns occurs in the low and middle income countries. In Africa it is estimated that between 17,000 and 30,000 children under five die each year due to burns. In Tanzania there are no specialized burn centers. Burn patients are often managed in the general surgical wards in most hospitals. Kilimanjaro Christian Medical Centre is one of the four tertiary referral hospitals in Tanzania. This study aimed to review the epidemiology presentation management and outcome of burn patients in this challenging environment. A cross-sectional prospective study involving 41 patients was undertaken from October 2011 to April 2012. 65.9% were males. The largest age group was below 5 years (36.6%). 19.5% were epileptic. More than half of the burns were due to open flame. 80.5% had second degree burns. 56.1% had a BSA of 15% or less and 56.1% had an APACHE score of 10 or less. It was found that 73.2% of burns occurred at home. The commonest prehospital first aid applied was honey. Only 41.5% arrived in hospital within the first 24h after burn. Among the 14.6% who had skin grafting, none had early excision of burn wound. 53.7% developed wound sepsis while 24.4% developed contractures. The mortality rate was 26.8%. Children under five are the worst affected by burns. Most patients had second degree burn wounds. Inappropriate management of the burn wound started just after injury and continued even in hospital. Mortality and complication rates are high. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Pediatric scalds: do cooking-related burns have a higher injury burden?

PubMed

Bachier, Marielena; Hammond, Sarah E; Williams, Regan; Jancelewicz, Timothy; Feliz, Alexander

2015-11-01

Pediatric scald burns result in frequent emergency room visits and hospitalizations. We investigated whether cooking-related burns produce greater morbidity requiring more extensive care than noncooking burns. We performed a 6-y review at our free-standing children's hospital. Children aged <18 y admitted for accidental scald burns were included. Demographics, injury pattern, treatment, and outcome (contractures and/or limited mobility and nonhealing and/or infected wounds) data were analyzed comparing cooking versus noncooking burns. The Mann-Whitney U test, a chi-square test, and the negative binomial were used to compare continuous, categorical, and count data between groups. Bivariate analysis was performed to identify risk factors among patients with adverse outcomes. We identified 308 patients; 262 (85%) cooking and 46 (15%) noncooking burns. Most patients were African-American males, with public insurance, and a median age of 2 y. Cooking burns preferentially occurred over the head, neck, and upper body; noncooking burns were distributed over the lower body (P < 0.02). Median total body surface area was equal for both groups (P > 0.11). In subgroup analysis, semisolid and grease burns resulted in increased rates of wound contractures and/or limited mobility when compared with noncooking burns (P = 0.05 and P = 0.008, respectively). Patients with complications were more likely to have third degree burns and required more consults, longer hospitalization, and more surgical debridements and clinic visits. Most accidental scald burns occurred in young children during food preparation. Greater long-term morbidity was found in patients with semisolid and grease burns. This subset of children has a higher injury burden and requires extensive care in the acute and long-term setting. Copyright © 2015 Elsevier Inc. All rights reserved.

Epidemiology of burns undergoing hospitalization to the National Burns Unit in the Sultanate of Oman: a 25-year review.

PubMed

Al-Shaqsi, Sultan; Al-Kashmiri, Ammar; Al-Bulushi, Taimoor

2013-12-01

The aim of this study was to describe the epidemiology of burns admitted to the National Burns Unit (NBU) in the Sultanate of Oman between 1987 and 2011. This is a retrospective review of burn patients admitted to Oman's National Burns Unit (NBU) between 1987 and 2011. The data extracted from the national burn registry. The study describes the admission rate by gender and age groups, occupation, causes of burns, time-to-admission, length of stay and in-hospital mortality of burns between 1987 and 2011. During a 25-year from 1987 to 2011, there were 3531 burn patients admitted to the National Burns Unit in Oman. The average admission rate to NBU is 7.02 per 100,000 persons per year. On average, males were more likely to be admitted to the NBU than females during the study period (P value < 0.04). Patients aged 1-10 years old constituted 46.6% of caseload during the study period. Flames and scalds caused 88.4% of burns. About half of all patients admitted to the NBU have burns to more than 11% of total body surface area (TBSA). The average stay in hospital was estimated to be 15.3 days per patient. The average in-hospital mortality rate was estimated to be 8.2% per year (range 1.9-22%). Burns are significant public health issue in the Sultanate of Oman. Children are disproportionately over-represented in this study. Prevention programmes are urgently needed to address this "silent and costly epidemic." Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

[Comparison of occupational and home accidents as a cause of severe burns. The experience of a large burn center in an industrial city].

PubMed

Romano, C; Arturi, L; Rubino, G F; Magliacani, G

1989-01-01

Among acute "traumatisms", occupational and domestic accidents chiefly share burn. To compare these two causes of severe burns, we examined clinical records of patients hospitalized from January 1986 to February 1989 in the "Grand Burns Center" at the C.T.O. hospital in Turin. Data exclusively refer to patients over 12 years old. 61 out of 313 cases (19%) were due to occupational burns, 221 (71%) to domestic ones (left cases including burns occurred in different surroundings). Males predominance was very high (95%) in the occupational settings, lower though still relevant (60%) in the domestic ones. The topographic distribution of the burns did not show any relevant difference. Similarly, the two groups did not differ as the affected percent of the body surface area (BSA) is concerned: in both cases burns extended cases. Decreased patients were fairly more numerous among the domestic burns (33%) as compared to the occupational ones (18%). The overwhelming majority (90.5%) of domestic burns were caused by fire; such a predominance, though present, was lower (68.8%) among occupational accidents. More in detail, domestic burns were caused as follows: alcohol spraying to stir a fire (26%), gas burst (25%), flammable substances exposed to heat sources (18%), hot water or different liquid (8%), fall over heating devices (6%), fires from cigarettes in bed (5%), kitchen stoves (with or without clothing fire) (5%), brushwood burning (4%), other (3%). It is worth noting that in as many as 40% of the cases of domestic burns patients were affected by a pre-existing neuro-psychic disorder, namely: personality disorders (15%), psychiatric disorders (%), epilepsy (9%), mental debility (7%).

Burning Mouth Syndrome and "Burning Mouth Syndrome".

PubMed

Rifkind, Jacob Bernard

2016-03-01

Burning mouth syndrome is distressing to both the patient and practitioner unable to determine the cause of the patient's symptoms. Burning mouth syndrome is a diagnosis of exclusion, which is used only after nutritional deficiencies, mucosal disease, fungal infections, hormonal disturbances and contact stomatitis have been ruled out. This article will explore the many causes and treatment of patients who present with a chief complaint of "my mouth burns," including symptomatic treatment for those with burning mouth syndrome.

Efficacy of enzymatic debridement of deeply burned hands.

PubMed

Krieger, Yuval; Bogdanov-Berezovsky, Alexander; Gurfinkel, Reuven; Silberstein, Eldad; Sagi, Amiram; Rosenberg, Lior

2012-02-01

The burned hand is a common and difficult to care-for entity in the field of burns. Due to the anatomy of the hand (important and delicate structures crowded in a small limited space without sub-dermal soft tissue), surgical debridement of the burned tissue is technically difficult and may cause considerable complications and, therefore, should be performed judiciously. Selective enzymatic debridement of the burn wound can preserve the spontaneous epithelialisation potential and reduce the added injury to the traumatised tissue added by a surgical debridement. The aim of the study was to assess the implication of a selective enzymatic compound (Debrase(®) - Ds) in the special field of deep hand burns, by comparing the actual burn area that required surgical coverage after enzymatic debridement to the burn area clinically judged to require skin grafting prior to debridement. This was a retrospective data collection and analysis from 154 complete files of prospective, open-label study in 275 hospitalised, Ds-treated burn patients. A total of 69 hand burns diagnosed as 'deep' was analysed; 36% of the wounds required surgical intervention after enzymatic debridement; 28.6% of the total burned area estimated initially as deep was covered by skin graft (statistically significant p<0.001). Debridement of deep-hand burns with a selective enzymatic agent decreased the perceived full-thickness wound area and skin-graft use. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

Current methods of burn reconstruction.

PubMed

Orgill, Dennis P; Ogawa, Rei

2013-05-01

After reading this article, the participant should be able to: 1. Explain the present challenges in reconstructive burn surgery. 2. Describe the most appropriate treatment methods and techniques for specific burn injury types, including skin grafts, dermal substitutes, and a variety of flap options. 3. Identify the appropriate use, advantages, and disadvantages of specific flaps in the treatment of burn injuries, including local, regional, superthin, prefabricated, prelaminated, and free flaps. Victims of thermal burns often form heavy scars and develop contractures around joints, inhibiting movement. As burns can occur in all cutaneous areas of the body, a wide range of reconstructive options have been utilized. Each method has advantages and disadvantages that must be considered by both patients and surgeons. The authors reviewed the literature for burn reconstruction and focused their discussion on areas that have been recently developed. They reviewed the mechanism of burn injury and discussed how this relates to the pathophysiology of the burn injury. Surgeons now have a wide array of plastic surgical techniques that can be used to treat burn victims. These range from skin grafts and local flaps to free flaps, prefabricated flaps, superthin flaps, and dermal scaffolds. Recent advances in burn reconstruction provide methods to decrease scar tissue and joint contractures. In the future, the authors hope that further developments in burn treatment will foster the development of new technologies that will allow site-specific reconstruction with minimal donor-site morbidity.

Estimating the usage of allograft in the treatment of major burns.

PubMed

Horner, C W M; Atkins, J; Simpson, L; Philp, B; Shelley, O; Dziewulski, P

2011-06-01

To assess the amount of allograft used in the past treatment of major burns and calculate a figure to guide estimation of the quantity of allograft required to treat future patients and aid resource planning. A retrospective observational study. Records of 143 patients treated with major burns at a regional centre, from January 2004 to November 2008 were accessed with biometric data and quantity of allograft used being recorded. This data was used to calculate an allograft index (cm² allograft used/burn surface area (cm²)) (AI) for each patient. 112 of the 143 patients had complete sets of data, of the 112, 89 patients survived the initial stay in hospital. For all data average AI=1.077 ± 0.090. AI varied according to burn % area with burns < 40% requiring 0.490 cm² allo/cm²burn, increasing in a logarithmic fashion (R²=0.995) for burn areas > 40%. The ability to estimate deceased donor skin requirements based on % body surface area affected is important in the care planning for patients with major burns. Our findings of 0.5 cm² allograft/cm² burn for injuries less than 40% TBSA, increasing to 1.82 cm² allograft/cm² burn for injuries up to 80% TBSA can be used for planning purposes for individual services and for burn disaster planning. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

In-situ burning of oil in coastal marshes. 2. Oil spill cleanup efficiency as a function of oil type, marsh type, and water depth.

PubMed

Lin, Qianxin; Mendelssohn, Irving A; Carney, Kenneth; Miles, Scott M; Bryner, Nelson P; Walton, William D

2005-03-15

In-situ burning of spilled oil, which receives considerable attention in marine conditions, could be an effective way to cleanup wetland oil spills. An experimental in-situ burn was conducted to study the effects of oil type, marsh type, and water depth on oil chemistry and oil removal efficiency from the water surface and sediment. In-situ burning decreased the totaltargeted alkanes and total targeted polycyclic aromatic hydrocarbons (PAHs) in the burn residues as compared to the pre-burn diesel and crude oils. Removal was even more effective for short-chain alkanes and low ring-number PAHs. Removal efficiencies for alkanes and PAHs were >98% in terms of mass balance although concentrations of some long-chain alkanes and high ring-number PAHs increased in the burn residue as compared to the pre-burn oils. Thus, in-situ burning potentially prevents floating oil from drifting into and contaminating adjacent habitats and penetrating the sediment. In addition, in-situ burning significantly removed diesel oil that had penetrated the sediment for all water depths. Furthermore, in-situ burning at a water depth 2 cm below the soil surface significantly removed crude oil that had penetrated the sediment. As a result, in-situ burning may reduce the long-term impacts of oil on benthic organisms.

Cytokine expression profile over time in burned mice.

PubMed

Finnerty, Celeste C; Przkora, Rene; Herndon, David N; Jeschke, Marc G

2009-01-01

The persistent inflammatory response induced by a severe burn increases patient susceptibility to infections and sepsis, potentially leading to multi-organ failure and death. In order to use murine models to develop interventions that modulate the post-burn inflammatory response, the response in mice and the similarities to the human response must first be determined. Here, we present the temporal serum cytokine expression profiles in burned mice in comparison to sham mice and human burn patients. Male C57BL/6 mice were randomized to control (n=47) or subjected to a 35% TBSA scald burn (n=89). Mice were sacrificed 3, 6, 9, 12, 24, and 48 h and 7, 10, and 14 days post-burn; cytokines were measured by multi-plex array. Following the burn injury, IL-6, IL-1beta, KC, G-CSF, TNF, IL-17, MIP-1alpha, RANTES, and GM-CSF were increased, p<0.05. IL-2, IL-3, and IL-5 were decreased, p<0.05. IL-10, IFN-gamma, and IL-12p70 were expressed in a biphasic manner, p<0.05. This temporal cytokine expression pattern elucidates the pathogenesis of the inflammatory response in burned mice. Expression of 11 cytokines were similar in mice and children, returning to lowest levels by post-burn day 14, confirming the utility of the burned mouse model for development of therapeutic interventions to attenuate the post-burn inflammatory response.

Utility of spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI) to non-invasively diagnose burn depth in a porcine model☆

PubMed Central

Burmeister, David M.; Ponticorvo, Adrien; Yang, Bruce; Becerra, Sandra C.; Choi, Bernard; Durkin, Anthony J.; Christy, Robert J.

2015-01-01

Surgical intervention of second degree burns is often delayed because of the difficulty in visual diagnosis, which increases the risk of scarring and infection. Non-invasive metrics have shown promise in accurately assessing burn depth. Here, we examine the use of spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI) for predicting burn depth. Contact burn wounds of increasing severity were created on the dorsum of a Yorkshire pig, and wounds were imaged with SFDI/LSI starting immediately after-burn and then daily for the next 4 days. In addition, on each day the burn wounds were biopsied for histological analysis of burn depth, defined by collagen coagulation, apoptosis, and adnexal/vascular necrosis. Histological results show that collagen coagulation progressed from day 0 to day 1, and then stabilized. Results of burn wound imaging using non-invasive techniques were able to produce metrics that correlate to different predictors of burn depth. Collagen coagulation and apoptosis correlated with SFDI scattering coefficient parameter ( μs′) and adnexal/vascular necrosis on the day of burn correlated with blood flow determined by LSI. Therefore, incorporation of SFDI scattering coefficient and blood flow determined by LSI may provide an algorithm for accurate assessment of the severity of burn wounds in real time. PMID:26138371

Epidemiology and outcome analysis of hand burns: A 5-year retrospective review of 378 cases in a burn center in Eastern China.

PubMed

Wang, Kang-an; Sun, Yu; Wu, Guo-sheng; Wang, Yi-ru; Xia, Zhao-fan

2015-11-01

Hands are frequent sites of burn but few related studies were reported in China. The aim of this study was to examine the impacts of gender, age, seasons, place, etiology, total body surface area (TBSA), depth, infection and comorbidities on prognosis following injury in a cohort of hand burn inpatients. This is a retrospective study of total 378 inpatients admitted to the burn center of Changhai hospital from January 2009 to December 2013. The present research showed the male inpatients were predominant and most of the inpatients aged from 20 to 49. Flame (37.04%) and electricity (25.40%) were the major causes of hand burns. Hand burns happened more commonly in work place (60.85%). The study preliminarily pointed out that male, flame and depth were the most significant factors impacting surgery. The main factors relevant to amputation were identified including the electrical burns and other etiology of burns. In addition, depth of hand burns was proved to have a higher impact on length of hospital stay (LOS) than other factors. The results of this study not only provide the necessary information of hand burns in Eastern China but also give the suggestions for the prevention of hand burns. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Pattern of unintentional burns: A hospital based study from Pakistan.

PubMed

Adil, Syed Omair; Ibran, Ehmer-Al; Nisar, Nighat; Shafique, Kashif

2016-09-01

Burns are major cause of morbidity and mortality in developing countries. Better understanding of the nature and extent of injury remains the major and only available way to halt the occurrence of the event. The present study was conducted to determine the prevalence of by self and by other unintentional burn, their comparison and the possible mode of acquisition by obtaining the history of exposure to known risk factors. A cross-sectional questionnaire based survey was conducted in Burns Centre of Civil Hospital Karachi, Pakistan and 324 hospitalized adult patients with unintentional burns were consecutively interviewed during August 2013 to February 2014. Information was collected on socio-demographic profile. The source of burn, affected body part and place of injury acquisition in terms of home, outside or work were also noted. Logistic regression model was conducted using SPSS software. Out of 324 patients, 295 (91%) had unintentional burn by self and 29 (9%) had unintentional burn by others. Male gender were 2.37 times and no schooling were 1.75 times more likely to have self-inflicted unintentional burn. Lower limb and head and neck were less likely to involve in unintentional burn by self. The burden of unintentional burn by self was considerably higher. Male gender and no schooling were found more at risk to have unintentional burn by self. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Effects of site preparation on seedling, growth: a preliminary comparison of broadcast burning and pile burning.

Treesearch

Don Minore

1986-01-01

Site preparation is often necessary to obtain adequate forest regeneration, but inappropriate treatment may reduce subsequent growth. Broadcast-burned and piled-and-burned plantations were studied in southwestern Oregon to determine if burning method affected the growth of Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco var. menziesii...

Lenticular burns following argon panretinal photocoagulation.

PubMed Central

Bloom, S. M.; Mahl, C. F.; Schiller, S. B.

1992-01-01

Photocoagulation burns of the crystalline lens are a rare complication of posterior segment laser surgery. These burns occur more commonly in eyes with cataracts and with small, high-power, long-duration argon blue-green burns. We describe the first occurrence of lenticular burns caused by a fractured laser fibre optic cord. Images PMID:1340772

A MODIS-based burned area assessment for Russian croplands: mapping requirements and challenges

USDA-ARS?s Scientific Manuscript database

Although agricultural burning is banned in Russia it is still a widespread practice and the challenge in mapping cropland burning has led to a wide range of burned area estimates. Accurately monitoring cropland burned area is an important task as these estimates are used in the calculation of cropla...

46 CFR 45.181 - Load line exemption requirements for the Burns Harbor and Milwaukee routes.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 2 2014-10-01 2014-10-01 false Load line exemption requirements for the Burns Harbor... line exemption requirements for the Burns Harbor and Milwaukee routes. Barges operating on the Burns... addresses and telephone numbers); (3) Service route (Milwaukee and/or Burns Harbor); (4) Design type...

46 CFR 45.181 - Load line exemption requirements for the Burns Harbor and Milwaukee routes.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 2 2013-10-01 2013-10-01 false Load line exemption requirements for the Burns Harbor... line exemption requirements for the Burns Harbor and Milwaukee routes. Barges operating on the Burns... addresses and telephone numbers); (3) Service route (Milwaukee and/or Burns Harbor); (4) Design type...

46 CFR 45.181 - Load line exemption requirements for the Burns Harbor and Milwaukee routes.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 2 2012-10-01 2012-10-01 false Load line exemption requirements for the Burns Harbor... line exemption requirements for the Burns Harbor and Milwaukee routes. Barges operating on the Burns... addresses and telephone numbers); (3) Service route (Milwaukee and/or Burns Harbor); (4) Design type...

46 CFR 45.181 - Load line exemption requirements for the Burns Harbor and Milwaukee routes.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 2 2011-10-01 2011-10-01 false Load line exemption requirements for the Burns Harbor... line exemption requirements for the Burns Harbor and Milwaukee routes. Barges operating on the Burns... addresses and telephone numbers); (3) Service route (Milwaukee and/or Burns Harbor); (4) Design type...

46 CFR 45.181 - Load line exemption requirements for the Burns Harbor and Milwaukee routes.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 2 2010-10-01 2010-10-01 false Load line exemption requirements for the Burns Harbor... line exemption requirements for the Burns Harbor and Milwaukee routes. Barges operating on the Burns... (Milwaukee and/or Burns Harbor); (4) Design type (covered/uncovered hopper, deck, etc.); (5) External...

30 CFR 250.1162 - When may I burn produced liquid hydrocarbons?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false When may I burn produced liquid hydrocarbons... Requirements Flaring, Venting, and Burning Hydrocarbons § 250.1162 When may I burn produced liquid hydrocarbons... hydrocarbons. The Regional Supervisor may allow you to burn liquid hydrocarbons if you demonstrate that...

Environmental factors that influence prescribed burning in the Northern Plains

USGS Publications Warehouse

Kruse, A.D.; Higgins, K.F.; Piehl, J.L.

1983-01-01

Several environmental conditions were recorded and analyzed for 192 prescribed burns in the Northern Great Plains. The purpose of these burns was to improve wildlife habitat and manipulate native prairie vegetation. All of the fires occurred in grassland and shrubsteppe vegetation types. Fuels were predominantly grasses and forbs intermixed with patches of shrubs. Nearly all of the fuels were 0.05 cm/h, do not burn. However, these are good conditions to burn stockpiles of unwanted fuels that are usually high risk elements during regular prescribed burns.2) Produce partial burns. Partial burns are defined as those where fire is discontinuous and patches of standing and lodged vegetation are left unburned. Partial burns occur most often when fine fuels feel moist when handled, where less than 2 days have passed since the last measurable precipitation, and when cloud cover is complete. Other conditions associated with partial burns are relative humidities >50 percent, temperatures 32 km/h, relative humidities 35 deg.C. These conditions occur most often in July, August, and September, but can occur anytime from April through October.

Lone star tick abundance, fire, and bison grazing in tall-grass prairie

USGS Publications Warehouse

Cully, J.F.

1999-01-01

Lone star ticks (Amblyomma americanum L.) were collected by drag samples of 1 km transects on 12 watersheds at Konza Prairie Research Natural Area near Manhattan, Kans., during summer 1995-1996. Watersheds were treated to 2 experimental treatments: 3 burn intervals (1-year, 4-year, and 20-year) and 2 grazing treatments (grazed by bison (Bos bison L.) or ungrazed). The objectives were to determine whether fire interval, time since most recent burn, and the presence of large ungulate grazers would cause changes in lone star tick abundance in tallgrass prairie in central Kansas. Watersheds burned at 1-year intervals had fewer larvae and adults than watersheds burned at 4-year or 20-year intervals. Watersheds burned during the year of sampling had fewer ticks than watersheds burned one or more years in the past. For watersheds burned 1 or more years in the past there was no effect from time since burn. The presence of bison did not affect tick abundance. Spring burning is an effective method to reduce tick populations in tallgrass prairie during the year of the burn.

Pattern of burn injury at north of Jordan.

PubMed

Bataineh, Ziad A; Al Quran, Thekraiat M; Al Balas, Hamzeh; Khammash, Muhmammad R

2018-01-01

To the best of our knowledge, pattern of burn injury was not reported yet at our region, our hospital considered the only tertiary referral center with the only burn unit at the region since 2001 till date, a retrospective analysis of our computerized filing system recorded 527 burn patients between 2001-2016, mean age was 26 years; 1.27:1 was the male to female ratio, 79 patients were found to have major burns, 46% of admissions were below 20 years' age, 92% was at domestic site of affection and 65% due to flame burn followed by scald burn in about 23%. The limbs were the most affected body site, majority of patients were below 15% TBSA and partial thickness, 77 patients found to have inhalational injury. Our mean hospital stay was 16 days and mortality was 8.2%. Mortality was associated with high TBSA affection, depth and flame type. This study shows the pattern of burn at north of Jordan, preventive measures by education and observation will reduce the incidence of burn and its sequel, non-flammable cook plates and stoves will probably help in decrease burn morbidity and mortality.

Moist Exposed Burn Ointment (MEBO) in partial thickness burns - a randomized, comparative open mono-center study on the efficacy of dermaheal (MEBO) ointment on thermal 2nd degree burns compared to conventional therapy.

PubMed

Hirsch, T; Ashkar, W; Schumacher, O; Steinstraesser, L; Ingianni, G; Cedidi, C C

2008-11-24

Wound healing in burn wounds presents a challenge in healthcare, and there is still a lack of alternatives in topical burn wound treatments. - The purpose of this study was to evaluate the efficacy of a new therapeutic ointment (MEBO) in the treatment of partial thickness burns. 40 patients received either topical treatment with Moist Exposed Burn Ointment (MEBO) or standard Flammazine treatment. All patients suffered from partial-thickness burn injuries (< 20% TBSA). Wounds were evaluated for 60 up to days regarding wound healing, water loss, inflammation, and pain alleviation. For transepidermal water loss, there was a difference of 2.3 gr/m2/h between MEBO, and Flammazine, favoring MEBO. However, this difference was not statistically significant (p=0.78). For all secondary efficacy parameter results were similar. - This study showed that MEBO ointment for topical treatment of burn injuries presents an attractive alternative for the topical treatment of limited partial thickness thermal burns.

ISBI Practice Guidelines for Burn Care.

PubMed

2016-08-01

Practice guidelines (PGs) are recommendations for diagnosis and treatment of diseases and injuries, and are designed to define optimal evaluation and management. The first PGs for burn care addressed the issues encountered in developed countries, lacking consideration for circumstances in resource-limited settings (RLS). Thus, the mission of the 2014-2016 committee established by the International Society for Burn Injury (ISBI) was to create PGs for burn care to improve the care of burn patients in both RLS and resource-abundant settings. An important component of this effort is to communicate a consensus opinion on recommendations for burn care for different aspects of burn management. An additional goal is to reduce costs by outlining effective and efficient recommendations for management of medical problems specific to burn care. These recommendations are supported by the best research evidence, as well as by expert opinion. Although our vision was the creation of clinical guidelines that could be applicable in RLS, the ISBI PGs for Burn Care have been written to address the needs of burn specialists everywhere in the world. Copyright © 2016. Published by Elsevier Ltd.

Soil geochemistry controls fire severity: A soil approach to improved understanding of forest fire consequences in southwest Montana.

NASA Astrophysics Data System (ADS)

Callahan, R.; Hartshorn, T.

2014-12-01

Fire severity can be defined using satellite imagery to ratio mid (~2.2 um) to near (~0.8 um) infrared reflectance values. We examined how lithology and topography affected burn severity, and how post-fire soils data could be used to ground-truth burn severity at two sites in southwestern Montana. A burned area reflectance classification (BARC), lithology, and terrain attributes were used to predict burn severity for the Millie Fire, which was triggered two years ago by lightning and burned ~4,000 ha. Burn severity showed a strong dependence on lithology: the ratio of areas with high burn severity vs. low or moderate burn severities was 2.9 for gneiss (vs. 0.3 for volcanics). The high-severity burn area for the gneiss was larger than the volcanics, despite the latter lithology covering ~270% greater area (~2,600 ha). Aspect and elevation also influenced burn severity with lower severity at higher elevations (2,600-3,000 m) and higher severity at lower elevations (1,800-2,400 m). Southern and western aspects burned more severely than northern and eastern aspects. To clarify whether post-fire soil geochemical changes might predict ground-based estimates of fire severity, a lab experiment was carried out . We expected residual enrichment of trace metal concentrations, as soil organic matter (SOM) was combusted, which we quantified as loss on ignition (LOI). To test this approach, burned and unburned soils were sampled from the ~6000 ha Beartrap 2 fire, which also burned two years. We simulated differing fire severities on unburned soil using a muffle furnace factorially (duration [5, 15, 30, 45, or 60 minutes] x temperature [50, 100, 200, 300, 400, or 500ºC]). Consistent with expectations, unburned samples had a lower mean (±1SD) concentrations for 23 of 30 elements than field-burned samples. For example, barium concentrations ([Ba]) in unburned samples were (708±37μg/g), 16% lower than field-burned [Ba] (841±7 μg/g). Simulated burning yielded smaller [Ba] (732±9 μg/g). Of the 30 trace metals examined, barium explained the greatest fraction of variance in post-burn LOI (R2 =0.79); gallium explained slightly less variance (R2=0.67). Our results document the promise of post-burn soil geochemistry to indicate soil burn severity, which could complement vegetation-based and remotely sensed indices.

[Experimental determination of the time-dependent extent of after-burning with reference to possibilities of the plastic surgery reconstruction of 3d degree burns].

PubMed

Bäumer, F; Henrich, H A; Ussmüller, J

1986-02-01

The present experiments try to answer the question as to the time-dependent extent of the after-burning process after full-thickness burn (third degree). For an early plastic surgical treatment it was of interest to determine the most early time of escharotomy. The time-dependent spreading of the after-burning area reached its maximum five days after the burn injury. The after-burning area was marked by intravenous injections of Patentblau which caused distinct intravital colouring. Subsequently no further progress could be observed. In the present experiments we suggest this time as the earliest time for plastic covering in case it would be dependent upon the end of the after-burning process.

Effect of parenteral glutamine supplementation combined with enteral nutrition on Hsp90 expression and lymphoid organ apoptosis in severely burned rats.

PubMed

Fan, Jun; Wu, Jing; Wu, Li-Dong; Li, Guo-Ping; Xiong, Meng; Chen, Xi; Meng, Qing-Yan

2016-11-01

The aim of this study is to investigate the effects of parenteral glutamine(GLN) supplementation combined with enteral nutrition (EN) on heat shock protein 90(Hsp90) expression, apoptosis of lymphoid organs and circulating lymphocytes, immunological function and survival in severely burned rats. Male SD rats were randomly assigned into 4 groups: a sham burn+EN+GLN-free amino acid (AA) group (n=10), a sham burn+EN+GLN group (n=10), a burn+EN+AA group (n=10), and a burn +EN +GLN group (n=10). Two hours after a 30% total body surface area (TBSA), full-thickness scald burn injury on the back was made, the burned rats in two experimental groups (the burn+EN+AA group and the burn+EN +GLN group) were fed with a conventional enteral nutrition solution by oral gavage for 7 days. Simultaneously, the rats in the burn+EN+GLN group were given 0.35g GLN/kg body weight/day once via a tail vein injection for 7 days, whereas those in the burn+EN+AA group were administered isocaloric/isonitrogenous GLN-free amino acid solution (Tyrosine) for comparison. The rats in two sham burn control groups (the sham burn+EN+AA group and the sham burn+EN +GLN group) were treated in the same procedure as above, except for burn injury. All rats in each of the four groups were given 175kcal/kg body wt/day. There was isonitrogenous, isovolumic and isocaloric intake among four groups. At the end of the 7th day after nutritional programme were finished, all rats were anesthetized and samples were collected for further analysis. Serum immunoglobulin quantification was conducted by ELISA. Circulating lymphocyte numbers were counted by Coulter LH-750 Analyzer. The percentages and apoptotic ratio of CD4 and CD8T lymphocytes in circulation were determined by flow cytometry (FCM). The neutrophil phagocytosis index (NPI) was examined. The GLN concentrations in plasma, thymus, spleen and skeletal muscle were measured by high performance liquid chromatography (HPLC). The organ index evaluation and TUNEL analysis of thymus and spleen were carried out. The expression of Hsp90 in thymus and spleen was analyzed by western blotting. Moreover, the survival in burned rats was observed. The results revealed that parenteral GLN supplementation combined with EN significantly increased the GLN concentrations of plasma and tissues, the serum immunoglobulin content, the circulating lymphocyte number, the CD4/CD8 ratio, the indexes of thymus and spleen, NPI and survival as compared with the burn+EN+AA group (p<0.05). The expression of Hsp90 in thymus and spleen in the burn+EN+GLN group was significantly up-regulated as compared with the burn+EN+AA group (p<0.05). The apoptosis in circulating CD4 and CD8 lymphocytes, thymus and spleen in the burn+EN+GLN group was significantly decreased as compared with the burn+EN+AA group (p<0.05). The results of this study show that parenteral GLN supplementation combined with EN may increase the GLN concentrations of plasma and tissues, up-regulate the expression of Hsp90, attenuate apoptosis in lymphoid organ and circulating lymphocyte, enhance the immunological function and improve survival in severely burned rats. Clinically, therapeutic efforts at the modulation of the immune dysfunction may contribute to a favorable outcome in severely burned patients. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Causes, magnitude and management of burns in under-fives in district hospitals in Dar es Salaam, Tanzania.

PubMed

Justin-Temu, M; Rimoy, G; Premji, Z; Matemu, G

2008-04-01

To determine the causes, magnitude and management of burns in children under five years of age who were admitted in the district hospitals of Dar es Salaam City, Tanzania. In this study, a total of 204 under fives were enrolled. Questionnaires were used to elicit if the parent/caretaker had the knowledge of the cause of the burns, what was done immediately after burn injury, first aid given immediately after burn, source of the knowledge of first aid and when the child was taken to the hospital. Also the questionnaire was cited with data on the management of burns in the hospitals through observation and checking the treatment files. Forty nine percent were males while 50.5% were females. Most of the children (54.9%) were aged between 1-2 years. 78.4% had scalds while 21.6% had flame burns. No children were found to have burns caused by chemicals or electricity. Most of the burns (97.5%) occurred accidentally, although some (2.5%) were intentional. 68.6% of these burn injuries occurred in the kitchen. Immediately after burn 87.3% of the children had first aid applied on their wounds while 12.7% didn't apply anything. Of the agents used, honey was the most used (32.8%) followed by cold water (16.7%). The source of knowledge on these agents was from relatives and friends (72.5%), schools (7%), media (6%) and medical personnel (14%). The study further revealed that analgesics, intravenous fluids, antiseptics and antibiotics were the drugs used for treatment of burns in the hospital and that there was no specialized unit for burns in the hospitals. Causes of childhood burns are largely preventable requiring active social/medical education and public enlighten campaigns on the various methods of prevention. The government to see to it that hospitals have specialized units for managing burn cases and also the socio-economic status of its people be improved.

Determining the Uncertainties in Prescribed Burn Emissions Through Comparison of Satellite Estimates to Ground-based Estimates and Air Quality Model Evaluations in Southeastern US

NASA Astrophysics Data System (ADS)

Odman, M. T.; Hu, Y.; Russell, A. G.

2016-12-01

Prescribed burning is practiced throughout the US, and most widely in the Southeast, for the purpose of maintaining and improving the ecosystem, and reducing the wildfire risk. However, prescribed burn emissions contribute significantly to the of trace gas and particulate matter loads in the atmosphere. In places where air quality is already stressed by other anthropogenic emissions, prescribed burns can lead to major health and environmental problems. Air quality modeling efforts are under way to assess the impacts of prescribed burn emissions. Operational forecasts of the impacts are also emerging for use in dynamic management of air quality as well as the burns. Unfortunately, large uncertainties exist in the process of estimating prescribed burn emissions and these uncertainties limit the accuracy of the burn impact predictions. Prescribed burn emissions are estimated by using either ground-based information or satellite observations. When there is sufficient local information about the burn area, the types of fuels, their consumption amounts, and the progression of the fire, ground-based estimates are more accurate. In the absence of such information satellites remain as the only reliable source for emission estimation. To determine the level of uncertainty in prescribed burn emissions, we compared estimates derived from a burn permit database and other ground-based information to the estimates by the Biomass Burning Emissions Product derived from a constellation of NOAA and NASA satellites. Using these emissions estimates we conducted simulations with the Community Multiscale Air Quality (CMAQ) model and predicted trace gas and particulate matter concentrations throughout the Southeast for two consecutive burn seasons (2015 and 2016). In this presentation, we will compare model predicted concentrations to measurements at monitoring stations and evaluate if the differences are commensurate with our emission uncertainty estimates. We will also investigate if spatial and temporal patterns in the differences reveal the sources of the uncertainty in the prescribed burn emission estimates.

Should early amputation impact initial fluid therapy algorithms in burns resuscitation? A retrospective analysis using 3D modelling.

PubMed

Staruch, Robert M T; Beverly, A; Lewis, D; Wilson, Y; Martin, N

2017-02-01

While the epidemiology of amputations in patients with burns has been investigated previously, the effect of an amputation on burn size and its impact on fluid management have not been considered in the literature. Fluid resuscitation volumes are based on the percentage of the total body surface area (%TBSA) burned calculated during the primary survey. There is currently no consensus as to whether the fluid volumes should be recalculated after an amputation to compensate for the new body surface area. The aim of this study was to model the impact of an amputation on burn size and predicted fluid requirement. A retrospective search was performed of the database at the Queen Elizabeth Hospital Birmingham Regional Burns Centre to identify all patients who had required an early amputation as a result of their burn injury. The search identified 10 patients over a 3-year period. Burn injuries were then mapped using 3D modelling software. BurnCase3D is a computer program that allows accurate plotting of burn injuries on a digital mannequin adjusted for height and weight. Theoretical fluid requirements were then calculated using the Parkland formula for the first 24 h, and Herndon formula for the second 24 h, taking into consideration the effects of the amputation on residual burn size. This study demonstrated that amputation can have an unpredictable effect on burn size that results in a significant deviation from predicted fluid resuscitation volumes. This discrepancy in fluid estimation may cause iatrogenic complications due to over-resuscitation in burn-injured casualties. Combining a more accurate estimation of postamputation burn size with goal-directed fluid therapy during the resuscitation phase should enable burn care teams to optimise patient outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Work-related burn injuries in Ontario, Canada: a follow-up 10-year retrospective study

PubMed Central

Clouatre, Elsa; Gomez, Manuel; Banfield, Joanne; Jeschke, Marc G

2013-01-01

Work-related burn injuries contribute to a quarter of all burn injuries in USA. In 2009, the provincial Workplace Safety and Insurance Board reported 64,824 work-related injuries that resulted in time-lost, 1188 injuries (2%) were a result of burns. There have been two previous studies performed at a regional burn centre (1984-1990 and 1998-2000) looking at incidence and characteristics of work-related burns. There was no significant change between these two groups. The purpose of this study was to identify the recent pattern of work-related burns from 2001 to 2010 and to compare it to the previous studies. During the study period, 1427 patients were admitted for an acute injury to the regional burn centre. Of these, 330 were due to a work-related incident (23%). The mean age of patients was 40.5±11.9 years, 95% were male. The mean total body surface area burn was 11.9±16.2%. The most common mechanism of burn injury was flame (32.7%) followed by electrical (27%) and scald (19.7%), inhalation injury was present in 4.8% of patients and the mortality was 1.8%. Our study has shown that there has been a significant decrease in the incidence in work-related burns treated at the regional burn centre (23.1%, vs. 28.2% vs. 30.2% p<0.01), flame burns have now become the leading cause of injury, there was a significant reduction in inhalation injury (4.8% vs. 23% vs. 14.8%, p<0.00001), and mortality overtime (1.8%, vs. 4% vs. 6.7% p=0.02). These findings strongly suggests a change in the cause of work-related burns, improvement in burn care, and that prevention strategies may have been more effective. PMID:23352030

The effect of seasonality on burn incidence, severity and outcome in Central Malawi.

PubMed

Tyson, Anna F; Gallaher, Jared; Mjuweni, Stephen; Cairns, Bruce A; Charles, Anthony G

2017-08-01

In much of the world, burns are more common in cold months. However, few studies have described the seasonality of burns in sub-Saharan Africa. This study examines the effect of seasonality on the incidence and outcome of burns in central Malawi. A retrospective analysis was performed at Kamuzu Central Hospital and included all patients admitted from May 2011 to August 2014. Demographic data, burn mechanism, total body surface area (%TBSA), and mortality were analyzed. Seasons were categorized as Rainy (December-February), Lush (March-May), Cold (June-August) and Hot (September-November). A negative binomial regression was used to assess the effect of seasonality on burn incidence. This was performed using both the raw and deseasonalized data in order to evaluate for trends not attributable to random fluctuation. A total of 905 patients were included. Flame (38%) and Scald (59%) burns were the most common mechanism. More burns occurred during the cold season (41% vs 19-20% in the other seasons). Overall mortality was 19%. Only the cold season had a statistically significant increase in burn . The incidence rate ratios (IRR) for the hot, lush, and cold seasons were 0.94 (CI 0.6-1.32), 1.02 (CI 0.72-1.45) and 1.6 (CI 1.17-2.19), respectively, when compared to the rainy season. Burn severity and mortality did not differ between seasons. The results of this study demonstrate the year-round phenomenon of burns treated at our institution, and highlights the slight predominance of burns during the cold season. These data can be used to guide prevention strategies, with special attention to the implications of the increased burn incidence during the cold season. Though burn severity and mortality remain relatively unchanged between seasons, recognizing the seasonal variability in incidence of burns is critical for resource allocation in this low-income setting. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Mapping burned areas using dense time-series of Landsat data

USGS Publications Warehouse

Hawbaker, Todd J.; Vanderhoof, Melanie; Beal, Yen-Ju G.; Takacs, Joshua; Schmidt, Gail L.; Falgout, Jeff T.; Williams, Brad; Brunner, Nicole M.; Caldwell, Megan K.; Picotte, Joshua J.; Howard, Stephen M.; Stitt, Susan; Dwyer, John L.

2017-01-01

Complete and accurate burned area data are needed to document patterns of fires, to quantify relationships between the patterns and drivers of fire occurrence, and to assess the impacts of fires on human and natural systems. Unfortunately, in many areas existing fire occurrence datasets are known to be incomplete. Consequently, the need to systematically collect burned area information has been recognized by the United Nations Framework Convention on Climate Change and the Intergovernmental Panel on Climate Change, which have both called for the production of essential climate variables (ECVs), including information about burned area. In this paper, we present an algorithm that identifies burned areas in dense time-series of Landsat data to produce the Landsat Burned Area Essential Climate Variable (BAECV) products. The algorithm uses gradient boosted regression models to generate burn probability surfaces using band values and spectral indices from individual Landsat scenes, lagged reference conditions, and change metrics between the scene and reference predictors. Burn classifications are generated from the burn probability surfaces using pixel-level thresholding in combination with a region growing process. The algorithm can be applied anywhere Landsat and training data are available. For this study, BAECV products were generated for the conterminous United States from 1984 through 2015. These products consist of pixel-level burn probabilities for each Landsat scene, in addition to, annual composites including: the maximum burn probability and a burn classification. We compared the BAECV burn classification products to the existing Global Fire Emissions Database (GFED; 1997–2015) and Monitoring Trends in Burn Severity (MTBS; 1984–2013) data. We found that the BAECV products mapped 36% more burned area than the GFED and 116% more burned area than MTBS. Differences between the BAECV products and the GFED were especially high in the West and East where the BAECV products mapped 32% and 88% more burned area, respectively. However, the BAECV products found less burned area than the GFED in regions with frequent agricultural fires. Compared to the MTBS data, the BAECV products identified 31% more burned area in the West, 312% more in the Great Plains, and 233% more in the East. Most pixels in the MTBS data were detected by the BAECV, regardless of burn severity. The BAECV products document patterns of fire similar to those in the GFED but also showed patterns of fire that are not well characterized by the existing MTBS data. We anticipate the BAECV products will be useful to studies that seek to understand past patterns of fire occurrence, the drivers that created them, and the impacts fires have on natural and human systems.

Biomass Burning

Atmospheric Science Data Center

2015-07-27

Projects:  Biomass Burning Definition/Description:  Biomass Burning: This data set represents the geographical and temporal distribution of total amount of biomass burned. These data may be used in general circulation models (GCMs) and ...

Carbon dioxide emissions and energy balance closure before, during, and after biomass burning in mid-South rice fields

NASA Astrophysics Data System (ADS)

Fong, B.; Adviento-Borbe, A.; Reba, M. L.; Runkle, B.; Suvocarev, K.

2017-12-01

Biomass burning or field burning is a crop management practice that removes rice straw, reduces tillage, controls pests and releases nutrients for the next cropping season. Current field burning emissions are not included in agricultural field annual emissions largely because of the lack of studies, especially on the field scale. Field burning measurements are important for greenhouse gas emission inventories and quantifying the annual carbon footprint of rice. Paired eddy covariance systems were used to measure energy balance, CO2 fluxes, and H2O fluxes in mid-South US rice fields (total area of 25 ha) before, during and after biomass burning for 20 days after harvest. During the biomass burning, air temperatures increased 29°C, while ambient CO2 concentration increased from 402 to 16,567 ppm and H2O concentrations increased from 18.73 to 25.62 ppt. For the burning period, 67-86 kg CO2 ha-1 period-1 was emitted calculated by integrating fluxes over the biomass burning event. However, the estimated emission using aboveground biomass and combustion factors was calculated as 11,733 kg CO2 ha-1 period-1. Part of the difference could be attributed to sensor sensitivity decreasing 80% during burning for two minutes due to smoke. Net ecosystem exchange (NEE) increased by a factor of two, 1.14 before burning to 2.44 μmol m-2 s-1 possibly due to greater reduction of plant material and photosynthesis following burning. This study highlights the contribution of rice straw burning to total CO2 emissions from rice production.

Burn Injury Alters Epidermal Cholinergic Mediators and Increases HMGB1 and Caspase 3 in Autologous Donor Skin and Burn Margin

PubMed Central

Holmes, Casey J.; Plichta, Jennifer K.; Gamelli, Richard L.; Radek, Katherine A.

2016-01-01

Burn wound healing complications, such as graft failure or infection, are a major source of morbidity and mortality in burn patients. The mechanisms by which local burn injury alters epidermal barrier function in autologous donor skin and surrounding burn margin are largely undefined. We hypothesized that defects in the epidermal cholinergic system may impair epidermal barrier function and innate immune responses. The objective was to identify alterations in the epidermal cholinergic pathway, and their downstream targets, associated with inflammation and cell death. We established that protein levels, but not gene expression, of the α7 nicotinic acetylcholine receptor (CHRNA7) were significantly reduced in both donor and burn margin skin. Furthermore, the gene and protein levels of an endogenous allosteric modulator of CHRNA7, secreted mammalian Ly-6/urokinase-type plasminogen activator receptor-related protein-1 (SLURP1) and acetylcholine were significantly elevated in donor and burn margin skin. As downstream proteins of inflammatory and cell death targets of nAChR activation, we found significant elevations in epidermal High Mobility Group Box Protein 1 (HMGB1) and caspase 3 in donor and burn margin skin. Lastly, we employed a novel in vitro keratinocyte burn model to establish that burn injury influences the gene expression of these cholinergic mediators and their downstream targets. These results indicate that defects in cholinergic mediators and inflammatory/apoptotic molecules in donor and burn margin skin may directly contribute to graft failure or infection in burn patients. PMID:27648692

Initial evaluation and management of the critical burn patient.

PubMed

Vivó, C; Galeiras, R; del Caz, Ma D P

2016-01-01

The major improvement in burn therapy is likely to focus on the early management of hemodynamic and respiratory failures in combination with an aggressive and early surgical excision and skin grafting for full-thickness burns. Immediate burn care by first care providers is important and can vastly alter outcomes, and it can significantly limit burn progression and depth. The goal of prehospital care should be to cease the burning process as well as prevent future complications and secondary injuries for burn shock. Identifying burn patients appropriate for immediate or subacute transfer is an important step in reducing morbidity and mortality. Delays in transport to Burn Unit should be minimized. The emergency management follows the principles of the Advanced Trauma Life Support Guidelines for assessment and stabilization of airway, breathing, circulation, disability, exposure and environment control. All patients with suspected inhalation injury must be removed from the enclosure as soon as possible, and immediately administer high-flow oxygen. Any patient with stridor, shortness of breath, facial burns, singed nasal hairs, cough, soot in the oral cavity, and history of being in a fire in an enclosed space should be strongly considered for early intubation. Fibroscopy may also be useful if airway damage is suspected and to assess known lung damage. Secondary evaluation following admission to the Burn Unit of a burned patient suffering a severe thermal injury includes continuation of respiratory support and management and treatment of inhalation injury, fluid resuscitation and cardiovascular stabilization, pain control and management of burn wound. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Medical workers' cognition of using 50% nitrous oxide in children with burns: a qualitative study.

PubMed

Wang, Hai-Xia; Li, Yu-Xiang; Zhou, Ru-Zhen; Zhao, Ji-Jun

2015-09-01

Pain caused by dressing among children with burns is an issue worth discussing. Medical workers' understanding of pain during dressing in children with burns is correlated with the quality of pain management. Effective pain management is significant to improve anxiety and reduce pain and psychological distress during dressing for children with burns. We aimed to investigate medical workers' understanding of current pain management during dressing among children with burns and their attitudes toward the application of 50% nitrous oxide in pain management. Interviews were conducted with seven doctors and nurses from a burn center in East China. Data were collected by in-depth interviews and qualitative description after full transcription of each interview. Three themes were identified: (1) Medical workers felt sympathy for children with burns and believed that a gap existed between the current and expected situation in pain management. In addition, the prescription of analgesics during dressing for children with burns was not favored. (2) Given the fact that 50% nitrous oxide is effective in pain management for adult patients with burns, medical workers tended to apply it to children with burns during dressing after being provided the literature on the use of 50% nitrous oxide in children. (3) Guidelines for the application of 50% nitrous oxide during dressing for children with burns require further modification. Medical workers deemed the pain management for children with burns unsatisfactory, and they supported the application of 50% nitrous oxide during dressing for children with burns. Meanwhile, they hoped that administrators would also support it. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Surgical and psychiatric profile of patients who self-harm by burning in a regional burn unit over an 11-year period.

PubMed

Conlin, Samantha; Littlechild, Joseph; Aditya, Hosakere; Bahia, Hilal

2016-02-01

Patients admitted to hospital for deliberate self-harm by burning (DSHB) provide a challenge for medical, surgical and psychological management. We retrospectively reviewed all the patients admitted to a Scottish regional burn unit with DSHB over an 11-year period to assess demographics and outcome. Ward admission data were used to identify DSHB patients admitted to the South East Scotland regional burn unit in Livingston, UK between 2002 and 2012, as well as a control group of accidental burn patients. Data were extracted concerning burn injury, psychiatric history and inpatient management. A total of 53 DSHB patients with 58 attendances over the 11-year period were compared to 49 accidental burns patients. Compared to controls, DSHB patients were more likely to be unemployed, live alone and have a previous psychiatric diagnosis (p < 0.01). DSHB patients had more severe burns, a longer hospital stay and were more likely to undergo surgery (p < 0.01). DSHB patients with previous self-harm, suicide attempts and diagnoses of personality and eating disorder all had significantly less severe burns than DSHB patients without these risk factors (p < 0.05). In our experience, DSHB patients have more severe burn injuries and require longer, resource-intensive hospital stays. Burn units should have an appropriate specialist psychologist/psychiatrist who works within the Burn multi-disciplinary team to help manage this complex group of patients' healthcare needs and reduce their risk of further self-harm. © The Author(s) 2016.

Children with burns referred for child abuse evaluation: Burn characteristics and co-existent injuries.

PubMed

Pawlik, Marie-Christin; Kemp, Alison; Maguire, Sabine; Nuttall, Diane; Feldman, Kenneth W; Lindberg, Daniel M

2016-05-01

Intentional burns represent a serious form of physical abuse that must be identified to protect children from further harm. This study is a retrospectively planned secondary analysis of the Examining Siblings To Recognize Abuse (ExSTRA) network data. Our objective was to describe the characteristics of burns injuries in children referred to Child Abuse Pediatricians (CAPs) in relation to the perceived likelihood of abuse. We furthermore compare the extent of diagnostic investigations undertaken in children referred to CAPs for burn injuries with those referred for other reasons. Within this dataset, 7% (215/2890) of children had burns. Children with burns were older than children with other injuries (median age 20 months vs. 10 months). Physical abuse was perceived as likely in 40.9% (88) and unlikely in 59.1% (127). Scalds accounted for 52.6% (113) and contact burns for 27.6% (60). Several characteristics of the history and burn injury were associated with a significantly higher perceived likelihood of abuse, including children with reported inflicted injury, absent or inadequate explanation, hot water as agent, immersion scald, a bilateral/symmetric burn pattern, total body surface area ≥10%, full thickness burns, and co-existent injuries. The rates of diagnostic testing were significantly lower in children with burns than other injuries, yet the yield of skeletal survey and hepatic transaminases testing were comparable between the two groups. This would imply that children referred to CAPs for burns warrant the same level of comprehensive investigations as those referred for other reasons. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Mental health outcomes of burn: A longitudinal population-based study of adults hospitalized for burns.

PubMed

Logsetty, Sarvesh; Shamlou, Amir; Gawaziuk, Justin P; March, Justin; Doupe, Malcolm; Chateau, Dan; Hoppensack, Mike; Khan, Sazzadul; Medved, Maria; Leslie, William D; Enns, Murray W; Stein, Murray B; Asmundson, Gordon J G; Sareen, Jitender

2016-06-01

This study investigates the increased risk of mental health outcomes and health care utilization associated with burn with two year of follow-up using a longitudinal population-based matched cohort design. Adult burn survivors (n=157) were identified from a provincial burn registry and matched 1:5 with non-burn control subjects from the general population (matching variables age and gender). The prevalence of mental health outcomes and the rates of health care utilization between the groups were compared for the 2years pre and post index date using anonymously linked population-based administrative health care data. Rates were adjusted for age, gender and sociodemographic characteristics. While the burn cohort had an increased prevalence of mental health problems after burn compared to the control cohort, the burn group also had an increased prevalence of pre-burn depression (16.6% vs 7.8%; p=0.0005) and substance use disorders (8.9% vs 3.2%; p=0.001) when compared to controls. Once the pre-existing prevalence of mental illness was taken into account there was no significant change in the prevalence of mental health problems when comparing the burn group to controls over time. Although burns may not increase rates of mental health issues and health care utilization, burn survivors are a vulnerable group who already demonstrate increased rates of psychopathology and need for care. The present study highlights the importance of assessment and treatment of mental health outcomes in this population. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Outcomes of burns in the elderly: revised estimates from the Birmingham Burn Centre.

PubMed

Wearn, Christopher; Hardwicke, Joseph; Kitsios, Andreas; Siddons, Victoria; Nightingale, Peter; Moiemen, Naiem

2015-09-01

Outcomes after burn have continued to improve over the last 70 years in all age groups including the elderly. However, concerns have been raised that survival gains have not been to the same magnitude in elderly patients compared to younger age groups. The aims of this study were to analyze the recent outcomes of elderly burn injured patients admitted to the Birmingham Burn Centre, compare data with a historical cohort and published data from other burn centres worldwide. A retrospective review was conducted of all patients ≥65 years of age, admitted to our centre with cutaneous burns, between 2004 and 2012. Data was compared to a previously published historical cohort (1999-2003). 228 patients were included. The observed mortality for the study group was 14.9%. The median age of the study group was 79 years, the male to female ratio was 1:1 and median Total Body Surface Area (TBSA) burned was 5%. The incidence of inhalation injury was 13%. Median length of stay per TBSA burned for survivors was 2.4 days/% TBSA. Mortality has improved in all burn size groups, but differences were highly statistically significant in the medium burn size group (10-20% TBSA, p≤0.001). Burn outcomes in the elderly have improved over the last decade. This reduction has been impacted by a reduction in overall injury severity but is also likely due to general improvements in burn care, improved infrastructure, implementation of clinical guidelines and increased multi-disciplinary support, including Geriatric physicians. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

A ten-year experience with hemodialysis in burn patients at Los Angeles County + USC Medical Center.

PubMed

Soltani, Ali; Karsidag, Semra; Garner, Warren

2009-01-01

Acute renal failure (ARF) is a rare, but serious, complication after burn injury that is commonly thought to be fatal. Before the modern era, there were few survivors of burn injuries who required dialysis. We report our 10-year experience with ARF and dialysis at the Los Angeles County + USC burn unit. During the period of August 1994 to February 2004, 3356 patients were admitted. Furthermore, 1143 patients were admitted to the intensive care unit and 1125 had burns >10% TBSA. Thirty-three patients developed ARF necessitating dialysis, equaling 0.98% of all admitted patients, and 2.7% of patients with TBSA >10% burns, which is at the low end of published burn unit data. The average age of these patients requiring dialysis was 49 years, 91% were men, 24% were diabetic, and 39% were positive for substances of abuse at admission, and the average TBSA burned was 36%. This is compared with an average age of 31 years, 70% men, 7.3% diabetic, and 14.7% intoxicated in the general burned population at our burn unit. Furthermore, our overall mortality in the burn unit was 5% overall and 14% in patients with >10% TBSA burns during the study period. In patients requiring hemodialysis, the mortality rate was 69.7%. The average time to hemodialysis was 14 days in our series, and patients, on average, required 10.3 days of dialysis support. These mortality data are the lowest recorded for burned patients requiring dialysis and suggest that ARF is a survivable complication in some of these patients.

[Advances in the research of application of artificial intelligence in burn field].

PubMed

Li, H H; Bao, Z X; Liu, X B; Zhu, S H

2018-04-20

Artificial intelligence has been able to automatically learn and judge large-scale data to some extent. Based on database of a large amount of burn data and in-depth learning, artificial intelligence can assist burn surgeons to evaluate burn surface, diagnose burn depth, guide fluid supply during shock stage, and predict prognosis, with high accuracy. With the development of technology, artificial intelligence can provide more accurate information for burn surgeons to make clinical diagnosis and treatment strategies.

Standardization of deep partial-thickness scald burns in C57BL/6 mice

PubMed Central

Medina, Jorge L; Fourcaudot, Andrea B; Sebastian, Eliza A; Shankar, Ravi; Brown, Ammon W; Leung, Kai P

2018-01-01

Mouse burn models are used to understand the wound healing process and having a reproducible model is important. The different protocols used by researchers can lead to differences in depth of partial-thickness burn wounds. Additionally, standardizing a protocol for mouse burns in the laboratory for one strain may result in substantially different results in other strains. In our current study we describe the model development of a deep partial-thickness burn in C57BL/6 mice using hot water scalding as the source of thermal injury. As part of our model development we designed a template with specifications to allow for even contact of bare mouse skin (2×3 cm) with hot water while protecting the rest of the mouse. Burn depth was evaluated with H&E, Masson’s trichrome, and TUNEL staining. Final results were validated with pathology analysis. A water temperature of 54°C with a scalding time of 20 seconds produced consistent deep partial-thickness burns with available equipment described. Other than temperature and time, factors such as template materials and cooling steps after the burn could affect the uniformity of the burns. These findings are useful to burn research by providing some key parameters essential for researchers to simplify the development of their own mouse burn models. PMID:29755839

Henslow's sparrow winter-survival estimates and response to prescribed burning

USGS Publications Warehouse

Thatcher, B.S.; Krementz, D.G.; Woodrey, M.S.

2006-01-01

Wintering Henslow's sparrow (Ammodramus henslowii) populations rely on lands managed with prescribed burning, but the effects of various burn regimes on their overwinter survival are unknown. We studied wintering Henslow's sparrows in coastal pine savannas at the Mississippi Sandhill Crane National Wildlife Refuge, Jackson County, Mississippi, USA, during January and February 2001 and 2002. We used the known-fate modeling procedure in program MARK to evaluate the effects of burn age (1 or 2 growing seasons elapsed), burn season (growing, dormant), and calendar year on the survival rates of 83 radiomarked Henslow's sparrows. We found strong evidence that Henslow's sparrow survival rates differed by burn age (with higher survival in recently burned sites) and by year (with lower survival rates in 2001 likely because of drought conditions). We found some evidence that survival rates also differed by bum season (with higher survival in growing-season sites), although the effects of burn season were only apparent in recently burned sites. Avian predation was the suspected major cause of mortality (causing 6 of 14 deaths) with 1 confirmed loggerhead shrike (Lanius ludovicianus) depredation. Our results indicated that recently burned savannas provide high-quality wintering habitats and suggested that managers can improve conditions for wintering Henslow's sparrows by burning a large percentage of savannas each year.

Burns in Israel, comparative study: Demographic, etiologic and clinical trends 1997-2003 vs. 2004-2010.

PubMed

Harats, M; Peleg, K; Givon, A; Kornhaber, R; Goder, M; Jaeger, M; Haik, J

2016-05-01

To review hospitalised burn patients from 2004 to 2010 admitted to Israeli burn units and compare these result with data from 1997 to 2003. Retrospectively, data was collected from the Israeli Trauma Registry (ITR) encompassing all burn admissions to Israeli burn units from 2004-2010 and compared to 1997-2003. Of the 5269 burn patients admitted from 2004 to 2010, 39.8% were non-Jewish. Infants under two years were the prominent age group (24.1%). Second to third degree burns 1-9% TBSA/first degree burns were 71%, second to third degree burns 10-19% TBSA were 16% and those 20%>TBSA consisted of 13%. Only 2.7% involved an inhalation injury. The average length of stay was 11.67 days and mortality rate 3.72%. All data was compared to the previous year's 1997-2003 and trends were identified. Within Israel, high risk populations remain infants under two years of age, males and those from non-Jewish populations. National prevention strategies and campaigns are warranted to inform and educated parents of young children and those at risk of burns. Of note, advances in burn care and procedures might have contributed to a decrease in the length of hospital stay (LOS). Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Recent acceleration of biomass burning and carbon losses in Alaskan forests and peatlands

USGS Publications Warehouse

Turetsky, M.R.; Kane, E.S.; Harden, J.W.; Ottmar, R.D.; Manies, K.L.; Hoy, E.; Kasischke, E.S.

2011-01-01

Climate change has increased the area affected by forest fires each year in boreal North America. Increases in burned area and fire frequency are expected to stimulate boreal carbon losses. However, the impact of wildfires on carbon emissions is also affected by the severity of burning. How climate change influences the severity of biomass burning has proved difficult to assess. Here, we examined the depth of ground-layer combustion in 178 sites dominated by black spruce in Alaska, using data collected from 31 fire events between 1983 and 2005. We show that the depth of burning increased as the fire season progressed when the annual area burned was small. However, deep burning occurred throughout the fire season when the annual area burned was large. Depth of burning increased late in the fire season in upland forests, but not in peatland and permafrost sites. Simulations of wildfire-induced carbon losses from Alaskan black spruce stands over the past 60 years suggest that ground-layer combustion has accelerated regional carbon losses over the past decade, owing to increases in burn area and late-season burning. As a result, soils in these black spruce stands have become a net source of carbon to the atmosphere, with carbon emissions far exceeding decadal uptake.

Effects of normal acceleration on transient burning rate augmentation of an aluminized solid propellant

NASA Technical Reports Server (NTRS)

Northam, G. B.

1972-01-01

Instantaneous burning rate data for a polybutadiene acrylic acid propellant, containing 16 weight percent aluminum, were calculated from the pressure histories of a test motor with 96.77 sq cm of burning area and a 5.08-cm-thick propellant web. Additional acceleration tests were conducted with reduced propellant web thicknesses of 3.81, 2.54, and 1.27 cm. The metallic residue collected from the various web thickness tests was characterized by weight and shape and correlated with the instantaneous burning rate measurements. Rapid depressurization extinction tests were conducted in order that surface pitting characteristics due to localized increased burning rate could be correlated with the residue analysis and the instantaneous burning rate data. The acceleration-induced burning rate augmentation was strongly dependent on propellant distance burned, or burning time, and thus was transient in nature. The results from the extinction tests and the residue analyses indicate that the transient rate augmentation was highly dependent on local enhancement of the combustion zone heat feedback to the surface by the growth of molten residue particles on or just above the burning surface. The size, shape, and number density of molten residue particles, rather than the total residue weight, determined the acceleration-induced burning rate augmentation.

Effects of wet- and dry-season fires on Jacquemontia curtisii, a South Florida pine forest endemic

USGS Publications Warehouse

Spier, L.P.; Snyder, J.R.

1998-01-01

South Florida pine forests have a diverse endemic flora that has evolved under the influence of recurrent fire. We studied the response of Jacquemontia curtisii Peter ex Hallier f. (pineland clustervine), a perennial herbaceous member of that flora, to experimental fires during wet and dry seasons. In each of three populations, three treatments were applied: wet-season (June) prescribed fire, dry-season (January) prescribed fire, and an unburned control. Flowering, fruiting, and seedling establishment were followed for up to one year. Mortality of adult plants was twice as great after wet-season burns than after dry-season burns even though fire temperatures were higher in the dry-season burns. Within a season of burning, mortality was greater for the more severely burned plants or the smaller plants. Wet-season burns produced over three times more flowers than not burning, in spite of mortality of more than half the plants. Burning stimulated germination from the soil seed bank. Dry-season burns resulted in five times more seedlings than wet-season burns and more of these seedlings were alive one year after the burn. It is likely that the long-term viability of Jacquemontia curtisii populations is favored by diversity in fire season and severity.

Automobile carburetor- and radiator-related burns.

PubMed

Renz, B M; Sherman, R

1992-01-01

Seventy-nine persons who had sustained automobile engine carburetor- and radiator-related burns were admitted to Grady Memorial Hospital Burn Unit between June 1, 1984 and September 30, 1990. Forty patients with carburetor-priming flame burns had a mean age of 31.5 years, a mean burn size of 13.4% total body surface area, and a mean length of stay of 13.8 days. There were 37 male patients. Four patients had an inhalation injury. Twenty-two surgical procedures were performed on 13 patients. One patient was an innocent bystander, and one patient died. The clothing of 16 patients had ignited, which resulted in larger, deeper burns and in one death. Burns predominantly involved the right sides of the face, head, and torso; the right upper extremity; and the right hand. Thirty-nine patients had scald burns that were associated with uncapping a radiator. These patients had a mean age of 29.6 years, a mean burn size of 8.9% total body surface area, and a mean length of stay of 6.4 days. There were 36 male patients and three innocent bystanders. One autografting procedure was performed, and there were no deaths in this group of patients. The burn-prone person is the young adult male. The circumstances that result in such dangerous behavior are predictable, and resultant burn injuries are preventable.

Basidiomycete fungal communities in Australian sclerophyll forest soil are altered by repeated prescribed burning.

PubMed

Anderson, Ian C; Bastias, Brigitte A; Genney, David R; Parkin, Pamela I; Cairney, John W G

2007-04-01

Soil basidiomycetes play key roles in forest nutrient and carbon cycling processes, yet the diversity and structure of below ground basidiomycete communities remain poorly understood. Prescribed burning is a commonly used forest management practice and there is evidence that single fire events can have an impact on soil fungal communities but little is known about the effects of repeated prescribed burning. We have used internal transcribed spacer (ITS) terminal restriction fragment length polymorphism (T-RFLP) analysis to investigate the impacts of repeated prescribed burning every two or four years over a period of 30 years on soil basidiomycete communities in an Australian wet sclerophyll forest. Detrended correspondence analysis of ITS T-RFLP profiles separated basidiomycete communities in unburned control plots from those in burned plots, with those burned every two years being the most different from controls. Burning had no effect on basidiomycete species richness, thus these differences appear to be due to changes in community structure. Basidiomycete communities in the unburned control plots were vertically stratified in the upper 20 cm of soil, but no evidence was found for stratification in the burned plots, suggesting that repeated prescribed burning results in more uniform basidiomycete communities. Overall, the results demonstrate that repeated prescribed burning alters soil basidiomycete communities, with the effect being greater with more frequent burning.

Uncertainty analysis of moderate- versus coarse-scale satellite fire products for quantifying agricultural burning: Implications for Air Quality in European Russia, Belarus, and Lithuania

NASA Astrophysics Data System (ADS)

McCarty, J. L.; Krylov, A.; Prishchepov, A. V.; Banach, D. M.; Potapov, P.; Tyukavina, A.; Rukhovitch, D.; Koroleva, P.; Turubanova, S.; Romanenkov, V.

2015-12-01

Cropland and pasture burning are common agricultural management practices that negatively impact air quality at a local and regional scale, including contributing to short-lived climate pollutants (SLCPs). This research focuses on both cropland and pasture burning in European Russia, Lithuania, and Belarus. Burned area and fire detections were derived from 500 m and 1 km Moderate Resolution Imaging Spectroradiometer (MODIS), 30 m Landsat 7 Enhanced Thematic Mapper Plus (ETM+), and Landsat 8 Operational Land Imager (OLI) data. Carbon, particulate matter, volatile organic carbon (VOCs), and harmful air pollutants (HAPs) emissions were then calculated using MODIS and Landsat-based estimates of fire and land-cover and land-use. Agricultural burning in Belarus, Lithuania, and European Russia showed a strong and consistent seasonal geographic pattern from 2002 to 2012, with the majority of fire detections occurring in March - June and smaller peak in July and August. Over this 11-year period, there was a decrease in both cropland and pasture burning throughout this region. For Smolensk Oblast, a Russian administrative region with comparable agro-environmental conditions to Belarus and Lithuania, a detailed analysis of Landsat-based burned area estimations for croplands and pastures and field data collected in summer 2014 showed that the agricultural burning area can be up to 10 times higher than the 1 km MODIS active fire estimates. In general, European Russia is the main source of agricultural burning emissions compared to Lithuania and Belarus. On average, all cropland burning in European Russia as detected by the MCD45A1 MODIS Burned Area Product emitted 17.66 Gg of PM10 while annual burning of pasture in Smolensk Oblast, Russia as detected by Landsat burn scars emitted 494.85 Gg of PM10, a 96% difference. This highlights that quantifying the contribution of pasture burning and burned area versus cropland burning in agricultural regions is important for accurately calculating carbonaceous emissions and emissions that negatively impact air quality.

Characterisation of the impact of open biomass burning on urban air quality in Brisbane, Australia.

PubMed

He, Congrong; Miljevic, Branka; Crilley, Leigh R; Surawski, Nicholas C; Bartsch, Jennifer; Salimi, Farhad; Uhde, Erik; Schnelle-Kreis, Jürgen; Orasche, Jürgen; Ristovski, Zoran; Ayoko, Godwin A; Zimmermann, Ralf; Morawska, Lidia

2016-05-01

Open biomass burning from wildfires and the prescribed burning of forests and farmland is a frequent occurrence in South-East Queensland (SEQ), Australia. This work reports on data collected from 10 to 30 September 2011, which covers the days before (10-14 September), during (15-20 September) and after (21-30 September) a period of biomass burning in SEQ. The aim of this project was to comprehensively quantify the impact of the biomass burning on air quality in Brisbane, the capital city of Queensland. A multi-parameter field measurement campaign was conducted and ambient air quality data from 13 monitoring stations across SEQ were analysed. During the burning period, the average concentrations of all measured pollutants increased (from 20% to 430%) compared to the non-burning period (both before and after burning), except for total xylenes. The average concentration of O3, NO2, SO2, benzene, formaldehyde, PM10, PM2.5 and visibility-reducing particles reached their highest levels for the year, which were up to 10 times higher than annual average levels, while PM10, PM2.5 and SO2 concentrations exceeded the WHO 24-hour guidelines and O3 concentration exceeded the WHO maximum 8-hour average threshold during the burning period. Overall spatial variations showed that all measured pollutants, with the exception of O3, were closer to spatial homogeneity during the burning compared to the non-burning period. In addition to the above, elevated concentrations of three biomass burning organic tracers (levoglucosan, mannosan and galactosan), together with the amount of non-refractory organic particles (PM1) and the average value of f60 (attributed to levoglucosan), reinforce that elevated pollutant concentration levels were due to emissions from open biomass burning events, 70% of which were prescribed burning events. This study, which is the first and most comprehensive of its kind in Australia, provides quantitative evidence of the significant impact of open biomass burning events, especially prescribed burning, on urban air quality. The current results provide a solid platform for more detailed health and modelling investigations in the future. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of biomass open burning on particulate matter and polycyclic aromatic hydrocarbon concentration levels and PAH dry deposition in ambient air.

PubMed

Chiu, Jui C; Shen, Yun H; Li, Hsing W; Chang, Shun S; Wang, Lin C; Chang-Chien, Guo P

2011-01-01

The objectives of the present study were to investigate particulate matter (PM) and polycyclic aromatic hydrocarbon (PAH) concentrations in ambient air during rice straw open burning and non-open burning periods. In the ambient air of a rice field, the mean PM concentration during and after an open burning event were 1828 and 102 μg m⁻³, respectively, which demonstrates that during a rice field open burning event, the PM concentration in the ambient air of rice field is over 17 times higher than that of the non-open burning period. During an open burning event, the mean total PAH and total toxic equivalence (BaP(eq)) concentrations in the ambient air of a rice field were 7206 ng m⁻³ and 10.3 ng m⁻³, respectively, whereas after the open burning event, they were 376 ng m⁻³ and 1.50 ng m⁻³, respectively. Open burning thus increases total PAH and total BaP(eq) concentrations by 19-fold and 6.8-fold, respectively. During a rice straw open burning event, in the ambient air of a rice field, the mean dry deposition fluxes of total PAHs and total BaP(eq) were 1222 μg m⁻² day⁻¹ and 4.80 μg m⁻² day⁻¹, respectively, which are approximately 60- and 3-fold higher than those during the non-open burning period, respectively. During the non-open burning period, particle-bound PAHs contributed 79.2-84.2% of total dry deposition fluxes (gas + particle) of total PAHs. However, an open burning event increases the contribution to total PAH dry deposition by particle-bound PAHs by up to 85.9-95.5%. The results show that due to the increased amount of PM in the ambient air resulting from rice straw open burning, particle-bound PAHs contributed more to dry deposition fluxes of total PAHs than they do during non-open burning periods. The results show that biomass (rice straw) open burning is an important PAH emission source that significantly increases both PM and PAH concentration levels and PAH dry deposition in ambient air.

Temporal effects of prescribed burning on terpene production in Mediterranean pines.

PubMed

Valor, Teresa; Ormeño, Elena; Casals, Pere

2017-12-01

Prescribed burning is used to reduce fuel hazard but underburning can damage standing trees. The effect of burning on needle terpene storage, a proxy for secondary metabolism, in fire-damaged pines is poorly understood despite the protection terpenes confer against biotic and abiotic stressors. We investigated variation in needle terpene storage after burning in three Mediterranean pine species featuring different adaptations to fire regimes. In two pure-stands of Pinus halepensis Mill. and two mixed-stands of Pinus sylvestris L. and Pinus nigra ssp. salzmanni (Dunal) Franco, we compared 24 h and 1 year post-burning concentrations with pre-burning concentrations in 20 trees per species, and evaluated the relative contribution of tree fire severity and physiological condition (δ13C and N concentration) on temporal terpene dynamics (for mono- sesqui- and diterpenes). Twenty-four hours post-burning, monoterpene concentrations were slightly higher in P. halepensis than at pre-burning, while values were similar in P. sylvestris. Differently, in the more fire-resistant P. nigra monoterpene concentrations were lower at 24 h, compared with pre-burning. One year post-burning, concentrations were always lower compared with pre- or 24 h post-burning, regardless of the terpene group. Mono- and sesquiterpene variations were negatively related to pre-burning δ13C, while diterpene variations were associated with fire-induced changes in needle δ13C and N concentration. At both post-burning times, mono- and diterpene concentrations increased significantly with crown scorch volume in all species. Differences in post-burning terpene contents as a function of the pine species' sensitivity to fire suggest that terpenic metabolites could have adaptive importance in fire-prone ecosystems in terms of flammability or defence against biotic agents post-burning. One year post-burning, our results suggest that in a context of fire-induced resource availability, pines likely prioritize primary rather than secondary metabolism. Overall, this study contributes to the assessment of the direct and indirect effects of fire on pine terpene storage, providing valuable information about their vulnerability to biotic and abiotic stressors throughout time. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Herbicides as an alternative to prescribed burning for achieving wildlife management objectives

Treesearch

T. Bently Wigley; Karl V. Miller; David S. deCalesta; Mark W. Thomas

2002-01-01

Prescribed burning is used for many silvicultural and wildlife management objectives. However, the use of prescribed burning can be constrained due to difficulties in obtaining burning permits, concerns about liability, potential effects of scorch on growth and survival of crop trees, its sometimes ineffective results, limited burning days, and the costs of applying,...

Effect of crib dimensions on burning rate

Treesearch

S. McAllister; M. Finney

2013-01-01

The burning rate of unconfined cribs has long been identified to occur in two regimes: the densely-packed regime where the burning rate is proportional to the crib porosity and the loosely-packed regime where the burning rate is independent of porosity. Though the cribs used to define these burning regimes were primarily cubic in dimension, there are seemingly endless...

Using relative humidity to predict spotfire probability on prescribed burns

Treesearch

John R. Weir

2007-01-01

Spotfires have and always will be a problem that burn bosses and fire crews will have to contend with on prescribed burns. Weather factors (temperature, wind speed and relative humidity) are the main variables burn bosses can use to predict and monitor prescribed fire behavior. At the Oklahoma State University Research Range, prescribed burns are conducted during...

Responses of Understory Vegetation on Highly Erosive Louisiana Soils to Prescribed Burning in May

Treesearch

James D. Haywood; Alton Martin; John C. Novosad

1995-01-01

Prescribed burning is necessary to restore the herbaceous plant community normally associated with the fire-dependent longleaf pine, Pinus palustris Mill., ecosystem. Usually these burns are done in the winter months. However, burning during the early growing season may allow herbaceous plants to recover better than when burning is conducted during...

77 FR 13582 - Disability and Rehabilitation Research Project; Burn Model Systems Centers

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

.... (2008). A clarion to recommit and reaffirm burn rehabilitation. Journal of Burn Care & Research, 29(3... injury. Journal of Burn Care & Research, 30(2), 294-300. Schneider, J.C., Holavanahalli, R., Helm, P... for the year of 2009. Journal of Burn Care & Research, 31(6), 836-848. Ullrich, P.M., Askay, SW...

Spring Burn Aids Longleaf Pine Seedling Height Growth

Treesearch

William R. Maple

1977-01-01

Prescribed burning in midspring may stimulate height growth of longleaf pine seedlings. Seedlings were planted on sandy and clayey sites that were prescribed burned 2 years later. Treatments were cool, moderate, and hot burns and an unburned control. The hot, May burn significantly increased height growth of seedlings on the sandy site. The number of seedlings with 50...

40 CFR 279.23 - On-site burning in space heaters.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 27 2014-07-01 2014-07-01 false On-site burning in space heaters. 279... burning in space heaters. Generators may burn used oil in used oil-fired space heaters provided that: (a) The heater burns only used oil that the owner or operator generates or used oil received from...

75 FR 26198 - Foreign-Trade Zone 152 - Burns Harbor, Indiana, Application for Reorganization under Alternative...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

... DEPARTMENT OF COMMERCE Foreign-Trade Zones Board [Docket 32-2010] Foreign-Trade Zone 152 - Burns... six sites in the Burns Harbor/Gary, Indiana area: Site 1: (533,288 sq. ft.) located at 201 Mississippi... of Indiana/Burns International Harbor, Burns Harbor (Porter County); Site 3: (330 acres) within the...

How Disabling Are Pediatric Burns? Functional Independence in Dutch Pediatric Patients with Burns

ERIC Educational Resources Information Center

Disseldorp, Laurien M.; Niemeijer, Anuschka S.; Van Baar, Margriet E.; Reinders-Messelink, Heleen A.; Mouton, Leonora J.; Nieuwenhuis, Marianne K.

2013-01-01

Although the attention for functional outcomes after burn injury has grown over the past decades, little is known about functional independence in performing activities of daily living in children after burn injury. Therefore, in this prospective cohort study functional independence was measured by burn care professionals with the WeeFIM[R]…

40 CFR 279.23 - On-site burning in space heaters.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 28 2013-07-01 2013-07-01 false On-site burning in space heaters. 279... burning in space heaters. Generators may burn used oil in used oil-fired space heaters provided that: (a) The heater burns only used oil that the owner or operator generates or used oil received from...

21 CFR 880.5180 - Burn sheet.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Burn sheet. 880.5180 Section 880.5180 Food and... Burn sheet. (a) Identification. A burn sheet is a device made of a porous material that is wrapped aroung a burn victim to retain body heat, to absorb wound exudate, and to serve as a barrier against...

40 CFR 279.23 - On-site burning in space heaters.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false On-site burning in space heaters. 279... burning in space heaters. Generators may burn used oil in used oil-fired space heaters provided that: (a) The heater burns only used oil that the owner or operator generates or used oil received from...

21 CFR 880.5180 - Burn sheet.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Burn sheet. 880.5180 Section 880.5180 Food and... Burn sheet. (a) Identification. A burn sheet is a device made of a porous material that is wrapped aroung a burn victim to retain body heat, to absorb wound exudate, and to serve as a barrier against...

40 CFR 279.23 - On-site burning in space heaters.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 28 2012-07-01 2012-07-01 false On-site burning in space heaters. 279... burning in space heaters. Generators may burn used oil in used oil-fired space heaters provided that: (a) The heater burns only used oil that the owner or operator generates or used oil received from...

21 CFR 880.5180 - Burn sheet.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Burn sheet. 880.5180 Section 880.5180 Food and... Burn sheet. (a) Identification. A burn sheet is a device made of a porous material that is wrapped aroung a burn victim to retain body heat, to absorb wound exudate, and to serve as a barrier against...

40 CFR 279.23 - On-site burning in space heaters.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 27 2011-07-01 2011-07-01 false On-site burning in space heaters. 279... burning in space heaters. Generators may burn used oil in used oil-fired space heaters provided that: (a) The heater burns only used oil that the owner or operator generates or used oil received from...

21 CFR 880.5180 - Burn sheet.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Burn sheet. 880.5180 Section 880.5180 Food and... Burn sheet. (a) Identification. A burn sheet is a device made of a porous material that is wrapped aroung a burn victim to retain body heat, to absorb wound exudate, and to serve as a barrier against...

21 CFR 880.5180 - Burn sheet.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Burn sheet. 880.5180 Section 880.5180 Food and... Burn sheet. (a) Identification. A burn sheet is a device made of a porous material that is wrapped aroung a burn victim to retain body heat, to absorb wound exudate, and to serve as a barrier against...

Simulated biologic intelligence used to predict length of stay and survival of burns.

PubMed

Frye, K E; Izenberg, S D; Williams, M D; Luterman, A

1996-01-01

From July 13, 1988, to May 14, 1995, 1585 patients with burns and no other injuries besides inhalation were treated; 4.5% did not survive. Artificial neural networks were trained on patient presentation data with known outcomes on 90% of the randomized cases. The remaining cases were then used to predict survival and length of stay in cases not trained on. Survival was predicted with more than 98% accuracy and length of stay to within a week with 72% accuracy in these cases. For anatomic area involved by burn, burns involving the feet, scalp, or both had the largest negative effect on the survival prediction. In survivors burns involving the buttocks, transport to this burn center by the military or by helicopter, electrical burns, hot tar burns, and inhalation were associated with increasing the length of stay prediction. Neural networks can be used to accurately predict the clinical outcome of a burn. What factors affect that prediction can be investigated.

Retrospective analysis of patients with burn injury treated in a burn center in Turkey during the Syrian civil war

PubMed Central

Yuce, Yucel; Acar, Hakan A.; Erkal, Kutlu H.; Arditi, Nur B.

2017-01-01

Objectives: To report the management of burn injuries that occured in the Syria civil war, which were referred to our burn center. Methods: Forty-three patients with burns, injured in the civil war in Syria and whom were referred to Dr. Lütfi Kırdar Kartal Educating and Training Hospital Burn Centre of İstanbul, Turkey between 2011-2015 were analyzed in a retrospective study. Results: Most of our patients were in major burn classification (93%; 40/43) and most of them had burns >15% total on body surface area. Most of them were admitted to our center late after first management at centers with improper conditions and in cultures of these patients unusual and resistant strains specific to the battlefield were produced. Conclusion: Immediate transfer of the patients from the scene of incidence to burn centers ensures early treatment, this factor may be effective on the outcome of these patients. PMID:28042637

The progress of Chinese burn medicine from the Third Military Medical University-in memory of its pioneer, Professor Li Ao.

PubMed

Li, Haisheng; Zhou, Junyi; Peng, Yizhi; Zhang, Jiaping; Peng, Xi; Luo, Qizhi; Yuan, Zhiqiang; Yan, Hong; Peng, Daizhi; He, Weifeng; Wang, Fengjun; Liang, Guangping; Huang, Yuesheng; Wu, Jun; Luo, Gaoxing

2017-01-01

Professor Li Ao was one of the founders of Chinese burn medicine and one of the most renowned doctors and researchers of burns in China. He established one of the Chinese earliest special departments for burns at Third Military Medical University (TMMU) in 1958. To memorialize Professor Li Ao on his 100th birthday in 2017 and introduce our extensive experience, it is our honor to briefly review the development and achievement of the Chinese burn medicine from TMMU. The epidemiology and outcomes of admitted burn patients since 1958 were reviewed. Furthermore, main achievements of basic and clinical research for the past roughly 60 years were presented. These achievements mainly included the Chinese Rule of Nine, fluid resuscitation protocol, experience in inhalation injury, wound treatment strategies, prevention and treatment of burn infections, nutrition therapy, organ support therapies, and rehabilitation. The progress shaped and enriched modern Chinese burn medicine and promoted the development of world burn medicine.

An assessment of burn prevention knowledge in a high burn-risk environment: restaurants.

PubMed

Piazza-Waggoner, Carrie; Adams, C D; Goldfarb, I W; Slater, H

2002-01-01

Our facility has seen an increase in the number of cases of children burned in restaurants. Fieldwork has revealed many unsafe serving practices in restaurants in our tristate area. The current research targets what appears to be an underexamined burn-risk environment, restaurants, to examine server knowledge about burn prevention and burn care with customers. Participants included 71 local restaurant servers and 53 servers from various restaurants who were recruited from undergraduate courses. All participants completed a brief demographic form as well as a Burn Knowledge Questionnaire. It was found that server knowledge was low (ie, less than 50% accuracy). Yet, most servers reported that they felt customer burn safety was important enough to change the way that they serve. Additionally, it was found that length of time employed as a server was a significant predictor of servers' burn knowledge (ie, more years serving associated with higher knowledge). Finally, individual items were examined to identify potential targets for developing prevention programs.

AmeriFlux US-An2 Anaktuvuk River Moderate Burn

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hobbie, John; Rocha, Adrian; Shaver, Gaius

This is the AmeriFlux version of the carbon flux data for the site US-An2 Anaktuvuk River Moderate Burn. Site Description - The Anaktuvuk River fire on the North Slope of Alaska started on July 16, 2007 by lightning. It continued until the end of September when nearby lakes had already frozen over and burned >256,000 acres, creating a mosaic of patches that differed in burn severity. The Anaktuvuk River Severe Burn, Moderate Burn, and Unburned sites are 40 km to the west of the nearest road and were selected in late May 2008 to determine the effects of the firemore » on carbon, water, and energy exchanges during the growing season. Because the fire had burned through September of the previous year, initial deployment of flux towers occurred prior to any significant vegetative regrowth, and our sampling campaign captured the full growing season in 2008. The Moderate Burn site consisted of a large area with small patches of completely and partially burned tundra intermixed across the landscape.« less

Using Multitemporal and Multispectral Airborne Lidar to Assess Depth of Peat Loss and Correspondence With a New Active Normalized Burn Ratio for Wildfires

NASA Astrophysics Data System (ADS)

Chasmer, L. E.; Hopkinson, C. D.; Petrone, R. M.; Sitar, M.

2017-12-01

Accuracy of depth of burn (an indicator of consumption) in peatland soils using prefire and postfire airborne light detection and ranging (lidar) data is determined within a wetland-upland forest environment near Fort McMurray, Alberta, Canada. The relationship between peat soil burn depth and an "active" normalized burn ratio (ANBR) is also examined beneath partially and fully burned forest and understory canopies using state-of-the-art active reflectance from a multispectral lidar compared with normalized burn ratio (NBR) derived from Landsat 7 ETM+. We find significant correspondence between depth of burn, lidar-derived ANBR, and difference NBR (dNBR) from Landsat. However, low-resolution optical imagery excludes peatland burn losses in transition zones, which are highly sensitive to peat loss via combustion. The findings presented here illustrate the utility of this new remote sensing technology for expanding an area of research where it has previously been challenging to spatially detect and quantify such wildfire burn losses.

Motor vehicle-related burns: a review of 107 cases.

PubMed

Papaevangelou, J; Batchelor, J S; Roberts, A H

1995-02-01

Motor vehicles are a major cause of morbidity and mortality. Burn injuries sustained from motor vehicles form a small but important subgroup. The authors have reviewed the case notes of 107 patients with motor vehicle-related burns over a 13-year period. The age ranged from 18 months to 65 years and the male to female ratio was 4:1. The mechanisms of injury were variable, although four major categories could be identified. These accounted for 83 per cent of the cases. Car fires following road traffic accidents was the largest group accounting for 48.5 per cent of cases. The remaining three groups were: motorcycle-related burns following road traffic accidents (6.5 per cent of cases), garage fire-related burns (15 per cent of cases) and car radiator-related burns (13 per cent of cases). Garage fire-related burns had the highest mortality of the four groups (25 per cent). This study demonstrated that garage fire burns are an important subgroup of motor vehicle-related burns.

[Burns in workers in Switzerland: epidemiology and financial sequelae].

PubMed

de Roche, R; Lüscher, N J; Debrunner, H U; Fischer, R

1993-01-01

A complete statistical evaluation of epidemiologic data and costs of burn injuries in 1984 with a follow-up for 5 years is presented, considering a collective of 1.77 million workers in Switzerland. The majority of burns are minor injuries; only about 5% of the burn victimes are admitted to a hospital, 0.2% die. Only one fifth of the costs caused by burns are due to medical treatment and rehabilitation. All other expenses result from continuation of payments of salaries and annuities. The few treatments of severely burnt patients in the burn units cause effective costs higher than the tariff paid by the insurance. Even so, the predominant portion of the enormous costs is taken up by wages while off work and annuities. As our conclusion we stress the importance of primary care for all severe burns including all burns of the hands in a specialized centre. Any economic effort for primary burn treatment, however high it may be, is justified if the duration of rehabilitation and invalidity can thus be reduced.

Retrospective analysis of patients with burn injury treated in a burn center in Turkey during the Syrian civil war.

PubMed

Yuce, Yucel; Acar, Hakan A; Erkal, Kutlu H; Arditi, Nur B

2017-01-01

To report the management of burn injuries that occured in the Syria civil war, which were referred to our burn center. Methods: Forty-three patients with burns, injured in the civil war in Syria and whom were referred to Dr. Lütfi Kırdar Kartal Educating and Training Hospital Burn Centre of İstanbul, Turkey between 2011-2015 were analyzed in a retrospective study. Results: Most of our patients were in major burn classification (93%; 40/43) and most of them had burns greater than 15% total on body surface area. Most of them were admitted to our center late after first management at centers with improper conditions and in cultures of these patients unusual and resistant strains specific to the battlefield were produced. Conclusion: Immediate transfer of the patients from the scene of incidence to burn centers ensures early treatment, this factor may be effective on the outcome of these patients.

The Use of Stem Cells in Burn Wound Healing: A Review

PubMed Central

Ghieh, Fadi; Jurjus, Rosalyn; Ibrahim, Amir; Geagea, Alice Gerges; El Baba, Bassel; Chams, Sana; Matar, Michel; Zein, Wadih

2015-01-01

Burn wound healing involves a series of complex processes which are subject to intensive investigations to improve the outcomes, in particular, the healing time and the quality of the scar. Burn injuries, especially severe ones, are proving to have devastating effects on the affected patients. Stem cells have been recently applied in the field to promote superior healing of the wounds. Not only have stem cells been shown to promote better and faster healing of the burn wounds, but also they have decreased the inflammation levels with less scar progression and fibrosis. This review aims to highlight the beneficial therapeutic effect of stem cells in burn wound healing and to discuss the involved pathways and signaling molecules. The review covers various types of burn wound healing like skin and corneal burns, along with the alternative recent therapies being studied in the field of burn wound healing. The current reflection of the attitudes of people regarding the use of stem cells in burn wound healing is also stated. PMID:26236731

Tanning bed burns reported on Twitter: over 15,000 in 2013.

PubMed

Seidenberg, Andrew B; Pagoto, Sherry L; Vickey, Theodore A; Linos, Eleni; Wehner, Mackenzie R; Costa, Renata Dalla; Geller, Alan C

2016-06-01

Few surveillance tools exist for monitoring tanning bed injuries. Twitter data were examined to identify and describe reports of tanning bed-caused burns. Tweets sent in 2013 containing keywords for tanning bed use and burning were content analyzed to determine whether a burn caused by a tanning bed was described, and additional data on tanning behavior and burn characteristics were extracted. After content assessment, 15,178 (64 %) tweets were found to describe a tanning bed-caused burn. Sites most reportedly burnt were buttocks (n = 3117), face/head (n = 1020), and chest/breast (n = 546). Alarmingly, 200 burns to the eyes/eyelids were mentioned. A total of 456 tweets described burning >1 time from a tanning bed. A total of 211 tweets mentioned falling asleep inside the tanning bed. In 2013, over 15,000 tweets reported tanning bed-caused burns. Twitter data provides unique insight into tanning behaviors and injuries not captured through traditional public health surveillance.

Scalding in Turkish children: comparison of burns caused by hot water and hot milk.

PubMed

Tarim, Akin; Nursal, Tarik Zafer; Basaran, Ozgür; Yildirim, Sedat; Türk, Emin; Moray, Gökhan; Haberal, Mehmet

2006-06-01

Our aim in this study was to compare the clinical differences and etiologic risk factors for hot water and hot milk scald burns in Turkish children. The retrospective study examined the cases of 140 children aged 0.1-7 years who had scald burns treated in three burn units of a Turkish hospital network between March 2000 and December 2004. The patients were categorized in two groups: hot water burns or hot milk burns. Ninety-five (67.9%) patients had hot water burns and 45 (47.1%) had hot milk burns. The proportion of patients with hot milk burns who lived in rural areas was significantly higher than the corresponding proportion for the hot water cases (75.6% versus 52.6%, respectively; p<0.01). In 20 (44%) of the hot milk cases, the burn was caused by milk being boiled in large pots outdoors for cheese production. The other 25 hot milk cases were caused by milk being boiled in the kitchen. The mean (+/-S.D.) percentage total body surface area burned in the hot milk cases was higher than that in the hot water cases (33.6+/-2.24% versus 21.42+/-1.43%, respectively; p<0.001), and the corresponding mean percentages of TBSA with full-thickness burns were 9.2+/-2.52% versus 3.13+/-0.83%, respectively; (p=0.083). The mean percentages of TBSA with second-degree burns showed the same trend (29.0+/-12.39% versus 18.8+/-1.47%, respectively; p<0.001) higher percentage of the children with hot milk burns required antibiotics (78% versus 52.8%, respectively; p<0.006). Seven (7.4%) of the hot water burn patients and 15 (33.3%) of the hot milk burn patients died during the study period (p=0.025; overall mortality rate 15.7%). Children scalded with hot milk tend to have more extensive burns, and thus have higher mortality, than those scalded with hot water. To create effective programs for preventing scald injuries in Turkey and elsewhere, it is essential to consider ethnic and cultural issues based on these characteristics. Simple precautions should be explained and methods of using liquids such as hot milk should be researched in different geographic locations in order to formulate good prevention strategies.

Heparin Reduced Mortality and Sepsis in Severely Burned Children

PubMed Central

Zayas, G.J.; Bonilla, A.M.; Saliba, M.J

2007-01-01

Summary Objectives. In El Salvador, before 1999, morbidity and mortality in severely burned children were high. In 1998, all children with burns of 40% or larger size died and sepsis was found. With heparin use in 1999, some similarly burned children survived, and sepsis, pain, procedures, and scars were noted to be less. This retrospective study presents the details. Methods. A study was conducted at the National Children's Hospital in El Salvador of all children with burns over 20% size treated in 1998, when no heparin was used, and in 1999, when heparin was added to burns treatment, using an ethics committee approved protocol in use in twelve other countries. Sodium aqueous heparin solution USP from an intestinal source was infused intravenously and applied topically onto burn surfaces and within blisters for the first 1-3 days post-burn. Then heparin, in diminishing doses, was continued only topically until healing. The treatments in 1998 and 1999 were otherwise the same, except that fewer procedures were needed in 1999. Results. There were no significant differences in gender, age, weight, burn aetiology, or burn size between the burned children in 1998 and those in 1999. Burn pain was relieved and pain medicine was not needed in children treated with heparin in 1999. In 1998, one child survived who had a 35% size burn, and the eight children died who had burns of 40% and over. The survival rate was one out of nine (11%). The average burn size was 51.7%. With heparin use in 1999, six of the ten children survived burns of 50.7% average size. The increase in survival with heparin from 11% to 60% and, therefore, the decrease in mortality from 89% to 40% were significant (p < 0.04). Clinical symptoms and positive blood cultures documented bacterial sepsis in the nine children in 1998. In 1999, the blood cultures for sepsis were positive in the four children who died and negative in the six who survived. The nine versus four differences in the incidence of sepsis between 1998 and 1999 was significant (p < 0.008). The survivors had notably smooth skin. Conclusions. The use of heparin in this study relieved burn pain, significantly reduced mortality and sepsis with fewer procedures, and discernibly improved cosmetic results. PMID:21991064

Improved Rice Residue Burning Emissions Estimates: Accounting for Practice-Specific Emission Factors in Air Pollution Assessments of Vietnam

NASA Technical Reports Server (NTRS)

Lasko, Kristofer; Vadrevu, Krishna

2018-01-01

In Southeast Asia and Vietnam, rice residues are routinely burned after the harvest to prepare fields for the next season. Specific to Vietnam, the two prevalent burning practices include: a). piling the residues after hand harvesting; b). burning the residues without piling, after machine harvesting. In this study, we synthesized field and laboratory studies from the literature on rice residue burning emission factors for Particulate Matter less than 2.5 microns (PM2.5). We found significant differences in the resulting burning-practice specific emission factors, with 16.9 grams per square kilogram (plus or minus 6.9) for pile burning and 8.8 grams per square kilogram (plus or minus 3.5) for non-pile burning. We calculated burning practice specific emissions based on rice area data, region-specific fuel-loading factors, combined emission factors, and estimates of burning from the literature. Our results for year 2015 estimate 180 gigagrams of PM2.5 result from the pile burning method and 130 gigagrams result from non-pile burning method, with the most-likely current emission scenario of 150 gigagrams PM2.5 emissions for Vietnam. For comparison purposes, we calculated emissions using generalized agricultural emission factors employed in global biomass burning studies. These results estimate 80 gigagrams PM2.5, which is only 44 percent of the pile burning-based estimates, suggesting underestimation in previous studies. We compare our emissions to an existing all-combustion sources inventory, results show emissions account for 14-18 percent of Vietnam's total PM2.5 depending on burning practice. Within the highly-urbanized and cloud-covered Hanoi Capital region (HCR), we use rice area from Sentinel-1A to derive spatially-explicit emissions and indirectly estimate residue burning dates. Results from HYSPLIT (Hybrid Single-Particle Lagrangian Integrated Trajectory) back-trajectory analysis stratified by season show autumn has most emission trajectories originating in the North, while spring has most originating in the South, suggesting the latter may have bigger impact on air quality. From these results, we highlight locations where emission mitigation efforts could be focused and suggest measures for pollutant mitigation. Our study demonstrates the need to account for emissions variation due to different burning practices.

Burns

MedlinePlus

... doing so puts you in danger as well. Chemical and Electrical Burns For chemical and electrical burns, call 911 or your local ... the power source has been turned off. For chemical burns: Dry chemicals should be brushed off the ...

Transient Diabetes Insipidus Following Thermal Burn; A Case Report and Literature Review.

PubMed

Dash, Suvashis; Ghosh, Shibajyoti

2017-10-01

Diabetes insipidus is a disease charaterised by increased urine production and thrist. Neurogenic diabetes insipidus following head trauma,autoimmune disease and infection is quite common but diabetes insipidus following thermal burn injury is a rare complication.We should know about this complication as its management need a comprehensive approach for satisfactory outcome. Thermal burn can cause different complications in early post burn period like electrolyte imbalance, dehydration, acute renal failure, but diabetes insipidus is a very rare and unusual complication that may come across in thermal burn. We should be aware about this condition to prevent and treat mortality and morbidity in burn patients. We have reported a case of transient diabetes insipidus in a patient of thermal burn in early post burn period. Patient was treated accordingly, leading to complete recovery.

Burning characteristics and fiber retention of graphite/resin matrix composites

NASA Technical Reports Server (NTRS)

Bowles, K. J.

1980-01-01

Graphite fiber reinforced resin matrix composites were subjected to controlled burning conditions to determine their burning characteristics and fiber retention properties. Two types of burning equipment were used. Small samples were burned with a natural gas fired torch to study the effects of fiber orientation and structural flaws such as holes and slits that were machined into the laminates. Larger laminate samples were burned in a Heat Release Rate Calorimeter. Unidirectional epoxy/graphite and polyimide/graphite composites and boron powder filled samples of each of the two composite systems were burn tested and exposed to a thermal radiation. The effects of fiber orientation, flaws, and boron filler additives to the resins were evaluated. A high char forming polyimide resin was no more effective in retaining graphite fibers than a low char forming epoxy resin when burning in air.

Electroacupuncture improves burn-induced impairment in gastric motility mediated via the vagal mechanism in rats.

PubMed

Song, J; Yin, J; Sallam, H S; Bai, T; Chen, Y; Chen, J D Z

2013-10-01

Delayed gastric emptying (GE) is common in patients with severe burns. This study was designed to investigate effects and mechanisms of electroacupuncture (EA) on gastric motility in rats with burns. Male rats (intact and vagotomized) were implanted with gastric electrodes, chest and abdominal wall electrodes for investigating the effects of EA at ST-36 (stomach-36 or Zusanli) on GE, gastric slow waves, autonomic functions, and plasma interleukin 6 (IL-6) 6 and 24 h post severe burns. (i) Burn delayed GE (P < 0.001). Electroacupuncture improved GE 6 and 24 h post burn (P < 0.001). Vagotomy blocked the EA effect on GE. (ii) Electroacupuncture improved burn-induced gastric dysrhythmia. The percentage of normal slow waves was increased with EA 6 and 24 h post burn (P = 0.02). (iii) Electroacupuncture increased vagal activity assessed by the spectral analysis of heart rate variability (HRV). The high-frequency component reflecting vagal component was increased with EA 6 (P = 0.004) and 24 h post burn (P = 0.03, vs sham-EA). (iv) Electroacupuncture attenuated burn-induced increase in plasma IL-6 at both 6 (P = 0.03) and 24 h post burn (P = 0.003). Electroacupuncture at ST-36 improves gastric dysrhythmia and accelerates GE in rats with burns. The improvement seems to be mediated via the vagal pathway involving the inflammatory cytokine IL-6. © 2013 John Wiley & Sons Ltd.

Effect of blood transfusion on outcome after major burn injury: a multicenter study.

PubMed

Palmieri, Tina L; Caruso, Daniel M; Foster, Kevin N; Cairns, Bruce A; Peck, Michael D; Gamelli, Richard L; Mozingo, David W; Kagan, Richard J; Wahl, Wendy; Kemalyan, Nathan A; Fish, Joel S; Gomez, Manuel; Sheridan, Robert L; Faucher, Lee D; Latenser, Barbara A; Gibran, Nicole S; Klein, Robert L; Solem, Lynn D; Saffle, Jeffrey R; Morris, Stephen E; Jeng, James C; Voigt, David; Howard, Pamela A; Molitor, Fred; Greenhalgh, David G

2006-06-01

To delineate blood transfusion practices and outcomes in patients with major burn injury. Patients with major burn injury frequently require multiple blood transfusions; however, the effect of blood transfusion after major burn injury has had limited study. Multicenter retrospective cohort analysis. Regional burn centers throughout the United States and Canada. Patients admitted to a participating burn center from January 1 through December 31, 2002, with acute burn injuries of >or=20% total body surface area. Outcome measurements included mortality, number of infections, length of stay, units of blood transfused in and out of the operating room, number of operations, and anticoagulant use. A total of 21 burn centers contributed data on 666 patients; 79% of patients survived and received a mean of 14 units of packed red blood cells during their hospitalization. Mortality was related to patient age, total body surface area burn, inhalation injury, number of units of blood transfused outside the operating room, and total number of transfusions. The number of infections per patient increased with each unit of blood transfused (odds ratio, 1.13; p<.001). Patients on anticoagulation during hospitalization received more blood than patients not on anticoagulation (16.3+/-1.5 vs. 12.3+/-1.5, p<.001). The number of transfusions received was associated with mortality and infectious episodes in patients with major burns even after factoring for indices of burn severity. The utilization of blood products in the treatment of major burn injury should be reserved for patients with a demonstrated physiologic need.

Management of the Acute Partial-thickness Burned Hand; Moist Exposed Burn Ointment or Silver Sulphadiazine Cream both Combined with a Polyethylene Bag.

PubMed

Allam, A M; Mostafa, W; Zayed, E; El-Gamaly, J

2007-09-30

Hand burns predominantly affect young adults, and therefore have serious social and financial implications. In the present work, 106 patients with less than 25% body surface area burns and acute partial-thickness burned hands were managed using polyethylene bags and 1% local silver sulphadiazine (SSD) cream or moist exposed burn ointment (MEBO). Females made up 61.3% of the cases and flame burn was the majority cause (54.7%). There were no significant differences between the two groups regarding either the analgesic effect after local ointment application or hand movement inside the polyethylene bag. Local agent crustation over the wound was very evident in the hands managed by local 1% SSD cream (69.81%). On follow-up, the burned hands healed faster using local MEBO (10.48 versus 14.53 days), with fewer post-burn hand deformities and better active hand movements; however, the total cost until complete hand burn wound healing was higher with MEBO than with 1% SSD, although the final results were superior, with early return to work, when MEBO was used. We concluded that the use of MEBO as a topical agent and of polyethylene bags for the dressing of the acute partial-thickness burned hand accelerated healing; daily wound evaluation was easy as there was no crustation over it of the agent. It was more expensive than 1% SSD cream but presented fewer post-burn complications and more rapid healing, with shorter hospital stay.

Cement-related injuries: review of a series, the National Burn Repository, and the prevailing literature.

PubMed

Chung, Joseph Y; Kowal-Vern, Areta; Latenser, Barbara A; Lewis, Robert W

2007-01-01

The spectrum of cement-related injuries encompasses contact dermatitis, abrasions, ulcerations, chemical burns, and burns from explosions during the manufacturing process. The purpose of this study was to compile cement-related conditions seen in two burn units (1999-2005), literature case reports and series (1950-2006) and the (1989-2001) National Burn Repository (NBR). There were 3597 admissions in two Midwestern burn units, of which 12 cases (0.8%) were cement burns. They occurred in men, aged 15 to 64 years with a burn range of 0.25 to 10% TBSA, exposure time of 1 to 6 hours, treatment delay of 1 day to 2 weeks, hospitalization (2-14 days). Literature review of 109 cases indicated that cement-related injuries were predominantly seen in men, aged 26 to 45 years; with a cement-exposure time of 1.5 to 4 hours, treatment delay (1 day to 5 weeks), hospitalization (10-33 days), and healing time (2-7 weeks). There were 52,219 burn admissions in the NBR, of which 44 (0.08%) were cement-related burns; 95% were men with a mean age of 41 years, 6% TBSA cement burn and an 8-day hospital stay. The demographic characteristics of the burn units and NBR cases were similar to those in the literature. This preventable injury occurred primarily in the working age male patient and was associated with long healing times. Public awareness and enhanced manufacturer package warnings and education may decrease future cement-related injuries.

Expression and activity levels of chymase in mast cells of burn wound tissues increase during the healing process in a hamster model.

PubMed

Dong, Xianglin; Xu, Tao; Ma, Shaolin; Wen, Hao

2015-06-01

The present study aimed to investigate the changes in the expression levels and activity of mast cell chymase in the process of burn wound healing in a hamster model of deep second-degree burn. The hamster model was established by exposing a ~3 cm diameter area of bare skin to hot water (75°C) for 0, 6, 8, 10 or 12 sec. Tissue specimens were collected 24 h after burning and histological analysis revealed that hot water contact for 12 sec was required to produce a deep second-degree burn. Quantitative polymerase chain reaction and a radioimmunoassay were used to the determine changes in chymase mRNA expression levels and activity. The mRNA expression levels and activity of chymase were increased in the burn wound tissues when compared with the normal skin. However, no statistically significant differences were observed in mast cell chymase activity amongst the various post-burn stages. Chymase mRNA expression levels peaked at day 1 post-burn, subsequently decreasing at days 3 and 7 post-burn and finally increasing again at day 14 post-burn. In summary, a hamster model of deep second-degree burn can be created by bringing the skin into contact with water at 75°C for 12 sec. Furthermore, the mRNA expression levels and activity of chymase in the burn wound tissues increased when compared with those in normal skin tissues.

Expression and activity levels of chymase in mast cells of burn wound tissues increase during the healing process in a hamster model

PubMed Central

DONG, XIANGLIN; XU, TAO; MA, SHAOLIN; WEN, HAO

2015-01-01

The present study aimed to investigate the changes in the expression levels and activity of mast cell chymase in the process of burn wound healing in a hamster model of deep second-degree burn. The hamster model was established by exposing a ~3 cm diameter area of bare skin to hot water (75°C) for 0, 6, 8, 10 or 12 sec. Tissue specimens were collected 24 h after burning and histological analysis revealed that hot water contact for 12 sec was required to produce a deep second-degree burn. Quantitative polymerase chain reaction and a radioimmunoassay were used to the determine changes in chymase mRNA expression levels and activity. The mRNA expression levels and activity of chymase were increased in the burn wound tissues when compared with the normal skin. However, no statistically significant differences were observed in mast cell chymase activity amongst the various post-burn stages. Chymase mRNA expression levels peaked at day 1 post-burn, subsequently decreasing at days 3 and 7 post-burn and finally increasing again at day 14 post-burn. In summary, a hamster model of deep second-degree burn can be created by bringing the skin into contact with water at 75°C for 12 sec. Furthermore, the mRNA expression levels and activity of chymase in the burn wound tissues increased when compared with those in normal skin tissues. PMID:26136958

The effects of rapid enzymatic debridement of deep partial-thickness burns with Debrase on wound reepithelialization in swine.

PubMed

Singer, Adam J; Taira, Breena R; Anderson, Ryon; McClain, Steve A; Rosenberg, Lior

2010-01-01

Reepithelialization of deep burns requires spontaneous or active removal or debridement of the necrotic eschar, as recently defined by the American Burn Association. Debrase is a bromelain-derived enzymatic preparation that has been shown to result in rapid and selective debridement of human and animal burns. The authors hypothesized that rapid debridement of deep dermal burns with Debrase would result in earlier reepithelialization of the remaining dermis in a porcine model. Eighty deep dermal contact burns measuring 10 by 20 mm were created on the back and flanks of anesthetized domestic pigs (25 kg) using a brass template preheated in boiling water (100 degrees C) that was applied to the skin for a period of 30 seconds. The template was applied using a spring-loaded device designed to control the amount of pressure applied to the skin by the template. Burns were randomized to a 4-hour topical application of Debrase (lyophilized dry enzyme dissolved and activated in a hydrating vehicle) (n = 40) or its hydrating vehicle (n = 40) followed by daily application of a petrolatum-based antibiotic ointment. Wounds were visually assessed and photographed daily. Four-millimeter full-thickness punch biopsies were obtained for histological analysis using hematoxylin and eosin staining by a board-certified dermatopathologist masked to burn therapy at 7, 11, 13, and 15 days after injury. The primary outcome was the percentage of the burns that were completely reepithelialized at each time point. Secondary outcomes were time to complete reepithelialization and the mean percentage of reepithelialization on microscopic analysis. A sample of 40 burns in each group had 80% power to detect a 20% difference in the percentage of completely reepithelialized burns (two tailed, P < .05). The percentage of completely reepithelialized burns was higher for Debrase than control burns at days 11 (40.9% vs 3.1%; P = .002), 13 (87.5% vs 50%; P = .007), and 15 (97.5% vs 77.5%, P = .018). The mean (SD) percentage reepithelialization of Debrase-treated burns at 7 days was higher than of control burns (47.6% [3.2] vs 0% [0]; P < .001). A larger number of cells in the epidermis and dermis of debrided burns stained positive for the proliferation antigen Ki-67. There was no evidence of any adverse events in the normal skin adjacent to the Debrase-treated burns. Rapid enzymatic debridement of deep partial-thickness burns with Debrase results in earlier reepithelialization and cellular proliferation in swine, when compared with carrier and topical antibiotic dressings alone.

Firefighter burn injuries: predictable patterns influenced by turnout gear.

PubMed

Kahn, Steven A; Patel, Jignesh H; Lentz, Christopher W; Bell, Derek E

2012-01-01

Approximately 100 firefighters suffer fatal injuries annually and tens of thousands receive nonfatal injuries. Many of these injuries require medical attention and restricted activity but may be preventable. This study was designed to elucidate etiology, circumstances, and patterns of firefighter burn injury so that further prevention strategies can be designed. In particular, modification of protective equipment, or turnout gear, is one potential strategy to prevent burn injury. An Institutional Review Board-approved retrospective review was conducted with records of firefighters treated for burn injury from 2005 to 2009. Data collected included age, gender, TBSA, burn depth, anatomic location, total hospital days per patient, etiology, and circumstances of injury. Circumstances of injury were stratified into the following categories: removal/dislodging of equipment, failure of equipment to protect, training errors, and when excessive external temperatures caused patient sweat to boil under the gear. Over the 4-year period, 20 firefighters were treated for burn injury. Mean age was 38.9 ± 8.9 years and 19 of 20 patients were male. Mean burn size was 1.1 ± 2.7% TBSA. Eighteen patients suffered second-degree burns, while two patients suffered first-degree burns. Mean length of hospitalization was 2.45 days. Scald burns were responsible for injury to 13 firefighters (65%). Flame burns caused injury to four patients (20%). Only three patients received contact burns (15%). The face was the site most commonly burned, representing 29% of injuries. The hand/wrist and ears were the next largest groups, with 23 and 16% of the injuries, respectively. Other areas burned included the neck (10%), arm (6.5%), leg (6.5%), knees (3%), shoulders (3%), and head (3%). Finally, the circumstance of injury was evaluated for each patient. Misuse and noncontiguous areas of protective equipment accounted for 14 of the 20 injuries (70%). These burns were caused when hot steam/liquid entered the gear via gaps in the sleeve or face mask. Three patients (15%) received injury due to removal/dislodging of their safety equipment, two patients (10%) suffered their injuries during training exercises when they were not wearing their safety equipment, and the final patient (5%) received burns due to sweat evaporation. Firefighter burn injuries occur to predictable anatomic sites with common injury patterns. Modification and optimization of gear to eliminate gaps that allow steam/hot liquid entry may decrease burn injury. Improving education regarding the use of protective equipment may also be beneficial.

Traditional Herbal Remedies for Burn Wound Healing in Canon of Avicenna

PubMed Central

Aliasl, Jale; Khoshzaban, Fariba

2013-01-01

Burns are a worldwide problem. The incidence of severe burns has been higher than the combined incidence of tuberculosis and HIV infections. Throughout history there have been many different treatments prescribed for burns. The Canon is the masterpiece of Avicenna’s medical books. The Canon includes a description of 785 simple drugs. Avicenna believed in burn treatment, which follows two goals. The first goal is prevention of blistering and the second goal is treatment of the burn wound after it has created blisters, cold drugs are suitable for the first goal and dry drugs with moderate in cold and hot qualities are better for second goal, this study reviewed remedies for burn wounds in Canon.

Burn Wound Healing and Tissue Engineering.

PubMed

Singer, Adam J; Boyce, Steven T

In 2016 the American Burn Association held a State of the Science conference to help identify burn research priorities for the next decade. The current paper summarizes the work of the sub-committee on Burn Wound Healing and Tissue Engineering. We first present the priorities in wound healing research over the next 10 years. We then summarize the current state of the science related to burn wound healing and tissue engineering including determination of burn depth, limiting burn injury progression, eschar removal, management of microbial contamination and wound infection, measuring wound closure, accelerating wound healing and durable wound closure, and skin substitutes and tissue engineering. Finally, a summary of the round table discussion is presented.

The consequences of global biomass burning

NASA Technical Reports Server (NTRS)

Levine, Joel S.

1991-01-01

Global biomass burning encompasses forest burning for land clearing, the annual burning of grasslands, the annual burning of agricultural stubble and waste after harvests, and the burning of wood as fuel. These activities generate CO2, CH4 and other hydrocarbons, CO, H2, NO, NH3, and CH3Cl; of these, CO, CH4 and the hydrocarbons, and NO, are involved in the photochemical production of tropospheric O3, while NO is transformed to NO2 and then to nitric acid, which falls as acid rain. Biomass burning is also a major source of atmospheric particulates and aerosols which affect the transmission of incoming solar radiation and outgoing IR radiation through the atmosphere, with significant climatic effects.

An insight into burns in a developing country: a Sri Lankan experience.

PubMed

Lau, Y S

2006-10-01

Burn injuries represent a diverse and varied challenge to medical and paramedical staff. The management of burns and their sequelae in a well-equipped, modern burns unit remains demanding despite advances in surgical techniques and development of tissue-engineered biomaterials; in a developing country, these difficulties are amplified many times. Sri Lanka has a high incidence of burn-related injuries annually due to a combination of adverse social, economic and cultural factors. The management of burn injuries remains a formidable public health problem. The epidemiology of burns, challenges faced in their management and effective strategies specific to Sri Lanka, such as the Safe Bottle Lamp campaign, are highlighted in this paper.

Evaluation of a peer consultation program for burn inpatients. 2000 ABA paper.

PubMed

Williams, Rhonda M; Patterson, David R; Schwenn, Clay; Day, Jeanette; Bartman, Mark; Engrav, Loren H

2002-01-01

A burn survivor may provide unique psychological support to patients who have been burned more recently and enhance their adjustment to burn injury. The purpose of this study was to describe the peer consultation/burn survivor support program at a large regional burn center in the Northwest United States. Over the course of 17 months, three specially trained peer consultants who had survived their own burn injuries in the past made 167 visits to 108 patients, who, in turn, completed evaluation forms for each visit. Findings indicated that patients reported that the peer consultants approached them in an appropriate manner, answered their questions, and provided useful support and information.

Visual Impacts of Prescribed Burning on Mixed Conifer and Giant Sequoia Forests

Treesearch

Lin Cotton; Joe R. McBride

1987-01-01

Prescribed burning programs have evolved with little concern for the visual impact of burning and the potential prescribed burning can have in managing the forest scene. Recent criticisms by the public of the prescribed burning program at Sequoia National Park resulted in an outside review of the National Park fire management programs in Sequoia, Kings Canyon, and...

Modeling biomass burning emissions for Amazon forest and pastures in Rondônia, Brazil.

Treesearch

Liane S. Guild; J. Boone Kauffman; Warren B. Cohen; Christine A. Hlavka; Darold E. Ward

2004-01-01

As a source of atmospheric carbon, biomass burning emissions associated with deforestation in the Amazon are globally significant. Once deforested, these lands continue to be sources of substantial burning emissions for many years due to frequent pasture burning. The objective of this research was to quantify biomass-burning emissions at a local scale. We estimated...

Prescribed burning to restore mixed-oak communities in southern Ohio: Effects on breeding-bird populations

Treesearch

Vanessa L. Artman; Elaine K. Sutherland; Jerry F. Downhower

2001-01-01

Fire is being experimentally reintroduced to the forests of southern Ohio to determine its effectiveness in restoring and maintaining mixed-oak (Quercus spp.) forest communities. We studied the effects of repeated burning (1-4 years of annual burning) and recovery (1 year after burning) on the breeding bird community. Burning resulted in incremental but temporary...

40 CFR 52.620 - Identification of plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

.../29/1982 08/18/1983, 48 FR 37403 11-60-18 Control of open burning 11/29/1982 08/18/1983, 48 FR 37403 11-60-19 Agricultural burning, permit requirement 11/29/1982 08/18/1983, 48 FR 37403 11-60-20 Agricultural burning, applications 11/29/1982 08/18/1983, 48 FR 37403 11-60-21 Agricultural burning, “no burn...

Sensitivity of Landsat image-derived burn severity indices to immediate post-fire effects

Treesearch

A. T. Hudak; S. Lewis; P. Robichaud; P. Morgan; M. Bobbitt; L. Lentile; A. Smith; Z. Holden; J. Clark; R. McKinley

2006-01-01

The USFS Remote Sensing Applications Center (RSAC) and the USGS Center for Earth Resources Observation and Science (EROS) produce Burned Area Reflectance Classification (BARC) maps as a rapid, preliminary indication of burn severity on large wildfire events. Currently the preferred burn severity index is the delta Normalized Burn Ratio (dNBR), which requires NBR values...

Comparison of heat transfer and soil impacts of air curtain burner burning and slash pile burning

Treesearch

Woongsoon Jang; Deborah S. Page-Dumroese; Han-Sup Han

2017-01-01

We measured soil heating and subsequent changes in soil properties between two forest residue disposal methods: slash pile burning (SPB) and air curtain burner (ACB). The ACB consumes fuels more efficiently and safely via blowing air into a burning container. Five burning trials with different fuel sizes were implemented in northern California, USA. Soil temperature...

Pattern of burn injury at north of Jordan

PubMed Central

Bataineh, Ziad A; Al Quran, Thekraiat M; Al Balas, Hamzeh; Khammash, Muhmammad R

2018-01-01

To the best of our knowledge, pattern of burn injury was not reported yet at our region, our hospital considered the only tertiary referral center with the only burn unit at the region since 2001 till date, a retrospective analysis of our computerized filing system recorded 527 burn patients between 2001-2016, mean age was 26 years; 1.27:1 was the male to female ratio, 79 patients were found to have major burns, 46% of admissions were below 20 years’ age, 92% was at domestic site of affection and 65% due to flame burn followed by scald burn in about 23%. The limbs were the most affected body site, majority of patients were below 15% TBSA and partial thickness, 77 patients found to have inhalational injury. Our mean hospital stay was 16 days and mortality was 8.2%. Mortality was associated with high TBSA affection, depth and flame type. This study shows the pattern of burn at north of Jordan, preventive measures by education and observation will reduce the incidence of burn and its sequel, non-flammable cook plates and stoves will probably help in decrease burn morbidity and mortality. PMID:29531853

Analysis of Alaskan burn severity patterns using remotely sensed data

USGS Publications Warehouse

Duffy, P.A.; Epting, J.; Graham, J.M.; Rupp, T.S.; McGuire, A.D.

2007-01-01

Wildland fire is the dominant large-scale disturbance mechanism in the Alaskan boreal forest, and it strongly influences forest structure and function. In this research, patterns of burn severity in the Alaskan boreal forest are characterised using 24 fires. First, the relationship between burn severity and area burned is quantified using a linear regression. Second, the spatial correlation of burn severity as a function of topography is modelled using a variogram analysis. Finally, the relationship between vegetation type and spatial patterns of burn severity is quantified using linear models where variograms account for spatial correlation. These results show that: 1) average burn severity increases with the natural logarithm of the area of the wildfire, 2) burn severity is more variable in topographically complex landscapes than in flat landscapes, and 3) there is a significant relationship between burn severity and vegetation type in flat landscapes but not in topographically complex landscapes. These results strengthen the argument that differential flammability of vegetation exists in some boreal landscapes of Alaska. Additionally, these results suggest that through feedbacks between vegetation and burn severity, the distribution of forest vegetation through time is likely more stable in flat terrain than it is in areas with more complex topography. ?? IAWF 2007.

Fusarium spp infections in a pediatric burn unit: nine years of experience.

PubMed

Rosanova, María Teresa; Brizuela, Martín; Villasboas, Mabel; Guarracino, Fabian; Alvarez, Veronica; Santos, Patricia; Finquelievich, Jorge

2016-01-01

Fusarium spp are ubiquitous fungi recognized as opportunistic agents of human infections, and can produce severe infections in burn patients. The literature on Fusarium spp infections in pediatric burn patients is scarce. To describe the clinical and epidemiological features as well as outcome of Fusarium spp infections in pediatric burn patients. Retrospective, descriptive study of Fusarium spp infections in a specialized intensive care burn unit. In 15 patients Fusarium spp infections were diagnosed. Median age was 48 months. Direct fire injury was observed in ten patients. The median affected burn surface area was 45%. Twelve patients had a full thickness burn. Fourteen patients had a Garces Index ≥3. Fungal infection developed at a median of 11 days after burn injury. Fungi were isolated from burn wound in 14 patients and from the bone in one patient. Amphotericin B was the drug of choice for treatment followed by voriconazole. Median time of treatment completion was 23 days. One patient (7%) died of fungal infection-related causes. In our series Fusarium spp was an uncommon pathogen in severely burnt patients. The burn wound was the most common site of infection and mortality was low. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

Perceived social support among patients with burn injuries: A perspective from the developing world.

PubMed

Waqas, Ahmed; Turk, Marvee; Naveed, Sadiq; Amin, Atif; Kiwanuka, Harriet; Shafique, Neha; Chaudhry, Muhammad Ashraf

2018-02-01

Social support is among the most well-established predictors of post-burn psychopathology after burn. Despite a disproportionately large burden of burns in the developing world, the nature of social support among burn patients in this context remains elusive. We, therefore, seek to investigate social support and its biopsychosocial determinants among patients with burn injuries in Pakistan. A cross-sectional study of 343 patients presenting with burn injuries at four teaching hospitals in the Punjab province of Pakistan was conducted. Patient evaluation consisted of a multi-part survey of demographic status, clinical features, and social support as measured by the validated Urdu translation of the Multidimensional Scale of Perceived Social Support (MSPSS). Multiple regression analysis was performed to evaluate associations between patient characteristics and MSPSS score. Mean overall MSPSS score was 57.64 (std dev 13.57). Notable positive predictors of social support include male gender, Punjabi ethnicity, burn surface area, and ego resiliency. Our study reveals a troubling pattern of inadequate social support among certain subgroups of Pakistani burn patients. Addressing these inequities in the provision of social support must be prioritized as part of the global burn care agenda. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

The Associations of Gender With Social Participation of Burn Survivors: A Life Impact Burn Recovery Evaluation Profile Study.

PubMed

Levi, Benjamin; Kraft, Casey T; Shapiro, Gabriel D; Trinh, Nhi-Ha T; Dore, Emily C; Jeng, James; Lee, Austin F; Acton, Amy; Marino, Molly; Jette, Alan; Armstrong, Elizabeth A; Schneider, Jeffrey C; Kazis, Lewis E; Ryan, Colleen M

2018-05-04

Burn injury can be debilitating and affect survivors' quality of life in a profound fashion. Burn injury may also lead to serious psychosocial challenges that have not been adequately studied and addressed. Specifically, there has been limited research into the associations of burn injury on community reintegration based on gender. This work analyzed data from 601 burn survivors who completed field testing of a new measure of social participation for burn survivors, the Life Impact Burn Recovery Evaluation (LIBRE) Profile. Differences in item responses between men and women were examined. Scores on the six LIBRE Profile scales were then compared between men and women using analysis of variance and adjusted linear multivariate regression modeling. Overall, men scored significantly better than women on four of the six LIBRE Profile scales: Sexual Relationships, Social Interactions, Work & Employment, and Romantic Relationships. Differences were not substantially reduced after adjustment for demographic characteristics and burn size. Men scored better than women in most of the areas measured by the LIBRE Profile. These gender differences are potentially important for managing burn patients during the post-injury recovery period.

Effects of winter marsh burning on abundance and nesting activity of Louisiana seaside sparrows in the Gulf Coast Chenier Plain

USGS Publications Warehouse

Gabrey, S.W.; Afton, A.D.

2000-01-01

Louisiana Seaside Sparrows (Ammodramus maritimus fisheri) breed and winter exclusively in brackish and saline marshes along the northern Gulf of Mexico. Many Gulf Coast marshes, particularly in the Chenier Plain of southwestern Louisiana and southeastern Texas, are burned intentionally in fall or winter as part of waterfowl management programs. Fire reportedly has negatively affected two Seaside Sparrow subspecies (A. m. nigrescens and A. m. mirabilis) in Florida, but there is no published information regarding effects of fire on A. m. fisheri. We compared abundance of territorial male Louisiana Seaside Sparrows, number of nesting activity indicators, and vegetation structure in paired burned and unburned plots in Chenier Plain marshes in southwestern Louisiana during the 1996 breeding season (April-July) before experimental winter burns (January 1997) and again during two breeding seasons post-burn (1997-1998). We found that abundance of male sparrows decreased in burned plots during the first breeding season post-burn, but was higher than that of unburned plots during the second breeding season post-burn. Indicators of nesting activity showed a similar but non-significant pattern in response to burning. Sparrow abundance and nesting activity seemingly are linked to dead vegetation cover, which was lower in burned plots during the first breeding season post-burn, but did not differ from that in unburned plots during the second breeding season post-burn. We recommend that marsh management plans in the Gulf Coast Chenier Plain integrate waterfowl and Seaside Sparrow management by maintaining a mosaic of burned and unburned marshes and allowing vegetation to recover for at least two growing seasons before reburning a marsh.

Split thickness skin graft meshing ratio indications and common practices.

PubMed

Pripotnev, Stahs; Papp, Anthony

2017-12-01

Split thickness skin grafting is a commonly used technique in burn surgery for resurfacing wounds that are unlikely to heal without scarring. Meshing and expanding skin grafts allow for reconstruction of larger wounds with smaller donor sites. A retrospective chart review was performed of 210 patients with burns equal to or greater than 20% total body surface area admitted to Vancouver General Hospital between 1998 and 2014. Charts were reviewed to collect data on patient and burn demographics. A survey was sent to Canadian plastic surgeons registered with the CSPS to collect data on common practices in burn surgery nationwide. The patients that received 3:1 or higher meshed grafts were all flame burns, had a significantly higher average TBSA (51.89%±14.87 vs 29.13%±9.48, p=0.001), and a significantly higher full thickness burn TBSA (25.76%±21.97 vs 6.20%±9.04, p=0.001). We found no significant differences in gender, age, or burn location between the less than 2:1 and 3:1 or greater meshing ratio groups. The survey of plastic surgeons performing burn surgery in Canada revealed that 60% of responders had experience with skin grafts using meshing ratios of 3:1 or higher. Of these surgeons, 100% felt that burn size and 36% felt that burn location would influence their decision to use a 3:1 or higher meshing ratio. A larger burn size is the major influencing factor for the use of higher skin graft meshing ratios by Canadian burn surgeons. Furthermore, burn location determines the choice of donor and recipient sites in these cases. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Electrical burns: The trend and risk factors in the Ghanaian population.

PubMed

Agbenorku, P; Agbenorku, E; Akpaloo, J; Obeng, G; Agbley, D

2014-12-31

The usefulness of electricity in daily life offers several advantages which cannot be underestimated. Electricity is needed by industries for manufacturing and also in homes for lighting, cooking, washing, etc. However, electricity can cause severe life-threatening complications. This study investigates the trend and mortality risk factors of electrical burn injuries at the Burns Intensive Care Unit (BICU) of the Komfo Anokye Teaching Hospital (KATH), Ghana. The Burns Registry at KATH BICU containing information on patients who were admitted for electrical burns was used. Data on the sex, age, occupation, cause of injury, Total Body Surface Area burned (TBSA) and outcome of admissions was obtained. GraphPad version 5 was used for the analysis. There were 13 (2.7%) electrical burns, suffered by 11 males (84.6%) and 2 females (15.4%) out of a total 487 BICU admissions over a 4-year period (July 1, 2009 - June 30, 2013); the mean age of the electrical burn victims was 37.8 years (range = 22-56); the TBSA ranged from 5.0% - 98.0%. Mortality risk factors identified were high voltage electrical burns, older age (P=0.0250) and TBSA>20% (P=0.048). Four cases (30.8%) were transferred to the Main Burns Ward (Ward D2C); 6 cases (46.1%) were discharged home; 3 patients (23.1%) died; all deaths were recorded in persons who had high voltage electrical burns. Electrical burns can be severe and can cause death. Even though the current study showed that a small population was affected by electrical burns, society has to be continually conscious of the detrimental effects of electrical energy and take the necessary precautions to minimize this type of accident.

An epidemiological analysis of paediatric burns in urban and rural areas in south central China.

PubMed

Zhou, Bo; Zhou, Xiao; Ouyang, Li-zhi; Huang, Xiao-yuan; Zhang, Pi-hong; Zhang, Ming-hua; Ren, Li-cheng; Liang, Peng-fei

2014-02-01

This study aims to analyse the epidemiology of paediatric burns in south central China, illustrate the differences between rural and urban areas, and discern prevention measures to reduce paediatric burns. Data were obtained from all paediatric patients admitted to Department of Burns unit of Xiangya Hospital during 2009-2012. A retrospective review was performed, including cause of burn, pre-hospital treatment, place of burn occurrence, anatomical areas involved, extent of burn, date of injury, number of operations, complications, length of hospital stay, hospitalisation cost and cure rate. A total of 278 hospitalised paediatric patients were admitted in this study. The majority (56.47%) were 1-3 years old. Rural patients accounted for 67.99% in total; the ratio of boys to girls was 2.05. Scalding with hot fluids was the most common cause of burns in children (62.59%), followed by flame (17.63), fireworks (9.71%), electricity (5.76%) and other factors such as contact and chemical (4.32%). The living room was the location with the highest frequency of burns in children (53.24%). Burns were more likely to happen in winter and the upper extremities were the most involved anatomic site (53.24%). Total burn surface area (TBSA) ranging from 0% to 9% accounted for 55.4% in total. Rural patients underwent more operations and had longer and costlier hospital stays than urban patients. Compared with treatment in urban areas, rural burn patients received less first-aid treatment, underwent more surgery, had more complications and longer and more costly hospital stays. This finding strongly suggests that it is necessary to make more efforts to prevent burns, especially in rural areas. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Long-Term Social Reintegration Outcomes for Burn Survivors With and Without Peer Support Attendance: A Life Impact Burn Recovery Evaluation (LIBRE) Study.

PubMed

Grieve, Brian; Shapiro, Gabriel D; Wibbenmeyer, Lucy; Acton, Amy; Lee, Austin; Marino, Molly; Jette, Alan; Schneider, Jeffrey C; Kazis, Lewis E; Ryan, Colleen M

2017-10-31

To examine differences in long-term social reintegration outcomes for burn survivors with and without peer support attendance. Cross-sectional survey. Community-dwelling burn survivors. Burn survivors (N=601) aged ≥18 years with injuries to ≥5% total body surface area (TBSA) or burns to critical areas (hands, feet, face, or genitals). Not applicable. The Life Impact Burn Recovery Evaluation Profile was used to examine the following previously validated 6 scale scores of social participation: Family and Friends, Social Interactions, Social Activities, Work and Employment, Romantic Relationships, and Sexual Relationships. Burn support group attendance was reported by 330 (55%) of 596 respondents who responded to this item. Attendees had larger burn size (43.4%±23.6% vs 36.8%±23.4% TBSA burned, P<.01) and were more likely to be >10 years from injury (50% vs 42.5%, P<.01). Survivors who attended at least 1 support group scored significantly higher on 3 of the scales: Social Interactions (P=.01), Social Activities (P=.04), and Work and Employment (P=.05). In adjusted analyses, peer support attendance was associated with increased scores on the Social Interactions scale, increasing scores by 17% of an SD (95% confidence interval, 1%-33%; P=.04). Burn survivors who reported peer support attendance had better social interaction scores than those who did not. This is the first reported association between peer support group attendance and improvements in community reintegration in burn survivors. This cross-sectional study prompts further exploration into the potential benefits of peer support groups on burn recovery with future intervention studies. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A Soft Casting Technique for Managing Pediatric Hand and Foot Burns.

PubMed

Choi, Young Mee; Nederveld, Cindy; Campbell, Kristen; Moulton, Steven

2018-04-04

Hand and foot burns in children are difficult to dress. The authors have developed a soft casting technique to manage burns to these areas. The aim of this study is to report the outcomes using weekly dressing changes with a soft casting technique to manage pediatric hand and foot burns in the outpatient setting. A retrospective chart review was performed on children with burns to the hands or feet, who underwent dressing changes with a soft casting technique at the Children's Hospital Colorado Burn Center. Soft casting was performed by placing antibiotic ointment-impregnated nonadherent gauze over the burn wound(s), wrapping the extremity using rolled gauze, applying soft cast pad, plaster, soft cast tape, and an elastic bandage. This was changed weekly. Two hundred ninety-eight children with hand burns had a mean age of 16.8 ± 2 months. Two hundred forty-eight children had partial thickness burn injuries (83%), 50 had full thickness burn injuries (17%), and the mean total body surface area (TBSA) was 1 ± 2.4%. The mean time to heal was 10.1 ± 1.7 days for all subjects. Sixty-six children with foot burns were identified with a mean age of 24 ± 2.6 months. Forty-six children had partial thickness injuries (70%), 20 had full thickness burn injuries (30%), and the mean TBSA was 2.3 ± 2.9%. The mean time to heal was 14.1 ± 2.2 days for all subjects. Weekly dressing changes using a soft casting technique are effective for the outpatient management of pediatric hand and foot burns. This method avoids costly inpatient hospital care, reduces the number of painful dressing changes, and allows children to heal in their own environment.

Electrical burns: The trend and risk factors in the Ghanaian population

PubMed Central

Agbenorku, P.; Agbenorku, E.; Akpaloo, J.; Obeng, G.; Agbley, D.

2014-01-01

Summary The usefulness of electricity in daily life offers several advantages which cannot be underestimated. Electricity is needed by industries for manufacturing and also in homes for lighting, cooking, washing, etc. However, electricity can cause severe life-threatening complications. This study investigates the trend and mortality risk factors of electrical burn injuries at the Burns Intensive Care Unit (BICU) of the Komfo Anokye Teaching Hospital (KATH), Ghana. The Burns Registry at KATH BICU containing information on patients who were admitted for electrical burns was used. Data on the sex, age, occupation, cause of injury, Total Body Surface Area burned (TBSA) and outcome of admissions was obtained. GraphPad version 5 was used for the analysis. There were 13 (2.7%) electrical burns, suffered by 11 males (84.6%) and 2 females (15.4%) out of a total 487 BICU admissions over a 4-year period (July 1, 2009 – June 30, 2013); the mean age of the electrical burn victims was 37.8 years (range = 22–56); the TBSA ranged from 5.0% - 98.0%. Mortality risk factors identified were high voltage electrical burns, older age (P=0.0250) and TBSA>20% (P=0.048). Four cases (30.8%) were transferred to the Main Burns Ward (Ward D2C); 6 cases (46.1%) were discharged home; 3 patients (23.1%) died; all deaths were recorded in persons who had high voltage electrical burns. Electrical burns can be severe and can cause death. Even though the current study showed that a small population was affected by electrical burns, society has to be continually conscious of the detrimental effects of electrical energy and take the necessary precautions to minimize this type of accident. PMID:26336364

The impact of socio-economic deprivation on burn injury: A nine-year retrospective study of 6441 patients.

PubMed

Marsden, N J; Battle, C E; Combellack, E J; Sabra, A; Morris, K; Dickson, W A; Whitaker, I S; Evans, P A

2016-03-01

Low socio-economic status is thought to be associated with increased burn risk, however the significance and generalisability across different populations and cultures has been questioned. A nine-year retrospective study of burn presentations to a large teaching hospital (2005-2014) was performed to investigate the association between socio-economic status and burns. Demographic and injury data was collected via the trust 'Information portal'. The Welsh Index of Multiple: Deprivation 2011 was used to score for socio-economic status. Chi-squared test and Odds Ratios were calculated and statistical significance defined as p<0.05 throughout. 6441 burns were identified, with 755 (11.7%) admitted. Overall incidence rates were the highest published in the UK (0.35/1000/year) with sub group analysis showing the highest rates in under fives and males. Significant relationships between both age and burn mechanism and gender and burn mechanism (p=0.0005) were identified. Scald (67.1%) was the most common mechanism with the upper limb (48%) most commonly burned. Chi square analysis demonstrated a significant relationship between socio-economic deprivation, age and burn incidence (p≤0.0005), with a disproportionately high number of burns in patients under the age of 16 in the most deprived quintile (OR 1.23; 95% CI 1.06-1.44). This study specifically highlights patients under the age of 16 living in poorer socio-economic areas as the most at risk of suffering burns receiving hospital attention. This study demonstrates burns as a significant public health issue, and the results should aid in designing specific burn prevention strategies to target high-risk groups. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Burns in a major burns center in East China from 2005 to 2014: Incidence and outcome.

PubMed

Fan, Xiaoming; Ma, Bing; Zeng, Ding; Fang, Xiao; Li, Haihang; Xiao, Shichu; Wang, Guangyi; Tang, Hongtai; Xia, Zhaofan

2017-11-01

Information about epidemiology on burns is rare in China. The aim of this article is to describe the pattern of burns in East China during a 10-year time period. A retrospective data analysis was performed on all hospitalized patients to the burn center at the Changhai hospital, one of major burn centers in East China, from 2005 to 2014. We included 3376 patients in this study. Among them, 48.1% were from 27 provinces out of Shanghai and nearly 90% were from East China. August saw the most admissions and November saw the fewest. Spring and summer separately dominated in number of female and male patients. Children aged 2-5 and working-age adult were the most commonly treated. Home was the commonest place of injury, followed by industrial-related places, outdoors, public buildings, and vehicles or roads. Scalds remained the primary reason, followed by fire, contact burns, electricity, and chemicals. The average %TBSA of male patients was 14.2±21.3, significantly different from that of female patients (10.4±16.9). Extremities were the most vulnerable body region burned, followed by the trunk, face and hands. The average hospital length of stay in male patients was 25.4±72.4 days, significantly different from that of females' 19.9±27.6 days. The total mortality was 1.8% and the lethal area burned resulting in 50% mortality was 96.5% TBSA. Compared with published data, these result are encouraging, which demonstrate that burn care and treatment has made significant progress. Burn clinicians should bear not only the responsibility to treat and cure burns, but also the popularization of knowledge about burn precautions and emergency treatments. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Treatment of secondary burn wound progression in contact burns-a systematic review of experimental approaches.

PubMed

Schmauss, Daniel; Rezaeian, Farid; Finck, Tom; Machens, Hans-Guenther; Wettstein, Reto; Harder, Yves

2015-01-01

After a burn injury, superficial partial-thickness burn wounds may progress to deep partial-thickness or full-thickness burn wounds, if kept untreated. This phenomenon is called secondary burn wound progression or conversion. Burn wound depth is an important determinant of patient morbidity and mortality. Therefore, reduction or even the prevention of secondary burn wound progression is one goal of the acute care of burned patients. The objective of this study was to review preclinical approaches evaluating therapies to reduce burn wound progression. A systematic review of experimental approaches in animals that aim at reducing or preventing secondary burn wound progression was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. The selected references consist of all the peer-reviewed studies performed in vivo in animals and review articles published in English, German, Italian, Spanish, or French language relevant to the topic of secondary burn wound progression. We searched MEDLINE, Cochrane Library, and Google Scholar including all the articles published from the beginning of notations to the present. The search was conducted between May 3, 2012 and December 26, 2013. We included 29 experimental studies in this review, investigating agents that maintain or increase local perfusion conditions, as well as agents that exhibit an anti-coagulatory, an anti-inflammatory, or an anti-apoptotic property. Warm water, simvastatin, EPO, or cerium nitrate may represent particularly promising approaches for the translation into clinical use in the near future. This review demonstrates promising experimental approaches that might reduce secondary burn wound progression. Nevertheless, a translation into clinical application needs to confirm the results compiled in experimental animal studies.

Burn-associated bloodstream infections in pediatric burn patients: Time distribution of etiologic agents.

PubMed

Devrim, İlker; Kara, Ahu; Düzgöl, Mine; Karkıner, Aytaç; Bayram, Nuri; Temir, Günyüz; Şencan, Arzu; Sorguç, Yelda; Gülfidan, Gamze; Hoşgör, Münevver

2017-02-01

Infections are the leading cause of morbidity and mortality in patients with burns in burn units. Bloodstream infections (BSIs) in patients with burns may result from burn wound infection, use of invasive devices such as central venous catheters, and translocation of the gastrointestinal flora. In this study, we investigated the distribution and antimicrobial drug resistance of causative pathogens in children with burns and the durational changes of microorganisms in the distribution of BSIs in children. This study was conducted at the Pediatric Burn Unit (PBU) of Dr. Behçet Uz Children Research and Training Hospital during the period of November 2008-April 2015. The study subjects were all the patients admitted to the PBU, in whom microorganisms were isolated at least from one of the cultures, including blood and catheter cultures. Gram-positive bacteria were the most common causative agents of BSI in patients with burns (66.4%), followed by gram-negative bacteria (22.1%) and fungi (11.5%). The median duration of development of BSIs caused by gram-positive bacteria from the time of burn was 5 days (ranging from 2 to 54 days of burn), which was significantly shorter than that of BSIs caused by gram-negative bacteria (12 days) and fungal pathogens (13 days). The etiologic agents of BSIs in children may differ from those in adults. Gram-negative drug-resistant bacteria such as multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii were important agents of BSI in patients with burns, especially in the long term; however, gram-positive bacteria should also be considered while deciding the antimicrobial therapy, especially in the early periods of burn. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Burns first aid treatment in remote Northern Australia.

PubMed

Read, David J; Tan, Swee Chin; Ward, Linda; McDermott, Kathleen

2018-03-01

It is well demonstrated that adequate burns first aid treatment (BFAT) improves clinical outcomes for the injured but adequacy remains low in many studies. This study presents a twelve month assessment of the adequacy of burns first aid treatment for patients managed by the Burns Service, Royal Darwin Hospital (RDH). Prospective study design of all patients managed by the Burns Service, Royal Darwin Hospital. Data were collated from two sources; RDH Burns Registry, and the Burns Registry of Australia and New Zealand (BRANZ). Inclusion criterion was all patients managed by the Burns Service, Royal Darwin Hospital for the period 1 January 2014-31 December 2014. Variables collected and analysed include: demographics, burn mechanism, burn wound depth and adequacy of and circumstances around first aid. Overall 310 cases were analysed. Most injuries involved adults (68%), 19% Indigenous persons and 70% of all patients had their burn injury occur in the urban region. Adequate BFAT occurred in 41% of cases. Adults, contact burns and those where the burn injury occurred in the remote regions were less likely to receive adequate BFAT. Indigenous persons were less likely to attempt any BFAT at all and when they did receive BFAT it was more likely applied by an emergency responder or health professional. Overall adequacy of BFAT is low in the Top End of the Northern Territory. Remote dwellers and Indigenous persons are at increased risk of not applying or receiving adequate BFAT. The poor level of adequate BFAT demonstrated in this study suggests that the Top End community particularly remote and Indigenous persons would benefit from targeted BFAT education programs that are delivered in a culturally and linguistically appropriate fashion. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Knowledge, attitude, and belief regarding burn first aid among caregivers attending pediatric emergency medicine departments.

PubMed

Alomar, Mohammed; Rouqi, Faisal Al; Eldali, Abdelmoneim

2016-06-01

Emergency departments witness many cases of burns that can be prevented with various first-aid measures. Immediate and effective burn first aid reduces morbidity and determines the outcome. Thus, it is imperative that measures of primary burn prevention and first-aid knowledge be improved. This descriptive study determines the current level of knowledge, attitude, and belief regarding burn first aid among caregivers. Caregivers attending four pediatric emergency departments answered a structured questionnaire for demographic information, knowledge, and the burn first aid they provide including two case scenarios. Applying cold water for 15-20min, smothering burning clothes, and covering the pot of oil on fire with a wet cloth were considered appropriate responses. The main outcome measure was the proportion of caregivers who were aware of burn first aid and did not use inappropriate remedies. Additional questions regarding the best means of educating the public on burn first aid were included. Individual chi-squared tests and univariate logistic regressions were performed to correlate knowledge with demographic features, history of burns, and first-aid training. The 408 interviewed caregivers (55% women) reflected a wide range of age, occupation, and educational level. Sixty percent (60%) of respondents had a large family, with 52% reporting a history of burns. Overall, 41% treated burns with cool or cold water, although 97% had inappropriate or no knowledge of the duration. Further, 32% treated burns with nonscientific remedies alone or in combination, including honey, egg white, toothpaste, white flour, tomato paste, yogurt, tea, sliced potato, butter, or ice. Only 15% had first-aid training. While 65% of caregivers covered a pot of oil on fire with a wet cloth, only 24% reported smothering burning clothes. Participants preferred learning more of first aid for burns via social media (41%), hospital visits (30%), and television (TV) (16%). No significant correlation was found between age, family size, language, history of burns, or training and knowledge; however, female gender and higher educational level were associated with increased awareness, although this was not statistically significant (p=0.05 and p=0.17, respectively). The logistic regression accounting for all significant variables showed that the history of burns had the greatest effect on knowledge of first aid (p<0.03). Knowledge of burn first aid among caregivers is limited, with many resorting to non-scientific remedies. Use of social media, hospital visits, and TV for first-aid education might improve caregivers' awareness. A nationwide educational program emphasizing first-aid application of only cold water and reduced use of inappropriate home remedies for burns is recommended. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Minimum deltaV Burn Planning for the International Space Station Using a Hybrid Optimization Technique, Level 1

NASA Technical Reports Server (NTRS)

Brown, Aaron J.

2015-01-01

The International Space Station's (ISS) trajectory is coordinated and executed by the Trajectory Operations and Planning (TOPO) group at NASA's Johnson Space Center. TOPO group personnel routinely generate look-ahead trajectories for the ISS that incorporate translation burns needed to maintain its orbit over the next three to twelve months. The burns are modeled as in-plane, horizontal burns, and must meet operational trajectory constraints imposed by both NASA and the Russian Space Agency. In generating these trajectories, TOPO personnel must determine the number of burns to model, each burn's Time of Ignition (TIG), and magnitude (i.e. deltaV) that meet these constraints. The current process for targeting these burns is manually intensive, and does not take advantage of more modern techniques that can reduce the workload needed to find feasible burn solutions, i.e. solutions that simply meet the constraints, or provide optimal burn solutions that minimize the total DeltaV while simultaneously meeting the constraints. A two-level, hybrid optimization technique is proposed to find both feasible and globally optimal burn solutions for ISS trajectory planning. For optimal solutions, the technique breaks the optimization problem into two distinct sub-problems, one for choosing the optimal number of burns and each burn's optimal TIG, and the other for computing the minimum total deltaV burn solution that satisfies the trajectory constraints. Each of the two aforementioned levels uses a different optimization algorithm to solve one of the sub-problems, giving rise to a hybrid technique. Level 2, or the outer level, uses a genetic algorithm to select the number of burns and each burn's TIG. Level 1, or the inner level, uses the burn TIGs from Level 2 in a sequential quadratic programming (SQP) algorithm to compute a minimum total deltaV burn solution subject to the trajectory constraints. The total deltaV from Level 1 is then used as a fitness function by the genetic algorithm in Level 2 to select the number of burns and their TIGs for the next generation. In this manner, the two levels solve their respective sub-problems separately but collaboratively until a burn solution is found that globally minimizes the deltaV across the entire trajectory. Feasible solutions can also be found by simply using the SQP algorithm in Level 1 with a zero cost function. This paper discusses the formulation of the Level 1 sub-problem and the development of a prototype software tool to solve it. The Level 2 sub-problem will be discussed in a future work. Following the Level 1 formulation and solution, several look-ahead trajectory examples for the ISS are explored. In each case, the burn targeting results using the current process are compared against a feasible solution found using Level 1 in the proposed technique. Level 1 is then used to find a minimum deltaV solution given the fixed number of burns and burn TIGs. The optimal solution is compared with the previously found feasible solution to determine the deltaV (and therefore propellant) savings. The proposed technique seeks to both improve the current process for targeting ISS burns, and to add the capability to optimize ISS burns in a novel fashion. The optimal solutions found using this technique can potentially save hundreds of kilograms of propellant over the course of the ISS mission compared to feasible solutions alone. While the software tool being developed to implement this technique is specific to ISS, the concept is extensible to other long-duration, central-body orbiting missions that must perform orbit maintenance burns to meet operational trajectory constraints.

Management of post burn hand deformities

PubMed Central

Sabapathy, S. Raja; Bajantri, Babu; Bharathi, R. Ravindra

2010-01-01

The hand is ranked among the three most frequent sites of burns scar contracture deformity. One of the major determinants of the quality of life in burns survivors is the functionality of the hands. Burns deformities, although largely preventable, nevertheless do occur when appropriate treatment is not provided in the acute situation or when they are part of a major burns. Reconstructive procedures can greatly improve the function of the hands. Appropriate choice of procedures and timing of surgery followed by supervised physiotherapy can be a boon for a burns survivor. PMID:21321661

[Combined burn trauma in the array of modern civilian and combat burns].

PubMed

Ivchenko, E V; Borisov, D N; Golota, A S; Krassiĭ, A B; Rusev, I T

2015-02-01

The current article positions the combined burn and non-burn injuries in the general array of civilian and combat burns. For that purpose the official state statistics and scientific medical publications, domestic as well as foreign, have been analyzed. It has been shown that in peace time the combined burn/trauma injuries are infrequent. But the same type of injury becomes routine especially among the civilian population in the conditions of the modern so called "hybrid war". And the medical service should be prepared for it.

Childhood burns in Sulaimaniyah province, Iraqi Kurdistan: a prospective study of admissions and outpatients.

PubMed

Othman, Nasih; Kendrick, Denise; Al-Windi, Ahmad

2015-03-01

While it is globally observed that young children are at a higher risk of burn injuries, little is known about childhood burns in Iraqi Kurdistan. This study was undertaken to describe the epidemiology of burns amongst pre-school children in this region. A prospective study was undertaken from November 2007 to November 2008 involving all children aged 0-5 years attending the burns centre in Sulaimaniyah province for a new burn injury whether treated as an outpatient or admitted to hospital. 1,122 children attended the burns centre of whom 944 (84%) were interviewed (male 53%, female 47%). Mean age was 1.9 years with children aged 1 year comprising 32% and those aged 2 years comprising 21% of the sample. The incidence of burns was 1044/100,000 person-years (1030 in females and 1057 in males). Mechanisms of injury included scalds (80%), contact burns (12%) flames (6%) and other mechanisms (2%). Almost 97% of burns occurred at home including 43% in the kitchen. Winter was the commonest season (36%) followed by autumn (24%). There were 3 peak times of injury during the day corresponding to meal times. The majority of burns were caused by hot water (44%) and tea (20%) and the most common equipment/products responsible were tea utensils (41%). There were 237 admissions with an admission rate of 95 per 100,000 person-years. Scald injuries accounted for most admissions (84%). Median total body surface area affected by the burn or scald (TBSA) was 11% and median hospital stay was 7 days. In-hospital mortality was 8%. Mortality rate was 4% when TBSA was ≤25%, and 100% when TBSA was over 50%. Burn incidence is high in young children especially those aged 1-2 years. Preventive interventions targeted at families with young children & focusing on home safety measures could be effective in reducing childhood burns. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Evaluating an outreach service for paediatric burns follow up.

PubMed

Cubitt, Jonathan J; Chesney, Amy; Brown, Liz; Nguyen, Dai Q

2015-09-01

Complications following paediatric burns are well documented and care needs to be taken to ensure the appropriate follow up of these patients. Historically this has meant follow up into adulthood however this is often not necessary. The centralisation of burns services in the UK means that patients and their parents may have to travel significant distances to receive this follow up care. To optimise our burns service we have introduced a burns outreach service to enable the patients to be treated closer to home. The aim of this study is to investigate the impact of the introduction of the burns outreach service and within this environment define the optimum length of time needed to follow up these patients. A retrospective analysis was carried out of 100 consecutive paediatric burns patients who underwent surgical management of their burn. During the follow up period there were 43 complications in 32 patients (32%). These included adverse scarring (either hypertrophic or keloid), delayed healing (taking >1 month to heal) and contractures (utilising either splinting or surgical correction). Fifty-nine percent of these complications occurred within 6 months of injury and all occurred within 18 months. Size of burn was directly correlated to the risk of developing a complication. The outreach service reduced the distance the patient needs to travel for follow up by more than 50%. There was also a significant financial benefit for the service as the follow up clinics were on average 50% cheaper with burns outreach than burns physician. Burns outreach is a feasible service that not only benefits the patients but also is cheaper for the burns service. The optimum length of follow up for paediatric burns in 18 months, after which if there have not been any complications they can be discharged. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Verified Centers, Nonverified Centers or Other Facilities: A National Analysis of Burn Patient Treatment Location

PubMed Central

Zonies, David; Mack, Christopher; Kramer, Bradley; Rivara, Frederick; Klein, Matthew

2009-01-01

Background Although comprehensive burn care requires significant resources, patients may be treated at verified burn centers, non-verified burn centers, or other facilities due to a variety of factors. The purpose of this study was to evaluate the association between patient and injury characteristics and treatment location using a national database. Study Design We performed an analysis of all burn patients admitted to United States hospitals participating in the Healthcare Cost and Utilization Project over 2 years. Univariate and multivariate analyses were performed to identify patient and injury factors associated with the likelihood of treatment at designated burn care facilities. Definitve care facilities were categorized as American Burn Association verified centers, non-verified burn centers, or other facilities. Results Over the two years, 29,971 burn patients were treated in 1,376 hospitals located in 19 participating states. A total of 6,712 (22%) patients were treated at verified centers, with 26% and 52% treated at non-verified or other facilities, respectively. Patients treated at verified centers were younger than those at non-verified or other facilities (33.1 years vs. 33.7 years vs. 41.9 years, p<0.001) and had a higher rate of inhalation injury (3.4% vs. 3.2% vs. 2.2%, p<0.001). Independent factors associated with treatment at verified centers include burns to the head/neck (RR 2.4, CI 2.1-2.7), hand (RR 1.8, CI 1.6-1.9), electrical injury (RR 1.4, CI 1.4, CI 1.2-1.7), and fewer co-morbidities (RR 0.55, CI 0.5-0.6). Conclusions More than two-thirds of significantly burned patients are treated at non-verified burn centers in the U.S. Many patients meeting ABA criteria for transfer to a burn center are being treated at non-burn center facilities. PMID:20193892

Wound management and outcome of 595 electrical burns in a major burn center.

PubMed

Li, Haisheng; Tan, Jianglin; Zhou, Junyi; Yuan, Zhiqiang; Zhang, Jiaping; Peng, Yizhi; Wu, Jun; Luo, Gaoxing

2017-06-15

Electrical burns are important causes of trauma worldwide. This study aims to analyze the clinical characteristics, wound management, and outcome of electric burns. This retrospective study was performed at the Institute of Burn Research of the Third Military Medical University during 2013-2015. Data including the demographics, injury patterns, wound treatment, and outcomes were collected and analyzed. A total of 595 electrical burn patients (93.8% males) were included. The average age was 37.3 ± 14.6 y, and most patients (73.5%) were aged 19∼50 years. Most patients (67.2%) were injured in work-related circumstances. The mean total body surface area was 8.8 ± 11.8% and most wounds (63.5%) were full-thickness burns. Operation times of high-voltage burns and current burns were higher than those of low-voltage burns and arc burns, respectively. Of the 375 operated patients, 83.2% (n = 312) underwent skin autografting and 49.3% (n = 185) required skin flap coverage. Common types of skin flaps were adjacent (50.3%), random (42.2%), and pedicle (35.7%). Amputation was performed in 107 cases (18.0%) and concentrated on the hands (43.9%) and upper limbs (39.3%). The mean length of stay was 42.9 ± 46.3 d and only one death occurred (0.2%). Current burns and higher numbers of operations were major risk factors for amputation and length of stay, respectively. Electrical burns mainly affected adult males with occupational exposures in China. Skin autografts and various skin flaps were commonly used for electric burn wound management. More standardized and effective strategies of treatment and prevention are still needed to decrease amputation rates. Copyright © 2017 Elsevier Inc. All rights reserved.

Observations of biomass burning tracers in PM2.5 at two megacities in North China during 2014 APEC summit

NASA Astrophysics Data System (ADS)

Zhang, Zhisheng; Gao, Jian; Zhang, Leiming; Wang, Han; Tao, Jun; Qiu, Xionghui; Chai, Fahe; Li, Yang; Wang, Shulan

2017-11-01

To evaluate the effectiveness of biomass burning control measures on PM2.5 reduction, day- and nighttime PM2.5 samples were collected at two urban sites in North China, one in Beijing (BJ) and the other in Shijiazhuang (SJZ), during the 2014 Asia-Pacific Economic Cooperation (APEC) summit. Typical biomass burning aerosol tracers including levoglucosan (LG), Mannosan (MN), and water-soluble potassium (K+), together with other water-soluble ions and carbonaceous species were determined. The levels of biomass burning tracers dropped dramatically during the APEC period when open biomass burning activities were well controlled in North China, yet they increased sharply to even higher levels during the post-APEC period. Distinct linear regression relationships between LG and MN were found with lower LG/MN ratios from periods with much reduced open biomass burning activities. This was likely resulted from the reduced open crop residues burning and increased residential wood burning emissions, as was also supported by the simultaneous decrease in K+/LG ratio. The positive matrix factorization and air quality model simulation analyses suggested that PM2.5 concentration produced from biomass burning sources was reduced by 22% at BJ and 46% at SJZ during the APEC period compared to pre-APEC period, although they increased to higher levels after APEC mainly due to increased residential biomass burning emissions in winter heating season. Biomass burning was also found to be the most important contributor to carbonaceous species that might cause significant light extinction in this region. This study not only suggested implementing biomass burning controls measures were helpful to reduce PM2.5 in North China, but also pointed out both open crop residues burning and indoor biomass burning activities could make substantial contributions to PM2.5 and its major components in urban areas in North China.

The epidemiology of burns in young children from Mexico treated at a U.S. hospital.

PubMed

Patel, Dipen D; Rosenberg, Laura; Rosenberg, Marta; Leal, Jesus; Andersen, Clark R; Foncerrada, Guillermo; Lee, Jong O; Jimenez, Carlos J; Branski, Ludwik; Meyer, Walter J; Herndon, David N

2016-12-01

Young children are the most vulnerable for sustaining burns. At this pediatric burn hospital we have provided medical care to young children with severe burns from Mexico for many years. This study identified modifiable risk factors that could be used to assist in prevention of burns in this age group. A retrospective chart review was performed with children <5 years of age from Mexico who were injured from 2000 to 2013. The medical records of 447 acute patients were reviewed. There were 187 females and 260 males with large burns >20% total body surface area (TBSA) burned. Primary causes of burns were flame and scalds. Children with flame injuries were older (3.0±1.5 years of age) than those with scalds (2.6±1.2 years of age). Admissions attributed to flame burns were largely from explosions by propane tanks, gas line leaks, and house fires. Most admissions for scalds were predominantly from falling in large containers of hot water, food, or grease; and fewer were attributed to spills from hot liquids. Most cases reported to a social service agency were to find resources for families. Mortality rate for flame and scald burns was low. It is important take into account demographic, cultural, and socioeconomic variables when developing and implementing prevention programs. Burn prevention instruction for parents is crucial. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Patterns of burns and scalds in Mongolian children: a hospital-based prospective study.

PubMed

Gerelmaa, Gunsmaa; Tumen-Ulzii, Badarch; Nakahara, Shinji; Ichikawa, Masao

2018-03-01

To describe the circumstances of burn injury occurrence among Mongolian children and the products involved. Study participants were children aged 15 years and younger who were admitted to the Burn Unit of the National Trauma Orthopedic Research Center from August 2015 to July 2016. We collected data on participant demographics and the aetiology and clinical features of their burn injuries, and we analysed the data based on the NOMESCO Classification model. Of 906 children, 83% were aged 0-3 years, 66% were injured around the cooking area in the traditional tent-like dwelling called a ger or a detached house where no specified kitchen exists, and 28% were injured in a kitchen. Burn injuries resulted mostly from exposure to overflowing hot liquids (93%). Electric pots and electric kettles were the products most frequently involved in causing burn injuries (41% and 14%, respectively). Of 601 major burn injuries, 52% were due to electric pots. Moreover, burn injuries inflicted by electric pots were most likely to be major burn injuries (83%). Children typically fell into electric pots, while electric kettles were often pulled down by children. Burn injuries among Mongolian children mainly occurred in cooking area of a ger involving electric pots. The current practice of cooking on the floor should be reconsidered for child burn prevention. © 2018 John Wiley & Sons Ltd.

Treatment of burns in the first 24 hours: simple and practical guide by answering 10 questions in a step-by-step form

PubMed Central

2012-01-01

Residents in training, medical students and other staff in surgical sector, emergency room (ER) and intensive care unit (ICU) or Burn Unit face a multitude of questions regarding burn care. Treatment of burns is not always straightforward. Furthermore, National and International guidelines differ from one region to another. On one hand, it is important to understand pathophysiology, classification of burns, surgical treatment, and the latest updates in burn science. On the other hand, the clinical situation for treating these cases needs clear guidelines to cover every single aspect during the treatment procedure. Thus, 10 questions have been organised and discussed in a step-by-step form in order to achieve the excellence of education and the optimal treatment of burn injuries in the first 24 hours. These 10 questions will clearly discuss referral criteria to the burn unit, primary and secondary survey, estimation of the total burned surface area (%TBSA) and the degree of burns as well as resuscitation process, routine interventions, laboratory tests, indications of Bronchoscopy and special considerations for Inhalation trauma, immediate consultations and referrals, emergency surgery and admission orders. Understanding and answering the 10 questions will not only cover the management process of Burns during the first 24 hours but also seems to be an interactive clear guide for education purpose. PMID:22583548

Particulate matter characteristics during agricultural waste burning in Taichung City, Taiwan.

PubMed

Cheng, Man-Ting; Horng, Chuen-Liang; Su, Yi-Ru; Lin, Li-Kai; Lin, Yu-Chi; Chou, Charles C-K

2009-06-15

Agricultural waste burning is performed after harvest periods in June and November in Taiwan. Typically, farmers use open burning to dispose of excess rice straw. PM(2.5) and PM(2.5-10) measurements were conducted at National Chung Hsing University in Taichung City using a dichotomous sampler. The sampling times were during straw burning periods after rice harvest during 2002-2005. Ionic species including SO(4)(2-), NO(3)(-), NH(4)(+), K(+), Ca(2+), Cl(-) and Na(+) and carbonaceous species (EC and OC) in PM(2.5) and PM(2.5-10) were analyzed. The results showed that the average PM(2.5) and PM(2.5-10) concentrations were 123.6 and 31.5 microg m(-3) during agricultural waste burning periods and 32.6 and 21.4 microg m(-3) during non-waste burning periods, respectively. The fine aerosol ionic species including Cl(-), K(+) and NO(3)(-) increased 11.0, 6.7 and 5.5 times during agricultural burning periods compared with periods when agricultural waste burning is not performed. K(+) was found mainly in the fine mode during agricultural burning. High nitrogen oxidation ratio was found during agricultural waste burning periods which might be caused by the conversion of Nitrogen dioxide (NO(2)) to NO(3)(-). It is concluded that agricultural waste burning with low dispersion often causes high PM(2.5) and gases pollutant events.

Rehabilitation and social adjustment of people with burns in society.

PubMed

Din, Sirajud; Shah, Mussawar; Asadullah; Jamal, Humera; Bilal, Muhammad

2015-02-01

The present study was conducted on rehabilitation and social adjustment of people with burns in society with the main objective to determine the relationship between social adjustment of people with burns and their psychosocial rehabilitation. The study was limited to the Burn Unit, Khyber Teaching Hospital, Peshawar, Pakistan. At bi-variate level, the following were observed: the relationship of psychosocial rehabilitation was highly significant (P=0.000) considering that people with burns feel shame in the society, a highly significant relation (P=0.000) was found between psychosocial rehabilitation and burn as the hurdle to contact other members of the society, a highly significant (P=0.000) relation was found between psychosocial rehabilitation and perception that society provides social support to people with burns, a highly significant (P=0.000) relationship between psychosocial rehabilitation and people with burns feel alienated from the society, a significant association (P=0.024) was found between psychosocial rehabilitation and loss of social network, and a significant (P=0.002) association between psychosocial rehabilitation and society insult toward people with burns. Regular provision of treatment, quota in job allocation for people with burns, initiation of stipend through Benazir Income Support Program, and keeping and updating record of burns at the district level in census centers were suggested as recommendations in light of the study. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Effect of piracetam and nimodipine on full-thickness skin burns in rabbits.

PubMed

Sari, Elif; Dincel, Gungor C

2016-08-01

The potential of several drugs for full-thickness skin burns has been investigated, but the treatment of such burns remains a challenge in plastic surgery. The present study was designed to determine the effect of systemic and topical administration of piracetam and nimodipine on full-thickness skin burn wound healing. A total of 36 New Zealand male rabbits were divided into six groups. Full-thickness skin burns were produced in all the groups, except the control group. Piracetam was administered systemically (piracetam-IV) and topically (piracetam-C) for 14 days, and nimodipine was administered systemically (nimodipine-IV) and topically (nimodipine-C) over the burn wounds for 14 days. The sham group underwent burn injury but was not administered any drug. After 21 days, gross examination and histopathological analysis were performed and the results were compared statistically. Nimodipine-C and nimodipine-IV had no effect on burn wound healing. However, both piracetam-IV and piracetam-C significantly enhanced the healing of the full-thickness skin burn wounds, although the latter was more effective, useful and practical in burn wound healing. The histopathological features of the wounds in the piracetam-C group were closer to those of the control group than those of the other groups. Piracetam-C rather than piracetam-IV may promote full-thickness burn wound healing in rabbits. © 2015 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Composition of breeding bird communities in Gulf Coast Chenier Plain marshes: Effects of winter burning

USGS Publications Warehouse

Gabrey, S.W.; Afton, A.D.

2004-01-01

Marsh managers along the Gulf Coast Chenier Plain frequently use winter burns to alter marsh vegetation and improve habitat quality for wintering waterfowl. However, effects of these burns on marsh avifauna are not well documented. We recorded abundances of breeding bird species and vegetation structure in burned and unburned control marshes during one breeding season before (1996) and two breeding seasons after (1997, 1998) experimental winter burns. We used non-metric multidimensional scaling analysis to assess the extent and direction of changes in bird community compositions of burned and unburned control marshes and to investigate the influence of vegetation structure on bird community composition. Overall, we found that Seaside Sparrows (Emberizidae: Ammodramus maritimus [Wilson]) and Red-winged Blackbirds and Boat-tailed Grackles (Icteridae: Agelaius phoeniceus [L.] and Quiscalus major Vieillot, respectively) comprised > 85% of observed birds. In burned marshes during the first breeding season following experimental burns (1997), icterid abundance increased while Seaside Sparrow abundance decreased relative to pre-burn (1996) conditions. This pattern was reversed during the second breeding season post-burn. No obvious patterns of change in avian abundance were detected in unburned control marshes over the 3-year period. Qualitative changes in breeding bird community composition were related to effects of winter burning on percent cover of dead vegetation and Spartina patens (Aiton) Muhl.

Muscle Contractile Properties in Severely Burned Rats

PubMed Central

Wu, Xiaowu; Wolf, Steven E.; Walters, Thomas J.

2010-01-01

Burn induces a sustained catabolic response which causes massive loss of muscle mass after injury. A better understanding of the dynamics of muscle wasting and its impact on muscle function is necessary for the development of effective treatments. Male Sprague-Dawley rats underwent either a 40% total body surface area (TBSA) scald burn or sham burn, and were further assigned to subgroups at four time points after injury (days 3, 7, 14 and 21). In situ isometric contractile properties were measured including twitch tension (Pt), tetanic tension (Po) and fatigue properties. Body weight decreased in burn and sham groups through day 3, however, body weight in the sham groups recovered and increased over time compared to burned groups, which progressively decreased until day 21 after injury. Significant differences in muscle wet weight and protein weight were found between sham and burn. Significant differences in muscle contractile properties were found at day 14 with lower absolute Po as well as specific Po in burned rats compared to sham. After burn, the muscle twitch tension was significantly higher than the sham at day 21. No significant difference in fatigue properties was found between the groups. This study demonstrates dynamics of muscle atrophy and muscle contractile properties after severe burn; this understanding will aid in the development of approaches designed to reduce the rate and extent of burn induced muscle loss and function. PMID:20381255

The accuracy of burn diagnosis codes in health administrative data: A validation study.

PubMed

Mason, Stephanie A; Nathens, Avery B; Byrne, James P; Fowler, Rob; Gonzalez, Alejandro; Karanicolas, Paul J; Moineddin, Rahim; Jeschke, Marc G

2017-03-01

Health administrative databases may provide rich sources of data for the study of outcomes following burn. We aimed to determine the accuracy of International Classification of Diseases diagnoses codes for burn in a population-based administrative database. Data from a regional burn center's clinical registry of patients admitted between 2006-2013 were linked to administrative databases. Burn total body surface area (TBSA), depth, mechanism, and inhalation injury were compared between the registry and administrative records. The sensitivity, specificity, and positive and negative predictive values were determined, and coding agreement was assessed with the kappa statistic. 1215 burn center patients were linked to administrative records. TBSA codes were highly sensitive and specific for ≥10 and ≥20% TBSA (89/93% sensitive and 95/97% specific), with excellent agreement (κ, 0.85/κ, 0.88). Codes were weakly sensitive (68%) in identifying ≥10% TBSA full-thickness burn, though highly specific (86%) with moderate agreement (κ, 0.46). Codes for inhalation injury had limited sensitivity (43%) but high specificity (99%) with moderate agreement (κ, 0.54). Burn mechanism had excellent coding agreement (κ, 0.84). Administrative data diagnosis codes accurately identify burn by burn size and mechanism, while identification of inhalation injury or full-thickness burns is less sensitive but highly specific. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Determinants of burn first aid knowledge: Cross-sectional study.

PubMed

Wallace, Hilary J; O'Neill, Tomas B; Wood, Fiona M; Edgar, Dale W; Rea, Suzanne M

2013-09-01

This study investigated demographic factors, experience of burn/care and first aid course attendance as factors influencing burn first aid knowledge. A cross-sectional study was undertaken using convenience sampling of members of sporting and recreation clubs. The main outcome measure was the proportion of correct responses to multiple-choice questions relating to four burn scenarios: (1) scald, (2) contact burn, (3) ignited clothing, and (4) chemical burn. A total of 2602 responses were obtained. Large gaps (30-50% incorrect answers) were identified in burn first aid knowledge across all scenarios. 15% more individuals gave correct answers if they had attended a first aid course compared to those who had not (p<0.0001); this proportion increased if the course was undertaken within the previous five years (p<0.0001) or contained a burns-specific component (p<0.0001). Males and younger (≤25 years) and older (≥65 years) age-groups had relatively lower levels of burn first aid knowledge. Gender and age were significant predictors of first aid course attendance, with males and younger (≤25 years) and older (≥65 years) age-groups less likely to have attended a first aid course. In this sample, first aid training undertaken within the last 5 years with a specific burns component was associated with enhanced burn first aid knowledge. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

The effect of family characteristics on the recovery of burn injuries in children.

PubMed

Sheridan, Robert L; Lee, Austin F; Kazis, Lewis E; Liang, Matthew H; Li, Nien-Chen; Hinson, Michelle I; Bauk, Helena; Meyer, Walter J; Stubbs, Teresa K; Palmieri, Tina L; Tompkins, Ronald G

2012-09-01

Interactions between family members and characteristics of family life and function may affect a child's recovery from burn injury. We prospectively examined the relationship between family characteristics and physical and psychosocial recovery from burns. The families of 399 burned children aged 5 years to 18 years admitted to one of four Shriners Hospitals for Children for management of acute burns completed the Family Environment Scale within 7 days of admission and then the American Burn Association/Shriners Hospitals for Children Burn Outcome Questionnaire (BOQ) at baseline, 3, 6, 12, 18, 24, 36, and 48 months. Generalized estimating equations with random effects for the time since burn were used to track recovery of the BOQ patient-centered domains associated with baseline family characteristics during the course of the study. The children had a mean age of 11 years and burn size of 32% total body surface area burned. Higher Family Environment Scale scores in cohesion, independence, organization, and active recreational orientation were associated with significantly better rates of recovery in multiple BOQ domains of health-related quality of life. Higher scores in conflict and achievement orientation predicted statistically significant impaired recovery. Higher expressiveness predicted greater difficulty with school reentry. Family characteristics affect the recovery of children after serious burns. Some of these may be amenable to focused anticipatory family interventions to help optimize outcomes. In particular, those characteristics that impair school reentry should be targeted.

Evaluation of burn injuries related to liquefied petroleum gas.

PubMed

Tarim, Mehmet Akin

2014-01-01

Liquefied petroleum gas (LPG) is a fuel that is widely used for domestic, agricultural, and industrial purposes. LPG is also commonly used in restaurants, industries, and cars; however, the home continues to be the main site for accidents. In Turkey, the increased usage of LPG as a cooking or heating fuel has resulted in many burn injuries from LPG mishaps. Between January 2000 and June 2011, 56 LPG-burned patients were compared with 112 flame-burned patients. There were no significant differences with respect to the mean age, sex, hospitalization time, and mortality in both groups. In the LPG-caused burn cases, 41 burns (73.2%) occurred at home, seven (12.5) were work-related mishaps, and eight (14.3) were associated with car accidents. The majority of the LPG burns (82%, 46 patients) resulted from a gas leak, and 18% of them were related to the failure to close LPG tubes in the patients' kitchens (10 patients). Burns to the face and neck (82 vs 67%, P = .039) and upper (62 vs 23%, P = .000) and lower (70 vs 45%, P = .002) extremities were significantly higher in LPG-caused burn cases than flame-burned cases. General awareness regarding the risk of LPG and first aid for burns appears to be lacking. The LPG delivery system should be standardized throughout countries that widely use LPG.

Fires and Burns Involving Home Medical Oxygen

MedlinePlus

... nfpa.org Fires and Burns Involving Home Medical Oxygen The air is normally 21% oxygen. Oxygen is not flammable, but fire needs it to burn. ¾ When more oxygen is present, any fire that starts will burn ...

Scald Burns

MedlinePlus

Safety Tips & Info Scald Burns Thousands of scald burns occur annually, and ALL are preventable! The two high-risk populations are children under the age ... the single most important factor in preventing scald burns. Increased awareness is the key to scald prevention! ...

Burn Safety Awareness on Playgrounds: Thermal Burns from Playground Equipment

MedlinePlus

... Safety Awareness on Playgrounds Thermal Burns from Playground Equipment The U.S. Consumer Product Safety Commission CPSC wants ... of the risk of thermal burns from playground equipment. You may remember the metal slides of your ...

Landscape Patterns of Burn Severity in the Soberanes Fire of 2016

NASA Technical Reports Server (NTRS)

Potter, Christopher

2016-01-01

The Soberanes Fire started on July 22, 2016 in Monterey County on the California Central Coast from an illegal campfire. This fire burned for 10 weeks at a record cost of more than $208 million for protection and control. A progressive analysis of the normalized burn ratio from the Landsat satellite showed that the final high burn severity (HBS) area for the Soberanes Fire comprised 22 percent of the total area burned, whereas final moderate burn severity (MBS) area comprised about 10 percent of the total area burned of approximately 53,470 ha (132,130 acres). The resulting landscape pattern of burn severity classes from the 2016 Soberanes Fire revealed that the majority of HBS area was located in the elevation zone between 500 and 1000 m, in the slope zone between 15 percent and 30 percent, or on south-facing aspects.

Pre-hospital care in burn injury

PubMed Central

Shrivastava, Prabhat; Goel, Arun

2010-01-01

The care provided to the victims of burn injury immediately after sustaining burns can largely affect the extent and depth of the wound. Although standard guidelines have been formulated by various burn associations, they are still not well known to public at large in our country. In burn injuries, most often, the bystanders are the first care providers. The swift implementation of the measures described in this article for first aid in thermal, chemical, electrical and inhalational injuries in the practical setting, within minutes of sustaining the burn, plays a vital role and can effectively reduce the morbidity and mortality to a great extent. In case of burn disasters, triage needs to be carried out promptly as per the defined protocols. Proper communication and transport from the scene of the accident to the primary care centre and onto the burn care facility greatly influences the execution of the management plans PMID:21321651

NASA Lewis Research Center lean-, rich-burn materials test burner rig

NASA Technical Reports Server (NTRS)

Stearns, C. A.; Robinson, R. C.

1994-01-01

The lean-, rich-burn materials test burner rig at NASA LeRC is used to evaluate the high temperature environmental durability of aerospace materials. The rig burns jet fuel and pressurized air, and sample materials can be subjected to both lean-burn and rich-burn environments. As part of NASA's Enabling Propulsion Materials (EPM) program, an existing rig was adapted to simulate the rich-burn quick-quench lean-burn (RQL) combustor concept which is being considered for the HSCT (high speed civil transport) aircraft. RQL materials requirements exceed that of current superalloys, thus ceramic matrix composites (CMC's) emerged as the leading candidate materials. The performance of these materials in the quasi reducing environment of the rich-burn section of the RQL is of fundamental importance to materials development. This rig was developed to conduct such studies, and its operation and capabilities are described.

Smoke inhalation increases intensive care requirements and morbidity in paediatric burns.

PubMed

Tan, Alethea; Smailes, Sarah; Friebel, Thessa; Magdum, Ashish; Frew, Quentin; El-Muttardi, Naguib; Dziewulski, Peter

2016-08-01

Burn survival has improved with advancements in fluid resuscitation, surgical wound management, wound dressings, access to antibiotics and nutritional support for burn patients. Despite these advancements, the presence of smoke inhalation injury in addition to a cutaneous burn still significantly increases morbidity and mortality. The pathophysiology of smoke inhalation has been well studied in animal models. Translation of this knowledge into effectiveness of clinical management and correlation with patient outcomes including the paediatric population, is still limited. We retrospectively reviewed our experience of 13 years of paediatric burns admitted to a regional burn's intensive care unit. We compared critical care requirements and patient outcomes between those with cutaneous burns only and those with concurrent smoke inhalation injury. Smoke inhalation increases critical care requirements and mortality in the paediatric burn population. Therefore, early critical care input in the management of these patients is advised. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Burn severity mapping in Australia 2009

USGS Publications Warehouse

McKinley, Randy; Clark, J.; Lecker, Jennifer

2012-01-01

In 2009, the Victoria Department of Sustainability and Environment estimated approximately 430,000 hectares of Victoria Australia were burned by numerous bushfires. Burned Area Emergency Response (BAER) teams from the United States were deployed to Victoria to assist local fire managers. The U.S. Geological Survey Earth Resources Observation and Science Center (USGS/EROS) and U.S. Forest Service Remote Sensing Applications Center (USFS/RSAC) aided the support effort by providing satellite-derived "soil burn severity " maps for over 280,000 burned hectares. In the United States, BAER teams are assembled to make rapid assessments of burned lands to identify potential hazards to public health and property. An early step in the assessment process is the creation of a soil burn severity map used to identify hazard areas and prioritize treatment locations. These maps are developed primarily using Landsat satellite imagery and the differenced Normalized Burn Ratio (dNBR) algorithm.

Spatial and temporal distribution of tropical biomass burning

NASA Astrophysics Data System (ADS)

Hao, Wei Min; Liu, Mei-Huey

1994-12-01

A database for the spatial and temporal distribution of the amount of biomass burned in tropical America, Africa, and Asia during the late 1970s is presented with a resolution of 5° latitude × 5° longitude. The sources of burning in each grid cell have been quantified. Savanna fires, shifting cultivation, deforestation, fuel wood use, and burning of agricultural residues contribute about 50, 24, 10, 11, and 5%, respectively, of total biomass burned in the tropics. Savanna fires dominate in tropical Africa, and forest fires dominate in tropical Asia. A similar amount of biomass is burned from forest and savanna fires in tropical America. The distribution of biomass burned monthly during the dry season has been derived for each grid cell using the seasonal cycles of surface ozone concentrations. Land use changes during the last decade could have a profound impact on the amount of biomass burned and the amount of trace gases and aerosol particles emitted.

Season and severity of prescribed burn in ponderosa pine forests: implications for understory native and exotic plants.

Treesearch

Becky K. Kerns; Walter G. Thies; Christine G. Niwa

2006-01-01

We investigated herbaceous richness and cover in relation to fire season and severity, and other variables, five growing seasons following prescribed fires. Data were collected from six stands consisting of three randomly applied treatments: no burn, spring burn, and fall burn. Fall burns had significantly more exotic/native annual/biennial (an/bi) species and greater...

Burn severity of areas reburned by wildfires in the Gila National Forest, New Mexico, USA

Treesearch

Zachary A. Holden; Penelope Morgan; Andrew T. Hudak

2010-01-01

We describe satellite-inferred burn severity patterns of areas that were burned and then reburned by wildland fire from 1984 to 2004 within the Gila Aldo Leopold Wilderness Complex, New Mexico, USA. Thirteen fires have burned 27 000 hectares across multiple vegetation types at intervals between fires ranging from 3 yr to 14 yr. Burn severity of reburned areas showed...

Thyroid Function in Critical Illness and Burn Injury,

DTIC Science & Technology

1993-07-01

measrent of tyida x hor-etioogyof hperhyridis, Oive Cop eta15 mones in burn patients and animal burn models etiology of hyperthyroidism , Oliver Cope et...post-burn hypermetabolic condition following major burns.’ ൡ In fact, the opposite is a function of transient hyperthyroidism . They question of...concluded that hyperthyroidism was not present protracted illness, whether medical, surgical, and was not the mediator of the hypermetabol- or

An unusual burn caused by hot argy wormwood leaf water

PubMed Central

Liang, Xun; Chen, Xu-Lin; Wang, Fei; Guo, Feng

2011-01-01

An unusual burn case caused by hot wormwood leaf water was discussed. A 29-year-old woman sustained a 7% second-degree burn on both buttocks and left thigh. This case report highlights a rare cause of a chemical burn that may become more common with increasing use of this Chinese traditional medicine. The prevention measures of this burn injury were also presented. PMID:24765332

Prescribed Burning and Direct-Seeding Old Clearcuts in the Piedmont

Treesearch

W. Henry McNab

1976-01-01

Logging slash 14 to 26 months old was burned at different seasons of the year in the Georgia Piedmont.The following winter, loblolly pine seeds were broadcast 1 to 13 months after burning. Burning 1 -year-old slash during early- or mid-growing season resulted in better stocking, greater height growth, and more effective hardwood control than burning during the dorm ant...

30 CFR 254.28 - What information must I include in the “In situ burning plan” appendix?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What information must I include in the âIn situ... include in the “In situ burning plan” appendix? Your in situ burning plan must be consistent with any... situ burning plan must include: (a) A description of the in situ burn equipment including its...

Two-year follow-up of outcomes related to scarring and distress in children with severe burns.

PubMed

Wurzer, Paul; Forbes, Abigail A; Hundeshagen, Gabriel; Andersen, Clark R; Epperson, Kathryn M; Meyer, Walter J; Kamolz, Lars P; Branski, Ludwik K; Suman, Oscar E; Herndon, David N; Finnerty, Celeste C

2017-08-01

We assessed the perception of scarring and distress by pediatric burn survivors with burns covering more than one-third of total body surface area (TBSA) for up to 2 years post-burn. Children with severe burns were admitted to our hospital between 2004 and 2012, and consented to this IRB-approved-study. Subjects completed at least one Scars Problems and/or Distress questionnaire between discharge and 24 months post burn. Outcomes were modeled with generalized estimating equations or using mixed linear models. Significance was accepted at p < 0.01. Responses of 167 children with a mean age of 7 ± 5 years and burns covering an average 54 ± 14% of TBSA were analyzed. Significant improvements over the 2-year period were seen in reduction of pain, itching, sleeping disturbance, tightness, range of motion, and strength (p < 0.01). There was a significantly increased persistent desire to hide the scarred body areas over time (p < 0.01). The perception of mouth scarring, inability to portray accurate facial expressions, and skin coloration did not improve over the follow-up period. According to self-assessment questionnaires, severely burned children exhibit significant improvements in their overall perception of scarring and distress. However, these patients remain self-conscious with respect to their body image even 2 years after burn injury. Implications for Rehabilitation According to self-assessment questionnaires, severely burned children perceive significant improvements in scarring and distress during the first 2 years post burn. Significant improvements were seen in reduction of pain, itching, sleeping disturbances, tightness, range of motion, and strength (p < 0.01). Burn care providers should improve the treatment of burns surrounding the mouth that with result in scarring, and develop strategies to prevent skin discoloration. Careful evaluation of pain and sleeping disorders during the first year post burn are warranted to improve the patient rehabilitation. Overall, significantly more female patients expressed a persistent desire to hide their scarred body areas. The rehabilitation team should provide access to wigs or other aids to pediatric burn survivors to address these needs.

Increased admissions for diabetes mellitus after burn.

PubMed

Duke, Janine M; Randall, Sean M; Fear, Mark W; Boyd, James H; O'Halloran, Emily; Rea, Suzanne; Wood, Fiona M

2016-12-01

Currently, limited long-term data on hyperglycaemia and insulin sensitivity in burn patients are available and the data that do exist are primarily related to paediatric severe burns. The aim of this study was to assess if burn is associated with increased post-burn admissions for diabetes mellitus. A population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of all persons hospitalized for a first burn (n=30,997) in 1980-2012 and a frequency matched non-injury comparison cohort, randomly selected from Western Australia's birth registrations and electoral roll (n=123,399). Crude admission rates and summed length of stay for diabetes mellitus were calculated. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and hazard ratios (HR), respectively. After adjustment for socio-demographic factors and pre-existing health status, the burn cohort had 2.21 times (95% Confidence Interval (CI): 1.36-1.56) as many admissions and almost three times the number of days in hospital with a diabetes mellitus diagnosis (IRR, 95% CI: 2.94, 2.12-4.09) than the uninjured cohort. Admission rates were significantly elevated for those burned during childhood (<18 years, IRR, 95% CI: 2.65, 1.41-4.97) and adulthood (≥18 years, IRR, 95% CI: 2.12, 1.76-2.55). Incident admissions were significantly elevated in the burn cohort during the first 5 years post-burn when compared with the uninjured (HR, 95% CI: 1.96, 1.46-2.64); no significant difference was found beyond 5 years post-burn (HR, 95% CI: 1.08, 0.82-1.41). Findings of increased hospital admission rates and prolonged length of hospital stay for diabetes mellitus in the burn cohort provide evidence that burns have longer term effects on blood glucose and insulin regulation after wound healing. The first five years after burn discharge appears to be a critical period with significantly elevated incident admissions for diabetes mellitus during this time. Results would suggest prolonged clinical management after discharge and or wound healing to minimise post-burn admissions for diabetes mellitus is required. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Development of the crop residue and rangeland burning in the 2014 National Emissions Inventory using information from multiple sources.

PubMed

Pouliot, George; Rao, Venkatesh; McCarty, Jessica L; Soja, Amber

2017-05-01

Biomass burning has been identified as an important contributor to the degradation of air quality because of its impact on ozone and particulate matter. One component of the biomass burning inventory, crop residue burning, has been poorly characterized in the National Emissions Inventory (NEI). In the 2011 NEI, wildland fires, prescribed fires, and crop residue burning collectively were the largest source of PM 2.5 . This paper summarizes our 2014 NEI method to estimate crop residue burning emissions and grass/pasture burning emissions using remote sensing data and field information and literature-based, crop-specific emission factors. We focus on both the postharvest and pre-harvest burning that takes place with bluegrass, corn, cotton, rice, soybeans, sugarcane and wheat. Estimates for 2014 indicate that over the continental United States (CONUS), crop residue burning excluding all areas identified as Pasture/Grass, Grassland Herbaceous, and Pasture/Hay occurred over approximately 1.5 million acres of land and produced 19,600 short tons of PM 2.5 . For areas identified as Pasture/Grass, Grassland Herbaceous, and Pasture/Hay, biomass burning emissions occurred over approximately 1.6 million acres of land and produced 30,000 short tons of PM 2.5 . This estimate compares with the 2011 NEI and 2008 NEI as follows: 2008: 49,650 short tons and 2011: 141,180 short tons. Note that in the previous two NEIs rangeland burning was not well defined and so the comparison is not exact. The remote sensing data also provided verification of our existing diurnal profile for crop residue burning emissions used in chemical transport modeling. In addition, the entire database used to estimate this sector of emissions is available on EPA's Clearinghouse for Inventories and Emission Factors (CHIEF, http://www3.epa.gov/ttn/chief/index.html ). Estimates of crop residue burning and rangeland burning emissions can be improved by using satellite detections. Local information is helpful in distinguishing crop residue and rangeland burning from all other types of fires.

Parent knowledge on paediatric burn prevention related to the home environment.

PubMed

Cox, Sharon G; Burahee, Abdus; Albertyn, Rene; Makahabane, Jahelihle; Rode, Heinz

2016-12-01

Burns amongst children in South Africa are common and usually occur in the immediate home environment. In surveys many parents have requested ongoing educational burn prevention programs. This exploratory thematic parent orientation study assessed the level of parental knowledge on burn prevention strategies in the home. Study populations included: Parent with a burned child admitted to hospital, parents of non-burnt hospital attenders and hospital naive parents unbiased by previous exposure to burns. Participants answered a burn prevention questionnaire consisting of five sections. In this, two pictures depicting the circumstances associated with paediatric burns sustained at home were used, one with 15 potential danger points and one sanitized. There was no educational intervention prior to parents viewing the pictures. There were 268 participants; 72 burnt inpatient, 97 non-burnt outpatients and 99 hospital naive participants. The inpatient population displayed the highest incidence of informal housing. A positive relationship was identified between the overall study population and burns general knowledge and prevention. Educated participants were more knowledgeable about burns and better at identifying risk factors. Knowledge about burns was higher in the outpatient population and the highest in the Naïve group when compared to the Inpatients group (p<0.01). The naïve group scored higher in prior knowledge about burns and burn prevention. Of the potential 15 danger points only four of 72 inpatients and three of 97 outpatients identified more than 80% of the potential danger points as compared to 43 of 99 of the naïve group. The dangling kettle cord, the use of a mug to pour paraffin into a lantern and the child pulling a tablecloth were the most common dangerous aspects identified. We demonstrated a positive correlation between participants' ability to identify potential dangers, identify safe practice and implementing safe practice. Our findings show that people living in environments optimal for burn incidents know relatively little about burn prevention strategies. Future intervention needs to not only target the population's behavior but most importantly needs to promote better education models. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Management of the Acute Partial-thickness Burned Hand; Moist Exposed Burn Ointment or Silver Sulphadiazine Cream both Combined with a Polyethylene Bag

PubMed Central

Allam, A.M.; Mostafa, W.; Zayed, E.; El-Gamaly, J.

2007-01-01

Summary Hand burns predominantly affect young adults, and therefore have serious social and financial implications. In the present work, 106 patients with less than 25% body surface area burns and acute partial-thickness burned hands were managed using polyethylene bags and 1% local silver sulphadiazine (SSD) cream or moist exposed burn ointment (MEBO). Females made up 61.3% of the cases and flame burn was the majority cause (54.7%). There were no significant differences between the two groups regarding either the analgesic effect after local ointment application or hand movement inside the polyethylene bag. Local agent crustation over the wound was very evident in the hands managed by local 1% SSD cream (69.81%). On follow-up, the burned hands healed faster using local MEBO (10.48 versus 14.53 days), with fewer post-burn hand deformities and better active hand movements; however, the total cost until complete hand burn wound healing was higher with MEBO than with 1% SSD, although the final results were superior, with early return to work, when MEBO was used. We concluded that the use of MEBO as a topical agent and of polyethylene bags for the dressing of the acute partial-thickness burned hand accelerated healing; daily wound evaluation was easy as there was no crustation over it of the agent. It was more expensive than 1% SSD cream but presented fewer post-burn complications and more rapid healing, with shorter hospital stay. PMID:21991086

Elevated thrombopoietin in plasma of burned patients without and with sepsis enhances platelet activation.

PubMed

Lupia, E; Bosco, O; Mariano, F; Dondi, A E; Goffi, A; Spatola, T; Cuccurullo, A; Tizzani, P; Brondino, G; Stella, M; Montrucchio, G

2009-06-01

Thrombopoietin (TPO) is a humoral growth factor that does not induce platelet aggregation per se, but enhances platelet activation in response to several agonists. Circulating levels of TPO are increased in patients with sepsis and are mainly related to sepsis severity. To investigate the potential contribution of elevated TPO levels in platelet activation during burn injury complicated or not by sepsis. We studied 22 burned patients, 10 without and 12 with sepsis, and 10 healthy subjects. We measured plasma levels of TPO, as well as leukocyte-platelet binding and P-selectin expression. The priming activity of plasma from burned patients or healthy subjects on platelet aggregation and leukocyte-platelet binding, and the role of TPO in these effects were also studied in vitro. Burned patients without and with sepsis showed higher circulating TPO levels and increased monocyte-platelet binding compared with healthy subjects. Moreover, TPO levels, monocyte-platelet binding and P-selectin expression were significantly higher in burned patients with sepsis than in burned patients without sepsis. In vitro, plasma from burned patients without and with sepsis, but not from healthy subjects, primed platelet aggregation, monocyte-platelet binding and platelet P-selectin expression. The effect of plasma from burned patients with sepsis was significantly higher than that of plasma from burned patients without sepsis. An inhibitor of TPO prevented the priming effect of plasma from burned patients. Increased TPO levels may enhance platelet activation during burn injury and sepsis, potentially participating in the pathogenesis of multi-organ failure in these diseases.

Estimates of global biomass burning emissions for reactive greenhouse gases (CO, NMHCs, and NOx) and CO2

NASA Astrophysics Data System (ADS)

Jain, Atul K.; Tao, Zhining; Yang, Xiaojuan; Gillespie, Conor

2006-03-01

Open fire biomass burning and domestic biofuel burning (e.g., cooking, heating, and charcoal making) algorithms have been incorporated into a terrestrial ecosystem model to estimate CO2 and key reactive GHGs (CO, NOx, and NMHCs) emissions for the year 2000. The emissions are calculated over the globe at a 0.5° × 0.5° spatial resolution using tree density imagery, and two separate sets of data each for global area burned and land clearing for croplands, along with biofuel consumption rate data. The estimated global and annual total dry matter (DM) burned due to open fire biomass burning ranges between 5221 and 7346 Tg DM/yr, whereas the resultant emissions ranges are 6564-9093 Tg CO2/yr, 438-568 Tg CO/yr, 11-16 Tg NOx/yr (as NO), and 29-40 Tg NMHCs/yr. The results indicate that land use changes for cropland is one of the major sources of biomass burning, which amounts to 25-27% (CO2), 25 -28% (CO), 20-23% (NO), and 28-30% (NMHCs) of the total open fire biomass burning emissions of these gases. Estimated DM burned associated with domestic biofuel burning is 3,114 Tg DM/yr, and resultant emissions are 4825 Tg CO2/yr, 243 Tg CO/yr, 3 Tg NOx/yr, and 23 Tg NMHCs/yr. Total emissions from biomass burning are highest in tropical regions (Asia, America, and Africa), where we identify important contributions from primary forest cutting for croplands and domestic biofuel burning.

Acute pavement burns: a unique subset of burn injuries: a five-year review of resource use and cost impact.

PubMed

Silver, Andrew G; Dunford, Gerrit M; Zamboni, William A; Baynosa, Richard C

2015-01-01

This study focuses on the hospital care of a rare subset of burn injuries caused by contact with environmentally heated pavement, to further understand the required use of resources. This article aims to show that pavement burns are typically more severe than their flame/scald counterparts. A retrospective review of patients admitted to the burn center with injuries suffered from contact with hot pavement was performed. Patients were stratified on the presence or absence of altered mental status (AMS) and additional inciting factors. A representative sample of similarly sized flame and scald wounds treated in the same time period was compiled for comparison. Those with pavement burns had a significantly greater requirement for operative intervention, repetitive debridements, overall cost/percent burned, and lengthier hospital stays than those with flame/scald burns. Pavement burn victims with AMS were significantly more likely to require an operation, a greater cost/percent burned, and longer hospital stays than those without AMS. Pavement burns are significantly worse than similarly sized scald/flame burns with regards to length of stay and total hospital costs, and the necessity of initial and repetitive operative intervention. These discrepancies are even greater in patients with AMS as a concomitant inciting factor. It is apparent that these wounds often continue to deepen during a patient's stay, likely because of continued pressure on the wounds while recumbent. As such, this article highly recommends pressure off-loading beds and more aggressive debridement in the treatment of these unique injuries.

Determination of burning area and port volume in complex burning regions of a solid rocket motor

NASA Technical Reports Server (NTRS)

Kingsbury, J. A.

1977-01-01

An analysis of the geometry of the burning in both star-cylindrical port interface regions and regions of partially inhibited slots is presented. Some characteristics parameters are defined and illustrated. Methods are proposed for calculating burning areas which functionally depend only on the total distance burned. According to this method, several points are defined where abrupt changes in geometry occur, and these are tracked throughout the burn. Equations are developed for computing port perimeter and port area at pre-established longitudinal positions. Some common formulas and some newly developed formulas are then used to compute burning surface area and port volume. Some specific results are presented for the solid rocket motor committed to the space shuttle project.

[Lay emphasis on the treatment of massive burn casualties in conflagration].

PubMed

Tang, Hong-tai; Ma, Bing; Xia, Zhao-fan

2012-06-01

Burn surgery belongs to disaster medicine. Burn is a common trauma that occurs in social activities of human beings in all ages, either in the time of peace or war. During the development of human medicine in modern times, the summary of experience in treating massive burn casualties due to severe fire accidents has effectively promoted the renovation of treating technology and theory of burns and the development of burn surgery. The results of treatment of burn injury in casualties occurred in the fire of Cocoanut Grove night club in Boston in 1942, and the high-rise apartment house fire in Shanghai in 2010 were summarized and analyzed in this article, emphasizing the correlating issues of inhalation injury.

Burns and Fire Safety

MedlinePlus

Number of Deaths Death Rate Burns and Fire Safety Fact Sheet (2015) Fatalities • 334 children ages 19 and under died from fires or burns ... burns were ages 4 and under. 1 The death rate for children this age (0.73 per 100, ...

Minor burns - aftercare

MedlinePlus

... Larger than 2 inches (5 cm) On the hand, foot, face, groin, buttocks, hip, knee, ankle, shoulder, elbow, or wrist First aid for Minor Burns First, calm and reassure the person who is burned. If clothing is not stuck to the burn, remove it. ...

Rapid response of soil fungal communities to low and high intensity fire

NASA Astrophysics Data System (ADS)

Smith, Jane E.; Cowan, Ariel D.; Reazin, Chris; Jumpponen, Ari

2016-04-01

Contemporary fires have created high-severity burn areas exceeding historical distributions in forests in the western United States. Until recently, the response of soil ecosystems to high intensity burns has been largely unknown. In complementary studies, we investigated the environmental effect of extreme soil heating, such that occurs with the complete combustion of large down wood during wildfires, on soil fungi and nutrients. We used TRFLP and next generation sequencing (Illumina MiSeq) to investigate the fungal communities. During the burning of large down wood, temperatures lethal to fungi were detected at 0-cm, 5-cm, and 10-cm depths in soils compared to 0-cm depth in soils receiving low intensity broadcast burns. We compared the soil fungal diversity in ten high intensity burned plots paired with adjacent low intensity burned plots before and one week after at 0-10 cm soil depth. Nonmetric Multidimensional Scaling (NMS) ordinations and analyses of taxon frequencies reveal a substantial community turnover and corresponding near complete replacement of the dominant basidiomycetes by ascomycetes in high intensity burns. These coarse-level taxonomic responses were primarily attributable to a few fire-responsive (phoenicoid) fungi, particularly Pyronema sp. and Morchella sp., whose frequencies increased more than 100-fold following high intensity burns. Pinus ponderosa seedlings planted one week post-burn were harvested after four months for EMF root tip analysis. We found: a) greater differences in soil properties and nutrients in high intensity burned soils compared to low intensity burned and unburned soils; b) no differences in EMF richness and diversity; and c) weak differences in community composition based on relative abundance between unburned and either burn treatments. These results confirm the combustion of large downed wood can alter the soil environment directly beneath it. However, an EMF community similar to low burned soils recolonized high burned soils within one growing season. Community results from both burn treatments suggest an increase in patchy spatial distribution of EMF. The importance of incorporating mixed fire effects in fuel management practices will help to provide EMF refugia for dry forest regeneration. Our studies highlight the strong and rapid fungal community responses to fires and differences among fires of different severities. We theorize that quick initiation of EMF recolonization is possible depending on the size of high burn patches, proximity of low and unburned soil, and survival of nearby hosts.

EVALUATION OF EFFECTIVENESS IN A NOVEL WOUND HEALING OINTMENT-CROCODILE OIL BURN OINTMENT

PubMed Central

Li, Hua-Liang; Deng, Yi-Tao; Zhang, Zi-Ran; Fu, Qi-Rui; Zheng, Ya-Hui; Cao, Xing-Mei; Nie, Jing; Fu, Li-Wen; Chen, Li-Ping; Xiong, You-Xiong; Shen, Dong-Yan; Chen, Qing-Xi

2017-01-01

Background: Crocodile oil and its products are used as ointments for burns and scalds in traditional medicines. A new ointment formulation - crocodile oil burn ointment (COBO) was developed to provide more efficient wound healing activity. The purpose of the study was to evaluate the burn healing efficacy of this new formulation by employing deep second-degree burns in a Wistar rat model. The analgesic and anti-inflammatory activities of COBO were also studied to provide some evidences for its further use. Materials and methods: The wound healing potential of this formulation was evaluated by employing a deep second-degree burn rat model and the efficiency was comparatively assessed against a reference ointment - (1% wt/wt) silver sulfadiazine (SSD). After 28 days, the animals were euthanized and the wounds were removed for transversal and longitudinal histological studies. Acetic acid-induced writhing in mice was used to evaluate the analgesic activity and its anti-inflammatory activity was observed in xylene -induced edema in mice. Results: COBO enhanced the burn wound healing (20.5±1.3 d) as indicated by significant decrease in wound closure time compared with the burn control (25.0±2.16 d) (P<0.01). Hair follicles played an importance role in the physiological functions of the skin, and their growth in the wound could be revealed for the skin regeneration situation. Histological results showed that the hair follicles were well-distributed in the post-burn skin of COBO treatment group, and the amounts of total, active, primary and secondary hair follicles in post-burn 28-day skin of COBO treatment groups were more than those in burn control and SSD groups. On the other hand, the analgesic and anti-inflammatory activity of COBO were much better than those of control group, while they were very close to those of moist exposed burn ointment (MEBO). Conclusions: COBO accelerated wound closure, reduced inflammation, and had analgesic effects compared with SSD in deep second degree rat burn model. These findings suggest that COBO would be a potential therapy for treating human burns. Abbreviations: COBO, crocodile oil burn ointment; SSD, silver sulfadiazine; MEBO, moist exposed burn ointment; TCM, traditional Chinese medicine; CHM, Chinese herbal medicine; GC-MS, gas chromatography-mass spectrometry. PMID:28480384

EVALUATION OF EFFECTIVENESS IN A NOVEL WOUND HEALING OINTMENT-CROCODILE OIL BURN OINTMENT.

PubMed

Li, Hua-Liang; Deng, Yi-Tao; Zhang, Zi-Ran; Fu, Qi-Rui; Zheng, Ya-Hui; Cao, Xing-Mei; Nie, Jing; Fu, Li-Wen; Chen, Li-Ping; Xiong, You-Xiong; Shen, Dong-Yan; Chen, Qing-Xi

2017-01-01

Crocodile oil and its products are used as ointments for burns and scalds in traditional medicines. A new ointment formulation - crocodile oil burn ointment (COBO) was developed to provide more efficient wound healing activity. The purpose of the study was to evaluate the burn healing efficacy of this new formulation by employing deep second-degree burns in a Wistar rat model. The analgesic and anti-inflammatory activities of COBO were also studied to provide some evidences for its further use. The wound healing potential of this formulation was evaluated by employing a deep second-degree burn rat model and the efficiency was comparatively assessed against a reference ointment - (1% wt/wt) silver sulfadiazine (SSD). After 28 days, the animals were euthanized and the wounds were removed for transversal and longitudinal histological studies. Acetic acid-induced writhing in mice was used to evaluate the analgesic activity and its anti-inflammatory activity was observed in xylene -induced edema in mice. COBO enhanced the burn wound healing (20.5±1.3 d) as indicated by significant decrease in wound closure time compared with the burn control (25.0±2.16 d) ( P <0.01). Hair follicles played an importance role in the physiological functions of the skin, and their growth in the wound could be revealed for the skin regeneration situation. Histological results showed that the hair follicles were well-distributed in the post-burn skin of COBO treatment group, and the amounts of total, active, primary and secondary hair follicles in post-burn 28-day skin of COBO treatment groups were more than those in burn control and SSD groups. On the other hand, the analgesic and anti-inflammatory activity of COBO were much better than those of control group, while they were very close to those of moist exposed burn ointment (MEBO). COBO accelerated wound closure, reduced inflammation, and had analgesic effects compared with SSD in deep second degree rat burn model. These findings suggest that COBO would be a potential therapy for treating human burns. Abbreviations: COBO, crocodile oil burn ointment; SSD, silver sulfadiazine; MEBO, moist exposed burn ointment; TCM, traditional Chinese medicine; CHM, Chinese herbal medicine; GC-MS, gas chromatography-mass spectrometry.

Burns and military clothing.

PubMed

McLean, A D

2001-02-01

Burn injury is a ubiquitous threat in the military environment. The risks during combat are well recognised, but the handling of fuel, oil, munitions and other hot or flammable materials during peacetime deployment and training also imposes an inherent risk of accidental burn injury. Over the last hundred years, the burn threat in combat has ranged from nuclear weapons to small shoulder-launched missiles. Materials such as napalm and white phosphorus plainly present a risk of burn, but the threat extends to encompass personnel in vehicles attacked by anti-armour weapons, large missiles, fuel-air explosives and detonations/conflagrations on weapons platforms such as ships. Large numbers of burn casualties were caused at Pearl Harbor, in Hiroshima and Nagasaki, Vietnam, during the Arab/Israeli Wars and in the Falkland Islands conflict. The threat from burns is unlikely to diminish, indeed new developments in weapons seek to exploit the vulnerability of the serviceman and servicewoman to burns. Clothing can be a barrier to some types of burn--both inherently in the properties of the material, but also by trapping air between clothing layers. Conversely, ignition of the clothing may exacerbate a burn. There is hearsay that burnt clothing products within a wound may complicate the clinical management, or that materials that melt (thermoplastic materials) should not be worn if there is a burn threat. This paper explores the incidence of burn injury, the mechanisms of heat transfer to bare skin and skin covered by materials, and the published evidence for the complication of wound management by materials. Even light-weight combat clothing can offer significant protection to skin from short duration flash burns; the most vulnerable areas are the parts of the body not covered--face and hands. Multilayered combat clothing can offer significant protection for short periods from engulfment by flames; lightweight tropical wear with few layers offers little protection. Under high heat loads in the laboratory, combat clothing can ignite, but there is little evidence that clothing ignition is a common occurrence in military burn casualties. Thermoplastic materials have many benefits in civil and military clothing. There is little objective evidence that they exacerbate burns, or complicate burn management. Their use in military clothing must be based on objective evidence, not hearsay.

Management of patients in a dedicated burns intensive care unit (BICU) in a developing country.

PubMed

Hashmi, Madiha; Kamal, Rehana

2013-05-01

In Pakistan the practice of managing extensive burns in dedicated intensive care units is not well established. This audit aims to define the characteristics of the victims of major burns and factors that increase mortality and outcome of the protocol-based management in a dedicated burns intensive care unit (BICU). This prospective audit included all patients admitted to the BICU of Suleiman Dawood Burns Unit in Karachi from 1st September 2002 to 31st August 2011. Demographic information, type and place of burn, total body surface area burn (TBSA), type of organ support provided, length of ICU stay, any associated medical diseases, and out outcome were documented. A total of 1597 patients were admitted to the BICU in 9 years. Median age of the patients was 22 (IQR =32-7). 32% victims were children <14 years and only 7% were >50 years old. Male to female ratio was 1.4:1. Fire was the leading cause of burns in adults (64%) and scald burns were most common in (64%) in children. 72.4% of the accidents happened at home, where kitchen was the commonest location (597 cases). Mean TBSA burnt was 32.5% (SD ± 22.95%, 95%CI: 31.36-33.61). 27% patients needed ventilatory support, 4% were dialyzed and split skin graftings were performed in 20% patients. Average length of ICU stay was 10.42 days. Epilepsy, psychiatric illness and drug addiction were not common associations with burns. Overall mortality was 41.30% but it decreased over the years from 75% to 27%. Groups of people most vulnerable to sustain burn are young females getting burnt in the kitchen, young males getting burnt at work, and small children falling in pots of hot water stored for drinking or bathing. TBSA >40%, age >50 years, fire burn and female gender were associated with a higher risk of death. Carefully planned, protocol based management of burn patients by burn teams of dedicated healthcare professionals, even with limited resources reduced mortality. Burn hazard awareness, prevention and educational programmes targeted at the vulnerable population, i.e. women and young children at home and men at their work place is the single most cost-effective way of reducing the incidence of burns in developing countries. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Fracture admissions after burns: A retrospective longitudinal study.

PubMed

Duke, Janine M; Randall, Sean M; Fear, Mark W; Boyd, James H; Wood, Fiona M

2017-09-01

Severe burn triggers systemic responses that result in reduced muscle mass and changes in bone formation, with recent evidence also suggesting systemic effects on bone after minor burns. The aim of this study was to assess if people hospitalised with a burn have increased admissions for fractures after discharge. A population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of all persons hospitalised for a first burn (n=30,997) during the period 1980-2012. Australian population-based annual rates for fracture admissions for the period 1993-2012 were obtained from the Australian Institute of Health and Welfare. Rates of hospital admissions for fractures in the burn cohort and the Australian population were standardised, using the direct method, to the age and gender structure of the Western Australian population at the 2006. Annual standardised fracture admission rates for the period 1993-2012 were graphed with estimated 95% confidence intervals. Age and gender specific fracture rates were also examined. A total of 4004 members of the burn cohort had at least one fracture admission for a total of 6096. The median (IQR) time to the first fracture admission after burn was 6.9 years (2.8-13.6) and the median age (IQR) at first fracture admission was 31 years (20-49). The burn cohort experienced admissions for fractures at a rate approximately twice that of the Australian population. While rates were generally higher for males in the burn cohort when compared with males in the Australian population, female burn patients had significantly higher rates over the entire study period when compared with the female Australian population. Elevated rates were observed for those younger than 20 years at the time of the burn admission; however, rates were significantly and consistently elevated during the study period for those 20 years and older at the time of the burn. Burn patients experienced significantly higher age and gender standardised rates of admissions for fractures after discharge from hospital for their index burn. Further prospective research is indicated to clarify any underlyling pathogenic processes linked to the burn that may increase a patient's risk of having a fracture serious enough to undergo admission. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Burn Injury and Explosions: An Australian Perspective

PubMed Central

Greenwood, John E.

2009-01-01

Objectives: Increasingly (but not exclusively), terrorist activity and the use of explosive devices have enjoyed the focus of the global media. This paper aims to bring a range of issues to attention, to highlight how burn injuries are sustained in such incidents and why burn injuries (and thus burn disasters) are so complicated to manage. Materials and Methods: The author's experience with burn injury caused during explosions and his involvement in burn disaster situations has been summarized to form the basis of the article. This has been expanded upon with discussion points which provide a strategy for planning for such events and by a broad sample of the literature. Results: Several strategies are suggested to facilitate planning for burn disasters and to illustrate to those not directly involved why forward planning is pivotal to success when these incidents occur. Conclusions: Disasters generating large numbers of burn-injured are relatively frequent. Explosive devices are widespread in their use both in military and increasingly in civilian fields. Encompassing a large range of aetiologies, geographical sites, populations, and resources; burn disaster management is difficult and planning essential. PMID:19834533

Burning mouth syndrome: the role of contact hypersensitivity.

PubMed

Marino, R; Capaccio, P; Pignataro, L; Spadari, F

2009-05-01

Burning mouth syndrome is a burning sensation or stinging disorder affecting the oral mucosa in the absence of any clinical signs or mucosal lesions. Some studies have suggested that burning mouth syndrome could be caused by the metals used in dental prostheses, as well as by acrylate monomers, additives and flavouring agents, although others have not found any aetiologic role for hypersensitivity to dental materials. To evaluate the extent and severity of adverse reactions to dental materials in a group of patients with burning mouth syndrome, and investigate the possible role of contact allergy in its pathogenesis. We prospectively studied 124 consecutive patients with burning mouth syndrome (108 males; mean age 57 years, range 41-83), all of whom underwent allergen patch testing between 2004 and 2007. Sixteen patients (13%) showed positive patch test reactions and were classified as having burning mouth syndrome type 3 or secondary burning mouth syndrome (Lamey's and Scala's classifications). Although we did not find any significant association between the patients and positive patch test reactions, it would be advisable to include hypersensitivity to dental components when evaluating patients experiencing intermittent oral burning without any clinical signs.

Alcohol Modulation of the Post Burn Hepatic Response

PubMed Central

Chen, Michael M; Carter, Stewart R; Curtis, Brenda J; O’Halloran, Eileen B; Gamelli, Richard L; Kovacs, Elizabeth J

2015-01-01

The widespread and rapidly increasing trend of binge drinking is accompanied by a concomitant rise in the prevalence of trauma patients under the influence of alcohol at the time of their injury. Epidemiologic evidence suggests up to half of all adult burn patients are intoxicated at the time of admission and the presence of alcohol is an independent risk factor for death in the early stages post burn. As the major site of alcohol metabolism and toxicity, the liver is a critical determinant of post burn outcome and experimental evidence implies an injury threshold exists beyond which burn-induced hepatic derangement is observed. Alcohol may lower this threshold for post burn hepatic damage through a variety of mechanisms including modulation of extrahepatic events, alteration of the gut-liver axis, and changes in signaling pathways. The direct and indirect effects of alcohol may prime the liver for the second-hit of many overlapping physiologic responses to burn injury. In an effort to gain a deeper understanding of how alcohol potentiates post burn hepatic damage, we summarize possible mechanisms by which alcohol modulates the post burn hepatic response. PMID:26284631

Vagus nerve stimulation blocks vascular permeability following burn injury in both local and distal sites

PubMed Central

Ortiz-Pomales, Yan T; Krzyzaniak, Michael; Coimbra, Raul; Baird, Andrew; Eliceiri, Brian P.

2012-01-01

Recent studies have shown that vagus nerve stimulation (VNS) can block the burn injury-induced systemic inflammatory response (SIRS). In this study we examined the potential for VNS to modulate vascular permeability (VP) in local sites (i.e. skin) and in secondary sites (i.e. lung) following burn injury. In a 30% total body surface area burn injury model, VP was measured using intravascular fluorescent dextran for quantification of the VP response in skin and lung. A peak in VP of the skin was observed 24 hours post-burn injury, that was blocked by VNS. Moreover, in the lung, VNS led to a reduction in burn-induced VP compared to sham-treated animals subjected to burn injury alone. The protective effects of VNS in this model were independent of the spleen, suggesting that the spleen was not a direct mediator of VNS. These studies identify a role for VNS in the regulation of VP in burns, with the translational potential of attenuating lung complications following burn injury. PMID:22694873

A comprehensive biomass burning emission inventory with high spatial and temporal resolution in China

NASA Astrophysics Data System (ADS)

Zhou, Ying; Xing, Xiaofan; Lang, Jianlei; Chen, Dongsheng; Cheng, Shuiyuan; Wei, Lin; Wei, Xiao; Liu, Chao

2017-02-01

Biomass burning injects many different gases and aerosols into the atmosphere that could have a harmful effect on air quality, climate, and human health. In this study, a comprehensive biomass burning emission inventory including domestic and in-field straw burning, firewood burning, livestock excrement burning, and forest and grassland fires is presented, which was developed for mainland China in 2012 based on county-level activity data, satellite data, and updated source-specific emission factors (EFs). The emission inventory within a 1 × 1 km2 grid was generated using geographical information system (GIS) technology according to source-based spatial surrogates. A range of key information related to emission estimation (e.g. province-specific proportion of domestic and in-field straw burning, detailed firewood burning quantities, uneven temporal distribution coefficient) was obtained from field investigation, systematic combing of the latest research, and regression analysis of statistical data. The established emission inventory includes the major precursors of complex pollution, greenhouse gases, and heavy metal released from biomass burning. The results show that the emissions of SO2, NOx, PM10, PM2.5, NMVOC, NH3, CO, EC, OC, CO2, CH4, and Hg in 2012 are 336.8 Gg, 990.7 Gg, 3728.3 Gg, 3526.7 Gg, 3474.2 Gg, 401.2 Gg, 34 380.4 Gg, 369.7 Gg, 1189.5 Gg, 675 299.0 Gg, 2092.4 Gg, and 4.12 Mg, respectively. Domestic straw burning, in-field straw burning, and firewood burning are identified as the dominant biomass burning sources. The largest contributing source is different for various pollutants. Domestic straw burning is the largest source of biomass burning emissions for all the pollutants considered, except for NH3, EC (firewood), and NOx (in-field straw). Corn, rice, and wheat represent the major crop straws. The combined emission of these three straw types accounts for 80 % of the total straw-burned emissions for each specific pollutant mentioned in this study. As for the straw burning emission of various crops, corn straw burning has the largest contribution to all of the pollutants considered, except for CH4; rice straw burning has highest contribution to CH4 and the second largest contribution to other pollutants, except for SO2, OC, and Hg; wheat straw burning is the second largest contributor to SO2, OC, and Hg and the third largest contributor to other pollutants. Heilongjiang, Shandong, and Henan provinces located in the north-eastern and central-southern regions of China have higher emissions compared to other provinces in China. Gridded emissions, which were obtained through spatial allocation based on the gridded rural population and fire point data from emission inventories at county resolution, could better represent the actual situation. High biomass burning emissions are concentrated in the areas with more agricultural and rural activity. The months of April, May, June, and October account for 65 % of emissions from in-field crop residue burning, while, regarding EC, the emissions in January, February, October, November, and December are relatively higher than other months due to biomass domestic burning in heating season. There are regional differences in the monthly variations of emissions due to the diversity of main planted crops and climatic conditions. Furthermore, PM2.5 component results showed that OC, Cl-, EC, K+, NH4+, elemental K, and SO42- are the main PM2.5 species, accounting for 80 % of the total emissions. The species with relatively high contribution to NMVOC emission include ethylene, propylene, toluene, mp-xylene, and ethyl benzene, which are key species for the formation of secondary air pollution. The detailed biomass burning emission inventory developed by this study could provide useful information for air-quality modelling and could support the development of appropriate pollution-control strategies.

Quantifying soil burn severity for hydrologic modeling to assess post-fire effects on sediment delivery

NASA Astrophysics Data System (ADS)

Dobre, Mariana; Brooks, Erin; Lew, Roger; Kolden, Crystal; Quinn, Dylan; Elliot, William; Robichaud, Pete

2017-04-01

Soil erosion is a secondary fire effect with great implications for many ecosystem resources. Depending on the burn severity, topography, and the weather immediately after the fire, soil erosion can impact municipal water supplies, degrade water quality, and reduce reservoirs' storage capacity. Scientists and managers use field and remotely sensed data to quickly assess post-fire burn severity in ecologically-sensitive areas. From these assessments, mitigation activities are implemented to minimize post-fire flood and soil erosion and to facilitate post-fire vegetation recovery. Alternatively, land managers can use fire behavior and spread models (e.g. FlamMap, FARSITE, FOFEM, or CONSUME) to identify sensitive areas a priori, and apply strategies such as fuel reduction treatments to proactively minimize the risk of wildfire spread and increased burn severity. There is a growing interest in linking fire behavior and spread models with hydrology-based soil erosion models to provide site-specific assessment of mitigation treatments on post-fire runoff and erosion. The challenge remains, however, that many burn severity mapping and modeling products quantify vegetation loss rather than measuring soil burn severity. Wildfire burn severity is spatially heterogeneous and depends on the pre-fire vegetation cover, fuel load, topography, and weather. Severities also differ depending on the variable of interest (e.g. soil, vegetation). In the United States, Burned Area Reflectance Classification (BARC) maps, derived from Landsat satellite images, are used as an initial burn severity assessment. BARC maps are classified from either a Normalized Burn Ratio (NBR) or differenced Normalized Burned Ratio (dNBR) scene into four classes (Unburned, Low, Moderate, and High severity). The development of soil burn severity maps requires further manual field validation efforts to transform the BARC maps into a product more applicable for post-fire soil rehabilitation activities. Alternative spectral indices and modeled output approaches may prove better predictors of soil burn severity and hydrologic effects, but these have not yet been assessed in a model framework. In this project we compare field-verified soil burn severity maps to satellite-derived and modeled burn severity maps. We quantify the extent to which there are systematic differences in these mapping products. We then use the Water Erosion Prediction Project (WEPP) hydrologic soil erosion model to assess sediment delivery from these fires using the predicted and observed soil burn severity maps. Finally, we discuss differences in observed and predicted soil burn severity maps and application to watersheds in the Pacific Northwest to estimate post-fire sediment delivery.

Burns - Multiple Languages

MedlinePlus

... Burn Care - العربية (Arabic) Bilingual PDF Health Information Translations Chinese, Simplified (Mandarin dialect) (简体中文) Expand Section Burn ... Chinese, Simplified (Mandarin dialect)) Bilingual PDF Health Information Translations Chinese, Traditional (Cantonese dialect) (繁體中文) Expand Section Burn ...

Biomass Burning Data and Information

Atmospheric Science Data Center

2015-04-21

Biomass Burning Data and Information This data set represents ... geographical and temporal distribution of total amount of biomass burned. These data may be used in general circulation models (GCMs) and ... models of the atmosphere. Project Title:  Biomass Burning Discipline:  Tropospheric Composition ...

California Burn Scars

Atmospheric Science Data Center

2014-05-15

article title:  Burn Scars Across Southern California     ... California between October 21 and November 18, 2003. Burn scars and vegetation changes wrought by the fires are illustrated in these ... and Nov 18, 2003 Images:  California Burn Scars location:  United States region:  ...

Aerosol Characteristics in the Northern Territory of Australia During the Dry Season With an Emphasis on Biomass Burning

DTIC Science & Technology

2005-08-01

properties and concentration of aerosol particles over the Amazon tropical forest during background and biomass burning ...characterize the seasonal variation (beginning to end) in the aerosol properties of the region. The main source of aerosol is biomass burning , and... Burning Emissions Part III: Intensive Optical Properties of Biomass Burning Particles , Atmos. Chem. Phys. Discuss., 4 5201-5260 45. see e. g.

Burn Wound Healing and Treatment: Review and Advancements

DTIC Science & Technology

2015-06-12

different days post burn. Burns. 2009;35:36–45. 176. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United...invasive imaging modalities into the routine treatment of burn wounds. Obese patients As the obese population continues to grow [176], new treatment...approaches will be required. Obese burn pa- tients present with a variety of unique characteristics that include: increased rates of diabetes

Burn Enhances Toll-Like Receptor Induced Responses by Circulating Leukocytes

DTIC Science & Technology

2012-04-30

Introduction Major burn is associated with a local and sys- temic activation of the innate immune system resulting in a profound inflammatory...plications. Previous studies have shown that responses after burn differ between fixed-tissue immune cells and circulating immune cells [15]. In the current...Abstract: Burn and toll-like receptors (TLR) are associated with innate immune system activation, but the impact of burn on TLR-induced inflammation

A Portable Burn Pan for the Disposal of Excess Propellants

DTIC Science & Technology

2016-06-01

of Vegetation in Vacinity of Burn Pan Caused by Radiant Heat ............... 32 Figure 12. Wet Propellant (120 kg) and Dry Propellant (460 kg) Burn...35 Figure 14. Graph of Component Temperatures During an HUTS Burn Pan Test ........................ 37 Figure 15. IR Camera Thermal...detector HUTS Howitzer Unit Training System burn pan IR Infrared JBER Joint Base Elmendorf Richardson (AK) Kg Kilogram m meter mg/kg milligram

Satellite versus ground-based estimates of burned area: A comparison between MODIS based burned area and fire agency reports over North America in 2007

Treesearch

Stephane Mangeon; Robert Field; Michael Fromm; Charles McHugh; Apostolos Voulgarakis

2015-01-01

North American wildfire management teams routinely assess burned area on site during firefighting campaigns; meanwhile, satellite observations provide systematic and global burned-area data. Here we compare satellite and ground-based daily burned area for wildfire events for selected large fires across North America in 2007 on daily timescales. In a sample of 26 fires...

An unusual burn caused by hot argy wormwood leaf water

PubMed Central

Liang, X.; Chen, X.-L.; Wang, F.; Guo, F.

2011-01-01

Summary An unusual burn case caused by hot wormwood leaf water is discussed. A 29-yr-old woman sustained a 7% seconddegree burn on both buttocks and the left thigh. This case report highlights a rare cause of chemical burn that may become more common with increasing use of this method of traditional Chinese medicine. Measures for preventing this type of burn injury are also presented. PMID:22396673

30 CFR 254.28 - What information must I include in the “In situ burning plan” appendix?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 2 2012-07-01 2012-07-01 false What information must I include in the âIn situ... information must I include in the “In situ burning plan” appendix? Your in situ burning plan must be... Contingency Plan(s). Your in situ burning plan must include: (a) A description of the in situ burn equipment...

30 CFR 254.28 - What information must I include in the “In situ burning plan” appendix?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 2 2014-07-01 2014-07-01 false What information must I include in the âIn situ... information must I include in the “In situ burning plan” appendix? Your in situ burning plan must be... Contingency Plan(s). Your in situ burning plan must include: (a) A description of the in situ burn equipment...

30 CFR 254.28 - What information must I include in the “In situ burning plan” appendix?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 2 2013-07-01 2013-07-01 false What information must I include in the âIn situ... information must I include in the “In situ burning plan” appendix? Your in situ burning plan must be... Contingency Plan(s). Your in situ burning plan must include: (a) A description of the in situ burn equipment...

Acoustic emission strand burning technique for motor burning rate prediction

NASA Technical Reports Server (NTRS)

Christensen, W. N.

1978-01-01

An acoustic emission (AE) method is being used to measure the burning rate of solid propellant strands. This method has a precision of 0.5% and excellent burning rate correlation with both subscale and large rocket motors. The AE procedure burns the sample under water and measures the burning rate from the acoustic output. The acoustic signal provides a continuous readout during testing, which allows complete data analysis rather than the start-stop clockwires used by the conventional method. The AE method helps eliminate such problems as inhibiting the sample, pressure increase and temperature rise, during testing.

Ultrasonic technique for characterizing skin burns

DOEpatents

Goans, Ronald E.; Cantrell, Jr., John H.; Meyers, F. Bradford; Stambaugh, Harry D.

1978-01-01

This invention, a method for ultrasonically determining the depth of a skin burn, is based on the finding that the acoustical impedance of burned tissue differs sufficiently from that of live tissue to permit ultrasonic detection of the interface between the burn and the underlying unburned tissue. The method is simple, rapid, and accurate. As compared with conventional practice, it provides the important advantage of permitting much earlier determination of whether a burn is of the first, second, or third degree. In the case of severe burns, the usual two - to three-week delay before surgery may be reduced to about 3 days or less.

Summer camps for children with burn injuries: a literature review.

PubMed

Maslow, Gary R; Lobato, Debra

2010-01-01

The first summer camps for children with burn injuries started over 25 years ago, and as of 2008, there were 60 camps worldwide. This review examines the literature on summer pediatric burn camps. The authors describe common characteristics of burn camp structure, activities, and staffing and then examine the scientific evidence regarding the effect of burn camp programs on campers and camp staff volunteers. A search of Pubmed and Psychinfo databases from 1970 to 2008 for articles related to pediatric burn summer camps identified 17 articles, of which 13 fit the inclusion criteria. Existing literature consists primarily of qualitative studies, suggesting that burn camp can decrease camper isolation, improve self-esteem, and promote coping and social skills. Studies examining volunteer staff at burn camp have consistently found that there are both personal and professional benefits. Quantitative studies of self-esteem have yielded equivocal results. No studies have examined safety or the effect of burn camp on medical or rehabilitation outcomes. For the past 25 years, pediatric summer camps for children with burn injuries have played an important rehabilitation role and provided a strong community that benefits both campers and staff. Future research using more rigorous research methods and examining a broader range of outcomes (eg, safety and medical/rehabilitation outcomes) is recommended.

Epidemiology of Burns in Rural Bangladesh: An Update.

PubMed

He, Siran; Alonge, Olakunle; Agrawal, Priyanka; Sharmin, Shumona; Islam, Irteja; Mashreky, Saidur Rahman; Arifeen, Shams El

2017-04-05

Each year, approximately 265,000 deaths occur due to burns on a global scale. In Bangladesh, around 173,000 children under 18 sustain a burn injury. Since most epidemiological studies on burn injuries in low and middle-income countries are based on small-scale surveys or hospital records, this study aims to derive burn mortality and morbidity measures and risk factors at a population level in Bangladesh. A household survey was conducted in seven rural sub-districts of Bangladesh in 2013 to assess injury outcomes. Burn injuries were one of the external causes of injury. Epidemiological characteristics and risk factors were described using descriptive as well as univariate and multivariate logistic regression analyses. The overall mortality and morbidity rates were 2 deaths and 528 injuries per 100,000 populations. Females had a higher burn rate. More than 50% of injuries were seen in adults 25 to 64 years of age. Most injuries occurred in the kitchen while preparing food. 88% of all burns occurred due to flame. Children 1 to 4 years of age were four times more likely to sustain burn injuries as compared to infants. Age-targeted interventions, awareness of first aid protocols, and improvement of acute care management would be potential leads to curb death and disability due to burn injuries.

Hot ash burns in the children of Western Australia: how and why they happen.

PubMed

Martin, L; Rea, S; McWilliams, T; Wood, F

2014-08-01

Burns from hot ash are common in the paediatric population in Western Australia. Fifty children were admitted to the paediatric burn centre with hot ash contact burns to the feet in 2011 and 2012. It is important to examine the extent of the problem, seasonal variations, and identify those at risk to determine strategies for prevention campaigns. Retrospective review of medical notes for all admissions to the paediatric burns unit was undertaken for 2011 and 2012. Data were collected for patient demographics, time, circumstance of injury, burn severity and treatment. Hot ash burns accounted for 8.6% of admissions but 16.1% of burns sustained in non-metro areas. Median age was just under 3 years, male or female. Median burn TBSA was 2%, and 44% of children required surgery. The burns were less common in summer, more common on non-school days and in children who were on camping trips away from home. Previous work has shown the value of targeted campaigns. The group for targeted prevention campaigns are the carers of very young children who go camping. Information distributed at camping shows and stores about the principles of campfire safety would reach the people at risk. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Deep sole burns in several participants in a traditional festival of the firewalking ceremony in Kee-lung, Taiwan--clinical experiences and prevention strategies.

PubMed

Chang, Shun-Cheng; Hsu, Chih-Kang; Tzeng, Yuan-Sheng; Teng, Shou-Cheng; Fu, Ju-Peng; Dai, Niann-Tzyy; Chen, Shyi-Gen; Chen, Tim-Mo; Feng, Chun-Che

2012-11-01

Firewalking is a common Taoist cleansing ceremony in Taiwan, but burns associated with the practice have rarely been reported. We analyzed the patients with plantar burns from one firewalking ceremony. In one firewalking ceremony, 12 Taoist disciples suffered from contact burns to the soles of their feet while walking over burning coals. Eight of them had at least second-degree burns over areas larger than 1% of their total body surface areas (TBSAs). The age, sex, medical history, date of injury, time taken to traverse the fire pit, depth and TBSA of the burns, treatment, length of stay, and outcome were recorded and analyzed. Deep, disseminated second- to third-degree burns were noted and healing took as long as three weeks in some patients. Because disseminated hypertrophic scars form after burns, the soles involved regain much of their tensile strength while walking. The patients experienced only a few difficulties in their daily lives three months after injury. From our experience treating patients with deep disseminated second- to third-degree plantar burns caused by firewalking, we conclude that they should be treated conservatively, with secondary healing rather than a skin graft. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

Upregulation of MAOA in the hippocampus results in delayed depressive-like behaviors in burn mice.

PubMed

Wang, Zhen; Chen, Lu; Rong, Xinzhou; Wang, Xuemin

2017-04-14

To observe depressive-like behavior and hippocampus monoamine oxidase A (MAOA) changes in burned mice. We tested depression and anxiety like behaviors of burn C57 mice with the sucrose preference test, forced swimming test (FST), open field test and elevated plus maze test and then detected the MAOA content and MAOA gene transcriptional levels in the hippocampus with western blot analysis and real-time quantitative PCR analysis. We then sought to reverse depressive-like behavior of burned mice with an MAOA inhibitor. (1) Mice showed depressive and anxiety like behaviors one week after they were burned; (2) The content of MAOA in the hippocampus of burned mice was significantly higher than that in control mice (P<0.05); (3) MAOA gene transcription in the hippocampus of burned mice was significantly increased (MAOA mRNA was increased, P<0.05); (4) treatment with a MAOA inhibitor (phenelzine) significantly increased the sucrose preference rate and decreased FST immobility time in burned mice, and also decreased elevated expression of MAOA in the hippocampus of burned mice. Burned mice showed "delayed" depressive-like behavior combined with a degree of anxiety; this phenomenon is likely associated with the increase in MAOA expression in the hippocampus. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Suicide by burning: epidemiological and clinical profiles.

PubMed

Theodorou, Panagiotis; Phan, Vu T Q; Weinand, Christian; Maegele, Marc; Maurer, Christoph A; Perbix, Walter; Leitsch, Sebastian; Lefering, Rolf; Spilker, Gerald

2011-04-01

Self-immolation constitutes a rare form of suicide in developed countries, though it accounts for unique injury characteristics in the burn intensive care unit. The aim of this study was to present the epidemiological and clinical features of patients burned during a suicidal attempt seen in a North Rhine-Westphalia burn intensive care unit (BICU). To address this aim, we undertook a 21-year retrospective study involving patients with thermal injuries admitted to the largest burn unit in Germany. A total of 125 suicide-related burn victims were identified in the study period (9.4%). Comparing the self-immolation group with the rest burn patient cohort, suicide victims were more likely to be single and to act under the influence of alcohol. The suicidal group had a larger extent of burns, higher incidence of inhalation injury, required more surgical procedures, catecholamines, blood transfusions, and a longer BICU stay. Their clinical course was complicated by prolonged intubation period, higher rate of multiple drug-resistant bacteria acquisition and sepsis, leading to a higher mortality rate. Although the proportion of self-immolation victims among all burned patients is not high, the markedly higher severity of their burns and their poorer quality of outcomes makes them an important clinical subgroup for further study.

[Fluid management and cause of death during shock period in patients with severe burns or burns complicated by inhalation injury].

PubMed

Zhang, Ming-liang; Li, Chi; Ma, Chun-xu

2003-11-01

To explore fluid management and cause of death during shock period in severe burns or burns with inhalation injury. One hundred and twelve patients with severe burns or burn complicated by inhalation injury admitted to our hospital from 1991 to 2000 were analyzed. The fluid management and death conditions during shock period were discussed. The fluid volume for resuscitation could be described as follows: the total fluid volume was 2.2 ml/(%TBSA.kg) including colloid fluid 0.5 ml/(%TBSA.kg), crystalloid fluid 1 ml/(%TBSA.kg)and water 0.7 ml/(%TBSA.kg) during first 24 hours. The total fluid volume was 1.8 ml/(%TBSA.kg) including colloid fluid 0.4 ml/(%TBSA.kg), crystalloid fluid 0.7 ml/(%TBSA.kg) and water 0.7 ml/(%TBSA.kg) during second 24 hours. There were no difference in fluid management between burns and burns with inhalation injury. Seven patients died due to respiratory failure during shock period. Many fluid formula can provide guidance for resuscitation and it is very important that early fluid therapy should accord with concrete clinical conditions of patients in order to pass smoothly through shock period. Early fluid management is not different between burns and burns with inhalation injury.

Temperature responses in severely burned children during exercise in a hot environment.

PubMed

McEntire, Serina J; Chinkes, David L; Herndon, David N; Suman, Oscar E

2010-01-01

The authors have previously described thermoregulatory responses of severely burned children during submaximal exercise in a thermoneutral environment. However, the thermoregulatory response of burned children to exercise in the heat is not well understood and could have important safety implications for rehabilitation. Children (n = 10) with >40% TBSA burns and nonburned children (n = 10) performed a 30-minute bout of treadmill exercise at 75% of their peak aerobic power in a heated environment. Intestinal temperature, burned and unburned skin temperature, and heart rate were recorded pre-exercise, every 2 minutes during exercise, and during recovery. Three of the 10 burned children completed the exercise bout in the heat; however, all the nonburned children completed the 30-minute bout. One burned child reached a core body temperature >39 degrees C at minute 23. Burned children had significantly higher core body temperature through the first 12 minutes of exercise compared with nonburned children. However, nine of 10 (90%) burned children did not become hyperthermic during exercise in the heat. Specific to this study, hyperthermia did not typically occur in burned children, relative to nonburned children. Whether this is due to an intolerance to exercise in the heat or to an inability to generate sufficient heat during exercise needs to be explored further.

Management of acid burns: experience from Bangladesh.

PubMed

Das, Kishore Kumar; Olga, Loren; Peck, Michael; Morselli, Paolo G; Salek, A J M

2015-05-01

Acid burn injuries in Bangladesh primarily occur as a result of intentional attacks although there are incidences of accidental acid burns in industry, on the street, and at home. A total of 126 patients with acid burns, 95 from attacks and 31 from accidents, were studied from July 2004 to December 2012. A diagnosis of acid burn was made from history, physical examination and in some cases from chemical analysis of the patients' clothing. Alkali burns were excluded from the study. In the burn unit of Dhaka Medical College Hospital, we applied a slightly different protocol for management of acid burns, beginning with plain water irrigation of the wound, which effectively reduced burn depth and the requirement of surgical treatment. Application of hydrocolloid dressing for 48-72 h helped with the assessment of depth and the course of treatment. Early excision and grafting gives good results but resultant acid trickling creates a marble cake-like appearance of the wound separated by the vital skin. Excision with a scalpel and direct stitching of the wounds are often a good option. Observation of patients on follow-up revealed that wounds showed a tendency for hypertrophy. Application of pressure garments and other scar treatments were given in all cases unless the burn was highly superficial. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

A novel perspective for burn-induced myopathy: Membrane repair defect

PubMed Central

Wang, Chao; Wang, Hongyu; Wu, Dan; Hu, Jianhong; Wu, Wei; Zhang, Yong; Peng, Xi

2016-01-01

Myopathy is a common complication of severe burn patients. One potential cause of this myopathy could be failure of the plasma membrane to undergo repair following injuries generated from toxin or exercise. The aim of this study is to assess systemic effect on muscle membrane repair deficiency in burn injury. Skeletal muscle fibers isolated from burn-injured mice were damaged with a UV laser and dye influx imaged confocally to evaluate membrane repair capacity. Membrane repair failure was also tested in burn-injured mice subjected to myotoxin or treadmill exercise. We further used C2C12 myotubules and animal models to investigate the role of MG53 in development of burn-induced membrane repair defect. We demonstrated that skeletal muscle myofibers in burn-injured mice showed significantly more dye uptake after laser damage than controls, indicating a membrane repair deficiency. Myotoxin or treadmill exercise also resulted in a higher-grade repair defect in burn-injured mice. Furthermore, we observed that burn injury induced a significant decrease in MG53 levels and its dimerization in skeletal muscles. Our findings highlight a new mechanism that implicates membrane repair failure as an underlying cause of burn-induced myopathy. And, the disorders in MG53 expression and MG53 dimerization are involved in this cellular pathology. PMID:27545095

Physical functional outcome assessment of patients with major burns admitted to a UK Burn Intensive Care Unit.

PubMed

Smailes, Sarah T; Engelsman, Kayleen; Dziewulski, Peter

2013-02-01

Determining the discharge outcome of burn patients can be challenging and therefore a validated objective measure of functional independence would assist with this process. We developed the Functional Assessment for Burns (FAB) score to measure burn patients' functional independence. FAB scores were taken on discharge from ICU (FAB 1) and on discharge from inpatient burn care (FAB 2) in 56 patients meeting the American Burn Association criteria for major burn. We retrospectively analysed prospectively collected data to measure the progress of patients' physical functional outcomes and to evaluate the predictive validity of the FAB score for discharge outcome. Mean age was 38.6 years and median burn size 35%. Significant improvements were made in the physical functional outcomes between FAB 1 and FAB 2 scores (p<0.0001). 48 patients were discharged home, 8 of these with social care. 8 patients were transferred to another hospital for further inpatient rehabilitation. FAB 1 score (≤ 9) is strongly associated with discharge outcome (p<0.006) and as such can be used to facilitate early discharge planning. FAB 2 score (≤ 26) independently predicts discharge outcome (p<0.0001) and therefore is a valid outcome measure to determine discharge outcome of burn patients. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

The management of small area burns and unexpected illness after burn in children under five years of age - A costing study in the English healthcare setting.

PubMed

Kandiyali, R; Sarginson, J H; Hollén, L I; Spickett-Jones, F; Young, A E R

2018-02-01

The objective of this economic study was to evaluate the resource use and cost associated with the management of small area burns, including the additional costs associated with unexpected illness after burn in children of less than five years of age. This study was conducted as a secondary analysis of a multi-centre prospective observational cohort study investigating the physiological response to burns in children. 452 children were included in the economic analysis (median age=1.60years, 61.3% boys, median total burn surface area [TBSA]=1.00%) with a mean length of stay of 0.69 days. Of these children, 21.5% re-presented to medical care with an unexpected illness within fourteen days of injury. The cost of managing a burn of less than 10% TBSA in a child less than five years of age was £785. The additional cost associated with the management of illness after burn was £1381. A generalised linear regression model was used to determine the association between an unexpected illness after burn, presenting child characteristics and NHS cost. Our findings may be of value to those planning economic evaluations of novel technologies in burn care. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Long term repeated prescribed burning increases evenness in the basidiomycete laccase gene pool in forest soils.

PubMed

Artz, Rebekka R E; Reid, Eileen; Anderson, Ian C; Campbell, Colin D; Cairney, John W G

2009-03-01

Repeated prescribed burning alters the biologically labile fraction of nutrients and carbon of soil organic matter (SOM). Using a long-term (30 years) repeated burning experiment where burning has been carried out at a 2- or 4-year frequency, we analysed the effect of prescribed burning on gross potential C turnover rates and phenol oxidase activity in relation to shifts in SOM composition as observed using Fourier-transform infrared spectroscopy. In tandem, we assessed the genetic diversity of basidiomycete laccases. While the overall effect of burning was a decline in phenol oxidase activity, Shannon diversity and evenness of laccases was significantly higher in burned sites. Co-correspondence analysis of SOM composition and laccase operational taxonomic unit frequency data also suggested a strong correlation. While this correlation could indicate that the observed increase in laccase genetic diversity due to burning is due to increased resource diversity, a temporal replacement of the most abundant members of the assembly by an otherwise dormant pool of fungi cannot be excluded. As such, our results fit the intermediate disturbance hypothesis. Effects were stronger in plots burned in 2-year rotations, suggesting that the 4-year burn frequency may be a more sustainable practice to ensure the long-term stability of C cycling in such ecosystems.

Epidemiology of Burns in Rural Bangladesh: An Update

PubMed Central

He, Siran; Alonge, Olakunle; Agrawal, Priyanka; Sharmin, Shumona; Islam, Irteja; Mashreky, Saidur Rahman; Arifeen, Shams El

2017-01-01

Each year, approximately 265,000 deaths occur due to burns on a global scale. In Bangladesh, around 173,000 children under 18 sustain a burn injury. Since most epidemiological studies on burn injuries in low and middle-income countries are based on small-scale surveys or hospital records, this study aims to derive burn mortality and morbidity measures and risk factors at a population level in Bangladesh. A household survey was conducted in seven rural sub-districts of Bangladesh in 2013 to assess injury outcomes. Burn injuries were one of the external causes of injury. Epidemiological characteristics and risk factors were described using descriptive as well as univariate and multivariate logistic regression analyses. The overall mortality and morbidity rates were 2 deaths and 528 injuries per 100,000 populations. Females had a higher burn rate. More than 50% of injuries were seen in adults 25 to 64 years of age. Most injuries occurred in the kitchen while preparing food. 88% of all burns occurred due to flame. Children 1 to 4 years of age were four times more likely to sustain burn injuries as compared to infants. Age-targeted interventions, awareness of first aid protocols, and improvement of acute care management would be potential leads to curb death and disability due to burn injuries. PMID:28379160

Burn care in South Africa: a micro cosmos of Africa.

PubMed

Rode, H; Cox, S G; Numanoglu, A; Berg, A M

2014-07-01

Burn injuries in Africa are common with between 300,000 and 17.5 million children under 5 years sustaining burn injuries annually, resulting in a high estimated fatality rate. These burns are largely environmentally conditioned and therefore preventable. The Western Cape Province in South Africa can be regarded as a prototype of paediatric burns seen on the continent, with large numbers, high morbidity and mortality rates and an area inclusive of all factors contributing to this extraordinary burden of injury. Most of the mechanisms to prevent burns are not easily modified due to the restraint of low socio-economic homes, overcrowding, unsafe appliances, multiple and complex daily demands on families and multiple psycho-social stressors. Children <4 years are at highest risk of burns with an average annual rate of 6.0/10,000 child-years. Burn care in South Africa is predominantly emergency driven and variable in terms of organization, clinical management, facilities and staffing. Various treatment strategies were introduced. The management of HIV positive children poses a problem, as well as the conflict of achieving equity of burn care for all children. Without alleviating poverty, developing minimum standards for housing, burn education, safe appliances and legislation, we will not be able to reduce the "curse of poor people" and will continue to treat the consequences.

Viable placental allograft as a biological dressing in the clinical management of full-thickness thermal occupational burns

PubMed Central

Johnson, Eric L.; Tassis, Elisabet K.; Michael, Georgina M.; Whittinghill, Susan G.

2017-01-01

Abstract Rationale: Occupational burn injuries can be detrimental and difficult to manage. The majority of complex cases are referred and managed at regional burn centers where access to specialized care is available. As an alternative to hospitalization with staged surgical procedures, placental products may be used for outpatient medical management of these common burn injuries, especially if access to a regional burn center is limited or restricted. Fresh amnion has been a treatment of choice in burns for more than 100 years. As a biological covering with a broad scope of potential uses, human placental membranes represent a dressing that is particularly advantageous for burn therapy. Recent advances in tissue-preservation technology have allowed for the commercialization of placental amnion products. Patient concerns: To address several complications associated with burn injuries—contractures, scar formation, and pain—a viable cryopreserved placental membrane (vCPM) (Grafix—PRIME, Osiris Therapeutics, Inc., MD) retaining the anti-inflammatory, anti-fibrotic, and antimicrobial properties of fresh placental tissues was chosen for clinical use in the 2 cases reported, where both patients had restricted access to the regional burn center. Diagnoses: Two cases of work-related extremity burns presented to a local rural hospital for immediate post-injury assessment. The 1st case was of a man who sustained a 55.4 cm2 full-thickness 3rd degree thermal burn with exposed bone and tendon, to the left dorsal forefoot after having an industrial pressure washer caught on his work boot. The 2nd case was of a female who sustained a 4.7 cm2 full-thickness 3rd degree crush burn to the dorsum extensor surface of her dominant hand's index finger after applying 80-pounds per square inch of heated pressure from a hydraulic press. Interventions: Both burn patients elected to continue their care at the outpatient-based wound and hyperbaric center, receiving a combination of weekly ad libitum debridement, applications of vCPM, and occupational therapy. Outcomes: Both burns reached timely wound closure, and patients regained full range of motion of the affected limb, allowing for early return to work. The average number of allograft applications was 7.5, allowing both patients to return to work in an average of 63.5 days without adverse events or post-treatment complications. Lessons: The incorporation of this product in the treatment of these complex burns prevented amputation in one patient, and skin autografting and potential index finger contracture-formation in the second patient. The incorporation of vCPM in burn management may offer a new approach to outpatient burn management and may mitigate several of the complications seen post burn injury, leading to favorable patient outcomes. PMID:29245303

[An epidemiological investigation of pediatric patients under 14 with large area burns: a multicenter study].

PubMed

Cheng, W F; Zhao, D X; Shen, Z A; Zhang, H Y; Tu, J J; Yuan, Z Q; Duan, P; Song, G D

2017-02-14

Objective: To investigate and evaluate the epidemiological characteristics of patients under 14 with large area burns in China. Methods: Data of pediatric patients aged 0-14yr with ≥30% total body surface area (TBSA) burned admitted into 106 burn centers in the mainland of China in 2014 were retrieved. The children were divided into three age groups: 0-3, 4-6 and 7-14 years according to the age. Information of age, gender, time of burn injury, causes of burns, admission time, prehospital emergency care of burn wound, burn area, inhalation injuries, the case fatality rate and length of hospital stay were collected for analysis. Results: Of the 486 cases included, 285 (58.6%) were boys and 201 (41.4%) were girls. The mean age of the children was (3.4±2.8) years. Children under 3 years old accounted for 67.5% of all the cases. 271 of the burn injuries (55.8%) occurred from April through August. Scalds and flames were the main causes of burns, which were the causes of 394 cases (81.1%) and 71 cases (14.6%), respectively. The burn injuries resulted from scalds and flames accounted for 89.6% and 7.3%, 70.8% and 21.9%, 51.6% and 41.9% in the age group of 0-3, 4-6 and 7-14 years respectively. The distribution of burn etiology in different age groups differed significantly (χ(2)=21.239, 59.442, 7.333, all P <0.01). Most of the patients (57.8%) were admitted within 2 hours after injury. However, when it came to the pre-hospital emergency management of burn wound, 164 patients (33.7%) did not use any drug or wound dressing, whereas the wound area of 236 patients (48.6%) were treated improperly with toothpaste, soy sauce, eggs or other non-standard disposal. The mean TBSA area of the patients was (42.1±14.5)%, while 288 (59.3%) of the patients suffered full thickness burns with mean TBSA of (24.5±17.9)%. The case fatality rate (CFR) was 4.1%, and the CFR of patients complicated with inhalation injury was significantly higher than those without ( P <0.01). The average length of stay for pediatric burn patients was (52.3±40.2) days. Conclusions: Children under 3 years old are important target population of severe burns. Scald is the most common type of burns, while the proportion of flames increases as age goes up. Most patients are likely to get clinical treatment in time, however, the pre-hospital emergency burn care is not satisfying at present.

Inflammatory response in multiple organs in a mouse model of acute alcohol intoxication and burn injury*

PubMed Central

Li, Xiaoling; Akhtar, Suhail; Kovacs, Elizabeth J.; Gamelli, Richard L.; Choudhry, Mashkoor A.

2011-01-01

The present study characterized the inflammatory response following burn injury and determined whether ethanol (EtOH) intoxication at the time of burn injury influences this response. To accomplish this, male mice were gavaged with EtOH (2.9 g/Kg) 4 hours prior to 12–15% total body surface area sham or burn injury. Mice were sacrificed on day one after injury; blood, small intestine, lung and liver were collected to measure IL-6, IL-10, IL-18 and MCP-1 levels. In addition, neutrophil infiltration, MPO activity and edema formation were also measured in the small intestine, lung and liver. There was no difference in the inflammatory markers in the small intestine, lung and liver in mice receiving either sham or burn injury alone except IL-6 which was increased in all 4 tissue compartments following burn injury alone. However, as compared to EtOH or burn injury alone, EtOH combined with burn injury resulted in a significant increase in cytokines, neutrophil infiltration, MPO activity and edema in the small intestine, liver and lung tissue. Furthermore, a significant increase in IL-6 and MCP-1 was observed in circulation following EtOH and burn injury compared to either EtOH intoxication or burn injury alone, no other cytokines were detected in circulation. These findings suggest that acute EtOH intoxication exacerbates the inflammatory response following burn injury. PMID:21593683

The Hand Burn Severity (HABS) score: A simple tool for stratifying severity of hand burns.

PubMed

Bache, Sarah E; Fitzgerald O'Connor, Edmund; Theodorakopoulou, Evgenia; Frew, Quentin; Philp, Bruce; Dziewulski, Peter

2017-02-01

Hand burns represent a unique challenge to the burns team due to the intricate structure and unrivalled functional importance of the hand. The initial assessment and prognosis relies on consideration of the specific site involved as well as depth of the burn. We created a simple severity score that could be used by referring non-specialists and researchers alike. The Hand Burn Severity (HABS) score stratifies hand burns according to severity with a numerical value of between 0 (no burn) and 18 (most severe) per hand. Three independent assessors scored the photographs of 121 burned hands of 106 adult and paediatric patients, demonstrating excellent inter-rater reliability (r=0.91, p<0.0001 on testing with Lin's correlation coefficient). A significant relationship was shown between the HABS score and a reliable binary outcome of the requirement for surgical excision on Mann-Whitney U testing (U=152; Z=9.8; p=0.0001). A receiver operator characteristic (ROC) curve analysis found a cut off score of 5.5, indicating that those with a HABS score below 6 did not require an operation, whereas those with a score above 6 did. The HABS score was shown to be more sensitive and specific that assessment of burn depth alone. The HABS score is a simple to use tool to stratify severity at initial presentation of hand burns which will be useful when referring, and when reporting outcomes. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Developing a burn injury severity score (BISS): adding age and total body surface area burned to the injury severity score (ISS) improves mortality concordance.

PubMed

Cassidy, J Tristan; Phillips, Michael; Fatovich, Daniel; Duke, Janine; Edgar, Dale; Wood, Fiona

2014-08-01

There is limited research validating the injury severity score (ISS) in burns. We examined the concordance of ISS with burn mortality. We hypothesized that combining age and total body surface area (TBSA) burned to the ISS gives a more accurate mortality risk estimate. Data from the Royal Perth Hospital Trauma Registry and the Royal Perth Hospital Burns Minimum Data Set were linked. Area under the receiver operating characteristic curve (AUC) measured concordance of ISS with mortality. Using logistic regression models with death as the dependent variable we developed a burn-specific injury severity score (BISS). There were 1344 burns with 24 (1.8%) deaths, median TBSA 5% (IQR 2-10), and median age 36 years (IQR 23-50). The results show ISS is a good predictor of death for burns when ISS≤15 (OR 1.29, p=0.02), but not for ISS>15 (ISS 16-24: OR 1.09, p=0.81; ISS 25-49: OR 0.81, p=0.19). Comparing the AUCs adjusted for age, gender and cause, ISS of 84% (95% CI 82-85%) and BISS of 95% (95% CI 92-98%), demonstrated superior performance of BISS as a mortality predictor for burns. ISS is a poor predictor of death in severe burns. The BISS combines ISS with age and TBSA and performs significantly better than the ISS. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Alcohol potentiates post burn remote organ damage through shifts in fluid compartments mediated by bradykinin

PubMed Central

Chen, Michael M.; O’Halloran, Eileen B.; Ippolito, Jill A.; Choudhry, Mashkoor A.; Kovacs, Elizabeth J.

2014-01-01

Of the 450,000 burn patients each year, 50% have a positive blood alcohol content and this predisposes them to worsened clinical outcomes. Despite high prevalence and established consequences, the mechanisms responsible for alcohol-mediated complications of post burn remote organ damage are currently unknown. To this end, mice received a single dose of alcohol (1.12 g/kg) or water by oral gavage and were subjected to a 15% total body surface area burn. Animals with a burn alone lost ~5% of their body weight in 24 hours whereas intoxicated and burned mice lost only 1% body weight (p<0.05) despite a 17% increase in hematocrit (p<0.05) and a 57% increase in serum creatinine (p<0.05) over burn injury alone. This retention of water weight despite increased dehydration suggests that intoxication at the time of a burn causes a shift in fluid compartments that may exacerbate end organ ischemia and damage as evidenced by a 3-fold increase in intestinal bacterial translocation (p<0.05), a 30% increase (p<0.05) in liver weight to body weight ratio, and an increase in alveolar wall thickness over a burn alone. Furthermore, administration of the bradykinin antagonist HOE140 30 minutes after intoxication and burn restored fluid balance and alleviated end organ damage. These findings suggest that alcohol potentiates post burn remote organ damage through shifts in fluid compartments mediated by bradykinin. PMID:25243425

Possible risk factors associated with burn wound colonization in burn units of Gaza strip hospitals, Palestine

PubMed Central

Al Laham, N.A.; Elmanama, A.A.; Tayh, G.A.

2013-01-01

Summary The epidemiological pattern and risk factors of burns and burn infections varies widely in different parts of the world. This study aims to determine the epidemiologic pattern of burn injuries and possible risk factors associated with burn infections in burn units of Gaza strip hospitals. A total of 118 patients were included in the study. The data collected included: patient age and gender, the causes, site, degree, and TBSA of the burns, as well as surgical operations, length of hospital stay, and microbiological profile of samples collected from patients, the environment, and from health care staff. Pediatric and adult patients accounted for 72% and 28% respectively. 58.5% of all patients were male and 41.5% were female. The most common etiological factors in children were scalding, while in adults these were open fire and flammable liquids. The mean TBSA was 12% with a range from 1–90%. Second and third degree burns accounted for 78% and 22% respectively. The area of the body most often affected was the torso (39%), followed by the lower limb (29.7%), and upper limb (17.8%). The predominant microorganisms isolated from burn wounds were Pseudomonas aeruginosa, Enterobacter spp. and Staphylococcus spp. The study showed the highest risk groups to be children and males, and enabled us to identify possible risk factors that can help in future efforts toward prevention and minimizing nosocomial infections in burn units of Gaza strip hospitals. PMID:24133399

Epidemiology and man-days loss in burn injuries amongst workers in an oil industry.

PubMed

Sarma, B P

2001-08-01

This retrospective study, conducted at the Indian Oil Corporation Ltd. (Assam Oil Division) Hospital, Digboi, in a period of 5 yr amongst workers of IOC Ltd. (AOD) describes work-associated injuries. Out of 2320 cases of different types of injuries involving workers over this period, 820 (35.3%) occurred at the workplace. 1430 (61.6%) at home or other places and 70 (3.1%) occurred on way to the workplace. Burn injuries were found in 132 cases (5.8% of the total injuries), but constituted 12.6% of the accidents at the workplace. The majority of the other injuries were soft tissue injuries, including sprains 1288 (55.5%) and hand injuries 688 (29.5%). Major burns (above 20% BSB) were found only in 5 cases. The most common sites of involvement in minor burns were the hands (45 cases), the legs (35 cases) and face (20 cases) with the remaining involving the chest and abdomen. Scald injury was observed in 66/132 (50%) cases, contact burns in 13/132 (10%) cases, flame burns in 33/132 (25%) cases, chemical burns in 11/132 (8.3%), and electrical burns in 9/132 (7%) cases. Mortality was 1.5%. Working days lost (man-days loss) in burn injuries was found to be higher in comparison to other injuries of similar severity. Causation of industrial burns is discussed and importance of prevention of burns in industries has been emphasised.

Contributions of Severe Burn and Disuse to Bone Structure and Strength in Rats

PubMed Central

Baer, L.A.; Wu, X.; Tou, J. C.; Johnson, E.; Wolf, S.E.; Wade, C.E.

2012-01-01

Burn and disuse results in metabolic and bone changes associated with substantial and sustained bone loss. Such loss can lead to an increased fracture incidence and osteopenia. We studied the independent effects of burn and disuse on bone morphology, composition and strength, and microstructure of the bone alterations 14 days after injury. Sprague-Dawley rats were randomized into four groups: Sham/Ambulatory (SA), Burn/Ambulatory (BA), Sham/Hindlimb Unloaded (SH) and Burn/Hindlimb Unloaded (BH). Burn groups received a 40% total body surface area full-thickness scald burn. Disuse by hindlimb unloading was initiated immediately following injury. Bone turnover was determined in plasma and urine. Femur biomechanical parameters were measured by three-point bending tests and bone microarchitecture was determined by microcomputed tomography (uCT). On day 14, a significant reduction in body mass was observed as a result of burn, disuse and a combination of both. In terms of bone health, disuse alone and in combination affected femur weight, length and bone mineral content. Bending failure energy, an index of femur strength, was significantly reduced in all groups and maximum bending stress was lower when burn and disuse were combined. Osteocalcin was reduced in BA compared to the other groups, indicating influence of burn. The reductions observed in femur weight, BMC, biomechanical parameters and indices of bone formation are primarily responses to the combination of burn and disuse. These results offer insight into bone degradation following severe injury and disuse. PMID:23142361

Epidemiology and screening of intentional burns in children in a Dutch burn centre.

PubMed

Bousema, Sara; Stas, Helene G; van de Merwe, Marjolijn H; Oen, Irma M M H; Baartmans, Martin G A; van Baar, Margriet E

2016-09-01

International estimates of the incidence of non-accidental burns (NAB) in children admitted to burn centres vary from 1% to 25%. Hardly any data about Dutch figures exist. The aim of this study was to evaluate the incidence, treatment and outcome of burns due to suspected child abuse in paediatric burns. We described the process of care and outcome, including the accuracy of the SPUTOVAMO screening tool and examined child, burn and treatment characteristics related to suspicions of child abuse or neglect. A retrospective study was conducted in children aged 0-17 years with a primary admission after burn injuries to the burn centre Rotterdam in the period 2009-2013. Data on patient, injury and treatment characteristics were collected, using the Dutch Burn Repository R3. In addition, medical records were reviewed. In 498 paediatric admissions, suspected child abuse or neglect was present in 43 children (9%). 442 screening questionnaires (89%) were completed. In 52 out of 442 questionnaires (12%) the completed SPUTOVAMO had one or more positive signs. Significant independent predictors for suspected child abuse were burns in the genital area or buttocks (OR=3.29; CI: 143-7.55) and a low socio-economic status (OR=2.52; 95%CI: 1.30-4.90). The incidence of suspected child abuse indicating generation of additional support in our population is comparable to studies with a similar design in other countries. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Development of the crop residue and rangeland burning in the ...

EPA Pesticide Factsheets

Biomass burning has been identified as an important contributor to the degradation of air quality because of its impact on ozone and particulate matter. One component of the biomass burning inventory, crop residue burning, has been poorly characterized in the National Emissions Inventory (NEI). In the 2011 NEI, wildland fires, prescribed fires, and crop residue burning collectively were the largest source of PM2.5. This paper summarizes our 2014 NEI method to estimate crop residue burning emissions and grass/pasture burning emissions using remote sensing data and field information and literature-based, crop-specific emission factors. We focus on both the postharvest and pre-harvest burning that takes place with bluegrass, corn, cotton, rice, soybeans, sugarcane and wheat. Estimates for 2014 indicate that over the continental United States (CONUS), crop residue burning excluding all areas identified as Pasture/Grass, Grassland Herbaceous, and Pasture/Hay occurred over approximately 1.5 million acres of land and produced 19,600 short tons of PM2.5. For areas identified as Pasture/Grass, Grassland Herbaceous, and Pasture/Hay, biomass burning emissions occurred over approximately 1.6 million acres of land and produced 30,000 short tons of PM2.5. This estimate compares with the 2011 NEI and 2008 NEI as follows: 2008: 49,650 short tons and 2011: 141,180 short tons. Note that in the previous two NEIs rangeland burning was not well defined and so the comparison is not e

[Effects of low-dose insulin on oxidation-reduction in rat organs after major burns].

PubMed

Wang, Wei; Jiang, Hong-mei; Li, Wei-ren; Zuo, Lu; Tao, Lei; Yu, Xiang

2013-11-12

To explore the effects of low-dose insulin on oxidation-reduction of heart and kidney in rats immediately after severe burns. Twenty four male Sprague-Dawley (SD) rats were randomly divided into 3 groups of sham burn, burn and treatment (n = 8 each). The sham burn group was placed into 37 °C warm water for 15 seconds to simulate burn process and received no fluid replacement. The burn and treatment groups were immersed into (95 ± 0.5) °C hot water for 15 seconds to make a rat model of 30% total burn surface area, III degree burn injury and immediately received an intraperitoneal injection of physiological saline (40 ml/kg). At the same time, a subcutaneous injection of insulin (1.0 U×kg(-1)×d(-1)) was given in the treatment group and a subcutaneous injection of same-volume physiological saline in the burn group. The rats were sacrificed after 24 post-scald hours (PSH). Abdominal aortic blood was collected for an analysis of blood glucose. The oxidation and antioxidation parameters of heart and kidney, such as malondialdehyde (MDA), xanthine oxidase (XO), myeloperoxidase (MPO), total superoxide dismutase (T-SOD), superoxide dismutase 1, 2 (SOD1, 2), catalase (CAT) and glutathione peroxidase (GPx), were detected by spectrophotometry. Compared with the sham burn group, MDA content, XO and MPO activities of heart and kidney were significantly higher in the burn group (all P < 0.05); in the treatment group, MDA content and XO activity of heart were significantly lower than the burn group ((0.85 ± 0.07) vs (1.11 ± 0.07) nmol/mg, (69.72 ± 1.94) vs (77.21 ± 2.10) U/g) while the MPO activities of heart and kidney were significantly lower (all P < 0.05).compared with the sham burn group, the activities of T-SOD, CAT, GPx of heart and kidney were significantly lower in the burn group, SOD1 activity of kidney was significantly lower, but SOD2 activity of kidney was significantly higher while SOD2 activity of heart was significantly lower (all P < 0.05); Compared with the burn group, the activities of T-SOD and SOD1 of heart in the treatment group were significantly higher ((83.5 ± 2.5) vs (79.6 ± 3.2), (62.8 ± 2.3) vs (58.8 ± 3.0) U/mg), CAT and GPx activity of heart and kidney were significantly higher (all P < 0.05). Compared with the sham burn group, blood glucose in the burn and treatment group were significantly higher ((7.81 ± 0.30), (7.19 ± 0.22) vs (6.30 ± 0.24) mmol/L) and blood glucose in the treatment group was significantly lower than the burn group((7.81 ± 0.30) mmol/L)(all P < 0.05). During an early stage, a low-dose insulin may intervene in heart tissue lipid peroxidation of severely burned rats. And differences exist in the effects of oxidation-reduction between heart and kidney.

Learn Not To Burn.

ERIC Educational Resources Information Center

English, Nancy; Hendricks, Charlotte M.

1997-01-01

Describes the "Learn Not to Burn Preschool Program," a low-cost fire safety awareness and burn prevention curriculum for young children. The program promotes eight burn prevention methods--including practicing an escape plan--using developmentally appropriate learning objectives to increase children's fire safety knowledge, skill, and…

Photoacoustic signal measurement for burned skins in the spectral range of 500-650 nm: experiment with rat burn models

NASA Astrophysics Data System (ADS)

Yamazaki, Mutsuo; Sato, Shunichi; Saito, Daizo; Fujita, Masanori; Okada, Yoshiaki; Kikuchi, Makoto; Ashida, Hiroshi; Obara, Minoru

2002-06-01

This paper reports the burn diagnosis that is based on the measurement of photoacoustic waves from skin, where the acoustic waves originate from the absorption of light by blood. For this purpose, a transducer composed of a ring-shaped piezoelectric film and a quartz fiber was made. An optical parametric oscillator (500 - 650 nm) was used as a light source and its output pulses were coupled to the quartz fiber. To investigate the optimum light wavelength, we conducted experiments using rat burn models. We demonstrated that the superficial dermal burn (SDB), deep dermal burn (DDB), deep burn (DB), and control (healthy skin) could be clearly differentiated based on the photoacoustic signals induced by the light of 532 - 580nm.

Training and burn care in rural India

PubMed Central

Chamania, Shobha

2010-01-01

Burn care is a huge challenge in India, having the highest female mortality globally due to flame burns. Burns can happen anywhere, but are more common in the rural region, affecting the poor. Most common cause is flame burns, the culprit being kerosene and flammable flowing garments worn by the women. The infrastructure of healthcare network is good but there is a severe resource crunch. In order to bring a positive change, there will have to be more trained personnel willing to work in the rural areas. Strategies for prevention and training of burn team are discussed along with suggestions on making the career package attractive and satisfying. This will positively translate into improved outcomes in the burns managed in the rural region and quick transfer to appropriate facility for those requiring specialised attention. PMID:21321647

Physical rehabilitation of pediatric burns.

PubMed

Atiyeh, B; Janom, H H

2014-03-31

Significant improvements have been made in the acute treatment of pediatric burn injuries over the past 3 decades which have significantly decreased mortality. Each year, more burned children are necessitating serious medical attention during their convalescence. For children with serious consequences resulting from burns that can persist from childhood through adolescence into adulthood, the value of long-term rehabilitation cannot be over stated. Burn injury management should not focus only on the immediate treatment. Long-term functional outcome and the required rehabilitation that burn victims must go through should be given equal if not more attention. The present is a review of the available modalities utilized for the physical rehabilitation of convalescent pediatric burns in order to overcome the catabolic state, improve muscle power and fitness, reduce disfiguring scars and prevent contractures.

Myelo-erythroid commitment after burn injury is under β-adrenergic control via MafB regulation.

PubMed

Hasan, Shirin; Johnson, Nicholas B; Mosier, Michael J; Shankar, Ravi; Conrad, Peggie; Szilagyi, Andrea; Gamelli, Richard L; Muthumalaiappan, Kuzhali

2017-03-01

Severely injured burn patients receive multiple blood transfusions for anemia of critical illness despite the adverse consequences. One limiting factor to consider alternate treatment strategies is the lack of a reliable test platform to study molecular mechanisms of impaired erythropoiesis. This study illustrates how conditions resulting in a high catecholamine microenvironment such as burns can instigate myelo-erythroid reprioritization influenced by β-adrenergic stimulation leading to anemia. In a mouse model of scald burn injury, we observed, along with a threefold increase in bone marrow LSK cells (lin neg Sca1 + cKit + ), that the myeloid shift is accompanied with a significant reduction in megakaryocyte erythrocyte progenitors (MEPs). β-Blocker administration (propranolol) for 6 days after burn, not only reduced the number of LSKs and MafB + cells in multipotent progenitors, but also influenced myelo-erythroid bifurcation by increasing the MEPs and reducing the granulocyte monocyte progenitors in the bone marrow of burn mice. Furthermore, similar results were observed in burn patients' peripheral blood mononuclear cell-derived ex vivo culture system, demonstrating that commitment stage of erythropoiesis is impaired in burn patients and intervention with propranolol (nonselective β1,2-adrenergic blocker) increases MEPs. Also, MafB + cells that were significantly increased following standard burn care could be mitigated when propranolol was administered to burn patients, establishing the mechanistic regulation of erythroid commitment by myeloid regulatory transcription factor MafB. Overall, results demonstrate that β-adrenergic blockers following burn injury can redirect the hematopoietic commitment toward erythroid lineage by lowering MafB expression in multipotent progenitors and be of potential therapeutic value to increase erythropoietin responsiveness in burn patients. Copyright © 2017 the American Physiological Society.

Biological markers of stress in pediatric acute burn injury.

PubMed

Brown, Nadia J; Kimble, Roy M; Rodger, Sylvia; Ware, Robert S; McWhinney, Brett C; Ungerer, Jacobus P J; Cuttle, Leila

2014-08-01

Burns and their associated wound care procedures evoke significant stress and anxiety, particularly for children. Little is known about the body's physiological stress reactions throughout the stages of re-epithelialization following an acute burn injury. Previously, serum and urinary cortisol have been used to measure stress in burn patients, however these measures are not suitable for a pediatric burn outpatient setting. To assess the sensitivity of salivary cortisol and sAA in detecting stress during acute burn wound care procedures and to investigate the body's physiological stress reactions throughout burn re-epithelialization. Seventy-seven participants aged four to thirteen years who presented with an acute burn injury to the burn center at the Royal Children's Hospital, Brisbane, Australia, were recruited between August 2011 and August 2012. Both biomarkers were responsive to the stress of burn wound care procedures. sAA levels were on average 50.2 U/ml higher (p<0.001) at 10 min post-dressing removal compared to baseline levels. Salivary cortisol levels showed a blunted effect with average levels at ten minutes post dressing removal decreasing by 0.54 nmol/L (p<0.001) compared to baseline levels. sAA levels were associated with pain (p=0.021), no medication (p=0.047) and Child Trauma Screening Questionnaire scores at three months post re-epithelialization (p=0.008). Similarly, salivary cortisol was associated with no medication (p<0.001), pain scores (p=0.045) and total body surface area of the burn (p=0.010). Factors which support the use of sAA over salivary cortisol to assess stress during morning acute burn wound care procedures include; sensitivity, morning clinic times relative to cortisol's diurnal peaks, and relative cost. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Comprehensive Examination of Bottom Ash, Soil Dust, and Direct Emissions and Aging of Laboratory Biomass Burning as Potential Sources of Ice Nucleating Particles

NASA Astrophysics Data System (ADS)

Polen, M.; Jahl, L.; Jahn, L.; Somers, J.; Sullivan, R. C.

2017-12-01

Recent laboratory and field studies have found that biomass burning can produce ice nucleating particles (INP) with varying efficiencies depending on fuel and burn conditions. Few studies have examined the ice nucleating potential of bottom ash, which has the potential to be lofted during intense burning events. To date, no publications have examined the impact of atmospheric aging or lofted soil particles on INP emitted from biomass burning. This study investigated each of these aspects through laboratory biomass fuel combustion studies. We burned a number of grasses from different locations, and collected filter samples of fresh and photochemically aged biomass burning aerosol, as well as bottom ash collected after the burn. Some burns included soil that the grasses grew in to test for the importance of soil dust to INP emissions lofting during intense fires. The composition and mixing state of the aerosol was determined using a suite of online and offline single-particle techniques. Our findings suggest that bottom ash is a relatively weak INP, but all samples froze consistently at -20 °C < T < -25 °C. We also found that oxidation of the biomass burning aerosol typically enhances ice nucleating activity over fresh, unaged particles, increasing the ice active site surface density by up to a factor of 3 at T = -25 °C. Lastly, the presence of soil dust can greatly enhance INP concentrations for biomass burning events with an increase in the freezing temperature spectrum by > 3 °C. Detailed analysis of these samples aims to provide a clearer understanding of what components of biomass burning increase the ambient concentrations of ice nucleation active particles, and how their ice nucleation properties evolve during atmospheric aging.

Ponderosa pine snag densities following multiple fires in the Gila Wilderness, New Mexico

USGS Publications Warehouse

Holden, Z.A.; Morgan, P.; Rollins, M.G.; Wright, R.G.

2006-01-01

Fires create and consume snags (standing dead trees), an important structural and ecological component of ponderosa pine forests. The effects of repeated fires on snag densities in ponderosa pine forests of the southwestern USA have not been studied. Line intercept sampling was used to estimate snag densities in areas of the Gila Wilderness that had burned one to three times under Wildland Fire Use for Resource Benefit (WFU), a fire management policy implemented since 1974 aimed at restoring natural fire regimes. Twenty randomly located transects were measured in areas burned since 1946; six in once-burned areas, six in twice-burned areas and eight in thrice-burned areas. The mean density ?? standard errors of large (>47.5 cm dbh) snags for areas that burned once, twice and thrice was 7.0 ?? 2.7, 4.4 ?? 1.1 and 4.1 ?? 1.3 snags/ha, respectively. Differences in snag densities between once- and multiple-burned areas were significant (F-test; p < 0.05). There was no significant difference in density of large snags between twice- and thrice-burned areas. Proportions of type 1 snags (recently created) were higher in once- and twice-burned areas than in areas that burned three times, likely reflecting high tree mortality and snag recruitment resulting from an initial entry fire. Type 3 snags (charred by previous fire) were more abundant in areas that burned multiple times. The lack of differences in snag densities between areas that burned two and three times suggests that repeated fires leave many snags standing. The increasing proportion of type 3 snags with repeated fires supports this conclusion. ?? 2005 Elsevier B.V. All rights reserved.

Burn care delivery in a sub-saharan african unit: A cost analysis study.

PubMed

Gallaher, Jared R; Mjuweni, Stephen; Cairns, Bruce A; Charles, Anthony G

2015-07-01

There are significant resource challenges to burn surgical care delivery in low and middle-income countries at baseline and only a few burn cost analysis studies from sub-Saharan Africa have been performed. This is a retrospective database analysis of prospectively collected data from all patients recorded in the burn registry between June 2011 and August 2014 located at the Kamuzu Central Hospital Burn Unit in Lilongwe, Malawi. We utilized activity-based costing, a bottom-up cost analysis methodology with cost allocation that allows determination of unit cost or cost per service. 905 patients were admitted to the burn unit during the study period. The calculated total monthly burn expenditure for all cost centers was $11,622.66. Per day, the total unit cost was $387.42 with a mean daily per-patient cost of $24.26 (SD ± $6.44). Consequently, the mean cost per in-patient admission was $559.85 (SD ± $736.17). The mean daily cost per 1% total burn surface per patient at our center is $2.65 (SD ± $3.01). This burn care cost analysis study helps quantify the relative contribution of differing cost centers that comprise burn care delivery and hospital costs in a sub-Saharan African setting. Accurate and relevant cost information on hospital services at the patient level is therefore fundamental for policy makers, payers, and hospitals. Our study has demonstrated that comprehensive burn care is possible at a cost much lower than found in other burn centers in low or middle-income countries and can be sustained with moderate funding. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Adult survivors' lived experience of burns and post-burn health: A qualitative analysis.

PubMed

Abrams, Thereasa E; Ogletree, Roberta J; Ratnapradipa, Dhitinut; Neumeister, Michael W

2016-02-01

The individual implications of major burns are likely to affect the full spectrum of patients' physical, emotional, psychological, social, environmental, spiritual and vocational health. Yet, not all of the post-burn health implications are inevitably negative. Utilizing a qualitative approach, this heuristic phenomenological study explores the experiences and perceptions early (ages 18-35) and midlife (ages 36-64) adults providing insight for how participants perceived their burns in relationship to their post-burn health. Participants were interviewed using semi-structured interview questions framed around seven domains of health. Interview recordings were transcribed verbatim then coded line by line, identifying dominant categories related to health. Categories were analyzed identifying shared themes among the study sample. Participants were Caucasian, seven males and one female. Mean age at time of interviews was 54.38 and 42.38 at time of burns. Mean time since burns occurred was 9.38 years with a minimum of (20%) total body surface area (TBSA) burns. Qualitative content analysis rendered three emergent health-related categories and associated themes that represented shared meanings within the participant sample. The category of "Physical Health" reflected the theme physical limitations, pain and sensitivity to temperature. Within the category of "Intellectual Health" were themes of insight, goal setting and self-efficacy, optimism and humor and within "Emotional Health" were the themes empathy and gratitude. By exploring subjective experiences and perceptions of health shared through dialog with experienced burned persons, there are opportunities to develop a more complete picture of how holistic health may be affected by major burns that in turn could support future long-term rehabilitative trajectories of early and midlife adult burn patients. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

How Much Global Burned Area Can Be Forecast on Seasonal Time Scales Using Sea Surface Temperatures?

NASA Technical Reports Server (NTRS)

Chen, Yang; Morton, Douglas C.; Andela, Niels; Giglio, Louis; Randerson, James T.

2016-01-01

Large-scale sea surface temperature (SST) patterns influence the interannual variability of burned area in many regions by means of climate controls on fuel continuity, amount, and moisture content. Some of the variability in burned area is predictable on seasonal timescales because fuel characteristics respond to the cumulative effects of climate prior to the onset of the fire season. Here we systematically evaluated the degree to which annual burned area from the Global Fire Emissions Database version 4 with small fires (GFED4s) can be predicted using SSTs from 14 different ocean regions. We found that about 48 of global burned area can be forecast with a correlation coefficient that is significant at a p < 0.01 level using a single ocean climate index (OCI) 3 or more months prior to the month of peak burning. Continental regions where burned area had a higher degree of predictability included equatorial Asia, where 92% of the burned area exceeded the correlation threshold, and Central America, where 86% of the burned area exceeded this threshold. Pacific Ocean indices describing the El Nino-Southern Oscillation were more important than indices from other ocean basins, accounting for about 1/3 of the total predictable global burned area. A model that combined two indices from different oceans considerably improved model performance, suggesting that fires in many regions respond to forcing from more than one ocean basin. Using OCI-burned area relationships and a clustering algorithm, we identified 12 hotspot regions in which fires had a consistent response to SST patterns. Annual burned area in these regions can be predicted with moderate confidence levels, suggesting operational forecasts may be possible with the aim of improving ecosystem management.

Severe childhood burns in the Czech Republic: risk factors and prevention

PubMed Central

Čelko, Alexander Martin; Dáňová, Jana; Barss, Peter

2009-01-01

Abstract Objective To assess risk factors for paediatric burn injuries in the Czech Republic and to suggest preventive measures. Methods This study included all children aged 0–16 years hospitalized during 1993–2000 at the Prague Burn Centre and data from the Czech Ministry of Health on national paediatric burn hospitalizations during 1996–2006. Personal, equipment and environmental risk factors were identified from hospital records. Findings The incidence of burn admissions among 0–14 year-olds increased from 85 to 96 per 100 000 between 1996 and 2006, mainly due to a 13% increase among 1–4 year-olds. Between 1993–2000 and 2006, the proportion of burn victims in the country hospitalized at the Prague Burn Centre increased from 9% to 21%. Detailed data were available on 1064 children (64% boys). Around 31% of all burn hospitalizations were in 1 year-olds. Some 79% of burns occurred at home: 70% in the kitchen, 14% in the living room or bedroom and 11% in the bathroom. Of the 18% occurring outdoors, 80% involved boys. Scalds from hot liquids accounted for 70% of all burns. The mean hospital stay was 22 days for boys and 18 days for girls. Conclusion Most burns involved scalds from hot liquids at home: beverages in kitchens and water in bathrooms. There is a need for passive preventive measures, such as redesigned domestic cooking and eating areas, safer electrical kettles and temperature control devices for bathrooms. Educational programmes should be developed for parents and caregivers. A national plan for child burn prevention with specific targets would be helpful. PMID:19551256

Oriental bittersweet (Celastrus orbiculatus): Spreading by fire

USGS Publications Warehouse

Pavlovic, Noel B.; Leicht-Young, Stacey A.; Grundel, Ralph

2016-01-01

In many forest ecosystems, fire is critical in maintaining indigenous plant communities, but can either promote or arrest the spread of invasive species depending on their regeneration niche and resprouting ability. We examined the effects of cutting and burning treatments on the vegetative response (cover, stem density) and root resources of Oriental bittersweet (Celastrus orbiculatus), a liana invasive to North America that was introduced from East Asia. Treatments were control, spring cut, spring burn, spring cut & burn, summer cut, fall cut, fall burn, fall cut & burn, and fall herbicide. Cover was reduced the greatest by herbicide and summer cutting treatments, but increased more in the second year on moraine soils than on sandy soils. Burning and cutting & burning combined resulted in a resprout density four times greater than stem density prior to treatment for stems <2.5 mm diameter than cutting alone. For stems, across all diameter classes, there was a more than 100% increase in stem density with burning and almost a 300% increase in stem density with cutting & burning in the spring. Density of resprouts and root-suckers, and survival increased with increasing stem size. While cutting of C. orbiculatus during the growing season (summer) reduced total nonstructural carbohydrates by 50% below early growing season levels and 75% below dormant season levels, burning did not significantly reduce total nonstructural carbohydrates. Thus, Oriental bittersweet is quite responsive to burning as a disturbance and resprouting and root-suckering creates additional opportunities for growth and attainment of the forest canopy. The positive response of Oriental bittersweet to burning has important implications for management of invasive lianas in fire-dependent forest landscapes.

Terror-inflicted thermal injury: A retrospective analysis of burns in the Israeli-Palestinian conflict between the years 1997 and 2003.

PubMed

Haik, Josef; Tessone, Ariel; Givon, Adi; Liran, Alon; Winkler, Eyal; Mendes, David; Goldan, Oren; Bar-Meir, Eran; Regev, Eli; Orenstein, Arie; Peleg, Kobi

2006-12-01

Terror attacks have changed in the past decade, with a growing tendency toward explosives and suicide bombings, which led to a rise in the incidence of thermal injuries among victims. The Israeli-Palestinian conflict of October 2000 marked a turning point when an organized terror campaign commenced. This article presents data of terror-associated burns from the Israeli National Trauma Registry (ITR) during the years 1997 to September 2000 and October 2000 to 2003. We analyzed demographic and clinical characteristics of 219 terror-related burn patients and 6,546 other burn patients admitted to hospitals in Israel between 1997 and 2003. Data were obtained from the ITR. Burns contributed about 9% of all terror related trauma and about 5% of all other trauma (p < 0.0001). These percentages have not changed significantly before and after October 2000. Terror-related burns afflict Jewish males more than predicted by their percentage in the population, whereas other burns afflict non-Jewish males more than predicted. Adults and young adults (15-59 years) are the predominant group in terror-related burns (80%), whereas children younger than 15 years are the predominant group in other burns (50%). Large burns (20% to 89% total body surface area) are more common in terror casualties, with greater mortality (6.4% in terror-related versus 3.4% in others; p = 0.0258). Although the incidence of burns has risen because of an organized campaign, this change was noticeable in other trauma forms as well in similar proportions. Terror-related burns afflict a targeted population, and generally take on a more severe course with greater mortality rates, thus requiring appropriate medical treatment.

Alternatively Activated Macrophages Drive Browning of White Adipose Tissue in Burns.

PubMed

Abdullahi, Abdikarim; Auger, Christopher; Stanojcic, Mile; Patsouris, David; Parousis, Alexandra; Epelman, Slava; Jeschke, Marc G

2017-08-16

The aim of this study was to uncover the mediators and mechanistic events that facilitate the browning of white adipose tissue (WAT) in response to burns. In hypermetabolic patients (eg, burns, cancer), the browning of WAT has presented substantial clinical challenges related to cachexia, atherosclerosis, and poor clinical outcomes. Browning of the adipose tissue has recently been found to induce and sustain hypermetabolism. Although browning appears central in trauma-, burn-, or cancer-induced hypermetabolic catabolism, the mediators are essentially unknown. WAT and blood samples were collected from patients admitted to the Ross Tilley Burn Centre at Sunnybrook Hospital. Wild type, CCR2 KO, and interleukin (IL)-6 KO male mice were purchased from Jax laboratories and subjected to a 30% total body surface area burn injury. WAT and serum collected were analyzed for browning markers, macrophages, and metabolic state via histology, gene expression, and mitochondrial respiration. In the present study, we show that burn-induced browning is associated with an increased macrophage infiltration, with a greater type 2 macrophage profile in the fat of burn patients. Similar to our clinical findings in burn patients, both an increase in macrophage recruitment and a type 2 macrophage profile were also observed in post burn mice. Genetic loss of the chemokine CCR2 responsible for macrophage migration to the adipose impairs burn-induced browning. Mechanistically, we show that macrophages recruited to burn-stressed subcutaneous WAT (sWAT) undergo alternative activation to induce tyrosine hydroxylase expression and catecholamine production mediated by IL-6, factors required for browning of sWAT. Together, our findings uncover macrophages as the key instigators and missing link in trauma-induced browning.

Burn Wound Infections and Antibiotic Susceptibility Patterns at Pakistan Institute of Medical Sciences, Islamabad, Pakistan

PubMed Central

Saaiq, Muhammad; Ahmad, Shehzad; Zaib, Muhammad Salman

2015-01-01

BACKGROND Burn wound infections carry considerable mortality and morbidity amongst burn injury victims who have been successfully rescued through the initial resuscitation. This study assessed the prevalent microrganisms causing burn wound infections among hospitalized patients; their susceptibility pattern to commonly used antibiotics; and the frequency of infections with respect to the duration of the burn wounds. METHODS This study was carried out at Burn Care Centre, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan over a period of two years (i.e. from June 2010 to May 2012). The study included all wound-culture-positive patients of either gender and all ages, who had sustained deep burns and underwent definitive management with wound excisions and skin auto-grafting. Patients with negative cultures of the wounds were excluded. Tissue specimens for culture and sensitivity were collected from burn wounds using standard collection techniques and analyzed at microbiological laboratory. RESULTS Out of a total of 95 positive microbial growths, 36 were Pseudomonas aeruginosa (35.29%) as the most frequent isolate found, followed by 21 Klebsiella pneumoniae (20.58%), 19 Staphylococcus aureaus (18.62%), 10 Proteus (9.80%), 7 E. coli (6.86%), 7 Acinetobacter (6.86%), and 4 Candida (3.92%). A variable antibiotic susceptibility pattern was observed among the grown microbes. Positive cultures were significantly more frequent among patients with over two weeks duration of burn wounds. CONCLUSION P. aeruginosa, K. pneumoniae and S. aureus constituted the most common bacterial microbes of burn wounds in our in-patients cases. Positive cultures were more frequent among patients with over two weeks duration of burn wounds. Early excision and skin grafting of deep burns and adherence to infection control measures can help to effectively reduce the burden of these infections. PMID:25606471

Perceptions of prescribed burning in a local forest community in Victoria, Australia.

PubMed

Bell, Tina; Oliveras, Immaculada

2006-11-01

The general perceptions of prescribed burning were elicited from forest users for an area that has been subject to this form of land management for at least 20 years. The largest group consisted of local residents living in and around the Wombat State Forest with two smaller groups of students from a nearby university campus and local professional land managers. A questionnaire was given to each participant in order to explore how the forest was used, to determine the level of knowledge of burning in the targeted forest and Victoria and the perception of the appearance, effectiveness of protection, and accessibility to the forest after prescribed burning. Generally all groups had similar responses with community members having stronger views on the effectiveness and practicalities of prescribed burning, whereas students were more neutral in their opinions. All participants claimed knowledge of prescribed burning activities within Victoria, but fewer had experience of planned fires in the Wombat State Forest. All groups agreed that areas that had not been recently burned had a better appearance than those that had, but this result may have included a range of value judgments. Land managers had a greater understanding of the ecological importance of season and timing of burning; however, some students and community members were equally knowledgeable. Prescribed burning did not impede access to the forest, nor did smoke from prescribed burns pose any great problem. The majority of the participants felt that the amount of prescribed burning done in the forest was adequate for engendering a feeling of protection to life and property, yet many were still suspicious of this management practice. These initial findings indicate several areas in which further research would be useful including the efficacy of education programs for community members and improved communication of burn plans by land managers.