Mohammad Ali Bahar, Ali Manafi, Nosratollah Bouduhi, Hamid Karimi, Mahshid Hormazdi, Siamac Esfandi, Somaye Abdollahi Sabet, Ali Kabir,
Volume 22, Issue 2 (8-2008)
Abstract
Abstract
Background: Wound infection is a frequent and severe complication in burn patients
accounting for a high number of mortalities. There are some reports comparing
swab and biopsy cultures of wounds of various etiologies or chronic wounds.
Objectives: The aim of the study was to evaluate burn wound infection by different
bacteriologic methods of surface swab and tissue biopsy culture and see if
they can predict the outcome.
Methods: Aprospective study was conducted in Shahid Motahari Burn Center,
Tehran , on patients suffering from burns with more than 20% of TBSAadmitted in
2001-2002. Wound swab and biopsy specimens were collected within the second
week. Patients were followed to the point of their discharge or death.
Results: Bacterial growth was reported in 100% of swabs, in 89.3% of the biopsies
in differential culture media, and in 18.7% of the biopsies in selective culture
media. These different cultures had similar pathogen reports. Of the 75 studied patients,
78.7% died. The frequency rates of positive tissue cultures and bacterial load
were not different between the dead and those who survived.
Conclusion: Bacteriologic methods do not have enough predictive value to assess
clinical outcome.
Mostafa Dahmardehei, Majid Khadem Rezaiyan, Farhang Safarnejad, Ali Ahmadabadi,
Volume 35, Issue 1 (1-2021)
Abstract
Background: Due to the COVID-19 outbreak, protective measures including alcohol-based hand rub, received unexampled popularity in Iran. Alcohol hand rub is effective, inexpensive and simple to use, but it is a flammable liquid, which might cause burn injuries. In this study, we investigated burn injuries due to alcohol hand sanitizers during the COVID-19 disease outbreak in Iran.
Methods: This cross-sectional study was performed on burn patients referred to Motahari Burns and Reconstruction Center from February 20th, 2020 (official announcement of the epidemic of COVID-19 in Iran) up to April 19th, 2020. All outpatients and hospitalized burn injuries caused by alcohol during the abovementioned period were included.
Results: There were 76 burn injuries due to the use of alcohol hand sanitizer. Sixty patients were treated outpatient, and 16 were hospitalized. The mean ± SD age of patients was 33.2±17.9 years and most were males (57 individuals, 75%). Also, the mean ± SD of TBSA was 6.1±6.5%. In hospitalized ones, the mean ± SD hospital stay was 11.7±8.6 days. The most burnt area was the head (39.5%) followed by the right upper limb (35.5%) and the left upper limb (23.7%). Patients were actively engaged in burn injury in 61.8% of cases, while they were passively burnt in 34.2% of cases and in 3.9% the mechanism was unknown. Burn injuries mostly happened in the yard (22.4%) followed by the rooftop (21.1%) and outdoors (18.4%).
Conclusion: Appropriate general education, especially through mass media, can reduce burns caused by alcohol-based sanitation during the COVID-19 outbreak. Most of these burn injuries involved face and hands, which are cosmetically and functionally important.
Maksim G. Ryabkov, Marfa N. Egorikhina, Nikita A. Koloshein, Kseniya S. Petrova, Mikhail G. Volovik, Nataliya Yu. Orlinskaya, Aleksandra O. Moskovchenko, Irina N. Charykova, Diana Ya. Aleynik, Daria D. Linkova, Igor E. Pogodin, Irina I. Kobyakova, Igor Yu. Arefyev,
Volume 37, Issue 1 (2-2023)
Abstract
Background: The quality of the wound healing at the donor site significantly determines the overall condition of the burn patient, the extent of wound fluid and protein losses, the severity of any systemic in-flammatory reaction, and the intensity of the pain syndrome. It is known that the stromal vas-cular fraction (SVF) has a beneficial effect on the healing of wound defects. This study is aimed at assessing the safety and effectiveness of the application of the SVF of autologous adipose tis-sue to stimulate wound healing of the donor site in patients with burns.
Methods: This placebo-controlled clinical study included 38 patients with third-degree thermal skin burns. The patients underwent liposuction, enzymatic isolation of the SVF, and intradermal injection of the preparation into the wounds in the donor site, followed by tewametry, cutome-try, thermography and biopsy after 12 days. Quantitative indicators were compared using the Mann-Whitney test for unrelated groups and the Wilcoxon test for related groups. Spearman's rank correlation coefficient (RS) was used to assess the correlation
Results: Epithelization of the wounds in all patients was seen over an average area of 88 (84;92) %, there being no significant differences between the actual and the control wound sites for this parameter. Transdermal water loss in the test wound sites was 2 times lower than in the control sites (P = 0.001). The wound donor sites regained their temperature distribution faster than the control sites (P = 0.042). Histological preparations of the skin of the wound sites revealed that their epidermal layer was 19% thicker compared to the controls (P = 0.043). It should be noted that five adverse events related to manipulations in the postoperative period were registered.
Conclusions: Transplantation of SVF autologous adipose tissue into the wound area in most clinical cases proceeded without complications. The area of epithelialization of wound areas af-ter the introduction of SVF did not change, although a significant decrease in transdermal water loss was observed in the wound areas with an improvement in their thermoregulation and an increase in the thickness of the epidermis.
Shahrabanoo Nakhaie, Behnam Sobouti, Seyyed Hamid Salehi, Vida Chavoshian,
Volume 37, Issue 1 (2-2023)
Abstract
Background: Serum albumin can function as a potential biomarker to determine the severity of the injury and clinical staging of children with burns. Therefore, in this study, we investigated the association between serum albumin level and complications and mortality rate in children with burns.
Methods: In this descriptive-analytic cross-sectional study, 85 patients younger than 18 years with burns who were admitted to Shahid Motahari hospital between 2021 and 2022 were studied. Demographic information, including patients' age, sex, weight, underlying diseases, medical information, albumin level, and C-reactive protein (CRP), was obtained from patient records. Patients were observed until discharge. The independent t-test, chi-square, Pearson correlation, and logistic regression were used for analysis and to examine the predictive role of albumin.
Results: Out of 85 patients, 47 and 38 were boys and girls, respectively. The mean age of the participants was 3.69 ± 3.09 years. The mean length of hospital stay was 2.3 days, with a median of 1.5 days. The mean percentage of burns was 23.44 ± 16.50, and burn grade 2 was the most common. A total of 25 patients (29.41%) were admitted to the intensive care unit (ICU), and 13 deaths (15.29%) were observed among the patients. The mean albumin level was significantly lower than in other patients with outcomes of pulmonary infection, sepsis, renal failure, ICU admission, and death (P < 0.001).
Conclusion: Serum Albumin has a significant predictive value in death, pulmonary infection, sepsis, admission to the ICU, and renal failure. Serum albumin may be a good prognostic marker associated with morbidity and mortality.
Siamak Farokh Forghani, Behnam Sobouti, Ardavan Shahbazi, Yaser Ghavami, Parinaz Ghanooni, Reza Vaghardoost,
Volume 38, Issue 1 (1-2024)
Abstract
Background: Treatment of hypertrophic burn scars is challenging. Intralesional injection of corticosteroids has been the first line of treatment. Triamcinolone Acetonide (TA) and Bleomycin (BLE) are standard therapeutic options. We conducted a comparative study to measure the effects of BLE and TA on hypertrophic burn scars.
Methods: In this clinical trial, we enrolled 25 patients with hypertrophic burn scars in this study. In each patient, two adjacent affected areas on the body were randomly selected for intralesional injection of TA and BLE. The size of the burn scars was between 10 and 40 cm2 (square centimeter). The injections were repeated at intervals of four weeks for three periods. Follow-up of patients continued until the end of the fourth month of treatment. We used the Vancouver Scar Scale and Patient and Observer Scar Assessment Scale system to compare the recovery of each lesion. Means, standard deviation, and p-values comparing the treatment of lesions with BLE and TA using two different scales were reported. Independent samples t-test and paired sample t-test were used to find out a statistically significant difference between BLE and TA treated lesions.
Results: The results showed that the hypertrophic scar scores in BLE and TA lesions were statistically significant from the perspective of patients and physicians (P = 0.035). The mean score of hypertrophic scars in the BLE and TA groups was also statistically significant (P = 0.023). The proportion of individuals who had no side effects after taking BLE and TA was much higher than those who experienced skin pain or hypopigmentation.
Conclusion: Intralesional BLE injection is more effective than TA in treating hypertrophic scars. Further studies with larger sample sizes are needed to approve these results.
Mahdi Heydari, Seyyed Mohsen Seyyedkazemi, Mohammad Taghi Joghataei, Fereshteh Mehraein Ghomi, Hoorieh Mohammadi Kenari, Nader Sadigh, Auob Rustamzadeh, Mehrdad Bakhtiari, Hamidreza Alizadeh-Otaghvar,
Volume 39, Issue 1 (1-2025)
Abstract
Background: Inflammation is the first response to tissue damage. A hematoma occurs when blood leaves the damaged vessels, and platelets play an important role in this process. This study aimed to investigate the effect of herbal bioactive compounds on the angiogenic factors and modulation of inflammatory mediators in deep second-degree burn patients.
Methods: In a randomized clinical trial, 54 patients were divided into two groups :Swalin ointment (n=31) and silver sulfadiazine (SSD) (n=23). Ointments were administered every other day for 28 days. The concentration of compounds in ointment oils was measured using the GC-MS technique. Serum levels of TNF-α and IL-6 were measured on days 3, 7, and 14, and tissue levels of VEGF, FGF, and PDGF variables were measured on day 14 by ELISA method. Student t-test was used to compare the mean in 2 groups, depending on the type of normal/abnormal distribution. The chi-square test was also used to check the relationship between qualitative variables.
Results: The most common compounds in Swalin ointment were Linoleic acid (41.37%), Elaidic acid (37.45%), and Palmitic acid (9.45%), respectively. The tissue level of VEGF, FGF, and PDGF on the 14th day was higher in the Swalin group compared to the SSD group (P<0.001). The serum level of IL-6 and TNF-α in both groups increased until day 7, but gradually decreased on day 14, which was significant in the Swalin group. IL-6 serum level was significant in the Swalin group (P<0.001). The serum level of TNF-α was also significant in the Swalin group (P<0.001).
Conclusion: The present study showed that Swalin ointment, due to the presence of a wide range of fatty acids, especially linoleic acid, leads to the modulation of systemic tissue inflammation. The ingredients of the ointment, especially hemp and sesame oil, increase the tissue level of angiogenic factors and accelerate remodeling and wound healing.
