Burn Injury

Medical disasters with significant numbers of burn injured patients create incredible challenge for disaster planners. North Carolina is served by two Burn Centers, with a similar ratio of resources (comparing staffed beds with the population). Burn Centers of the ABA Southern Region created a plan should there be a need for additional hospital burn beds (capacity) and burn care (capability) in response to a disaster.
All disasters are local. Nevertheless, regional support is critical in burn disaster planning. This work identified intrastate capacity and a stochastic model was developed using Monte Carlo simulation to quantify the regional capacity.
Results confirmed the scarcity of burn bed capacity with a key finding including identification of the threshold for needing interstate surge capacity. Findings include a more finite understanding of regional capacity, capability, and when a surge of patients may require the practice of altered standards of care.

explain why it is important for nurses involved in the care of such traumas to have good knowledge of the pathophysiology of this type of injury and the associated physical and psychological consequences Abstract In childhood, burn or scald injuries are comparatively common, and the greatest risk is to infants and toddlers. The extent and severity of injuries can vary greatly, which can significantly affect recovery and outcome. To provide high quality nursing care to the child who has sustained a burn injury and the family, the children's nurse should understand the pathophysiology of the trauma and the associated physical and psychological suffering. Evidence-based nursing management of these aspects is an essential component of recovery. Children's nurses working in hospitals, schools or in the community can engage with parents, families, school staff and children to provide information, advice, and health and safety promotion for burn prevention.

Luka bakar adalah kondisi yang memiliki pengaruh yang katastropik terhadap penderita dalam hal penderitaannya, kehidupan sosialnya, keterbatasan yang ditimbulkan dan perihal keuangan yang dikeluarkan untuk pengobatannya. Aspek medikolegal menuntut seorang dokter untuk melakukan pemeriksaan terhadap seseorang yang mengalami luka bakar baik yang masih hidup ataupun yang telah mati. Luka bakar adalah cedera terhadap jaringan yang disebabkan oleh kontak dengan panas kering (api), panas lembab (uap atau cairan panas), kimiawi (seperti, bahan-bahan korosif), barang-barang elektrik (aliran listrik atau lampu), friksi, atau energi elektromagnetik dan radian. Luka bakar dapat diklasifikasikan berdasarkan luas luka bakar dan derajat luka bakarnya. Kematian karena luka bakar dapat di bagi menjadi 2 yaitu kematian cepat dan kematian lambat. Perbedaan antara luka bakar antemortem dengan postmortem adalah pada luka bakar antemortem terdapat tanda-tanda intravital pada gelembung bula dan vesikula sedangkan pada luka bakar postmortem tidak terdapat tanda tersebut. Ada tiga point utama untuk membedakan luka bakar antemortem/postmortem, yaitu garis kemerahan, vesikasi, dan proses perbaikan.

Introduction
The number and adverse consequences of burn injuries in high income countries have decreased showing that such events are not “accidents” but  are preventable in most cases;  burn injuries in low and middle income countries still remain a significant health problem. WHO states that the vast majority (over 95%) of fire-related burns occur in LMICs .  Burn injuries are a major cause of prolonged hospital stays, disfigurement, disability, and death in Africa Region.
Evidence shows that prevention strategies can work.  However prevention strategies need to be tailored to the specific environment taking into account local risk factors and available resources. An examination of the patterns and causes of burns will allow site specific recommendations for interventions.
Methods
This literature review, specific to one country, the United Republic of Tanzania, was conducted by researching data bases of PubMed, SafetyLit, and African Journals on Line for primary sources  using key words <Tanzania> plus < burns, suicide, homicide , injury mortality, injury morbidity>.  Two sets of student data collected  as part of Bachelor’s degree final dissertations at MUHAS were used.  In all, twenty four  primary sources were found. 
Results
Data based risk factors for burn morbidty in Tanzania, are 1/ a young age, especially the 1-3 age group, 2/ home environment, especially around cooking fires, 3/ epilepsy, during seizures  and 4/ perceived inevitability of the incident, that it was not possible to prevent. An expected finding was that ground level cooking fires would be found to be a risk factor, but several studies have shown non-significant results about raised cooking fires, types of fuel used, and cooking appliances.
The risk factors for burn mortality are being male, between 20-30 years of age, and punished for alleged thieving by community mobs.
Discussion and Conclusion
An important factor in reducing burn morbidity, especially in children, is to educate people that burns are preventable in most cases and that most burns occur in the home around cooking fires.  Children need to be kept away from fires. Epileptics should be monitored for medication and kept away from cooking fires as well.  Community members who catch alleged thieves should be educated to follow the law.

The prediction of the outcome of patients presenting with severe burns is crucial in guiding clinical judgments. There are multiple models for predicting burn mortality that have been developed over many years. Advancements in burn management over the years have significantly decreased burn mortality. However, higher death rates are still a glaring issue in developing countries where these advancements are yet to be implemented. And in such countries the scoring system needs to be implemented routinely for every patient to find out the mortality and thus to improve the infrastructure and to train the manpower accordingly. There are various scoring systems that are formularized in predicting mortality in burns. In this article we would like to describe our pilot study in using Belgium outcome of burn injury scoring system in predicting mortality in burns patients.

Medical disasters with significant numbers of burn injured patients create incredible challenge for disaster planners. North Carolina is served by two Burn Centers, with a similar ratio of resources (comparing staffed beds with the population). Burn Centers of the ABA Southern Region created a plan should there be a need for additional hospital burn beds (capacity) and burn care (capability) in response to a disaster. All disasters are local. Nevertheless, regional support is critical in burn disaster planning. This work identified intrastate capacity and a stochastic model was developed using Monte Carlo simulation to quantify the regional capacity. Results confirmed the scarcity of burn bed capacity with a key finding including identification of the threshold for needing interstate surge capacity. Findings include a more finite understanding of regional capacity, capability, and when a surge of patients may require the practice of altered standards of care.

Through the years, the burn injury has been described using a variety of labels. These labels have ranged from one word terms to phrases including degrees of injury or more descriptive terms. A search was conducted relying on a common general internet search engine. After multiple searches varying the keywords, the top 100 searches identified the most prevalent terms or phrases, ranging from the common to the more obscure. The search was repeated using the most prevalent terms or phrases identified in the common internet search engine, focusing on either in the title or abstract for all papers indexed in PubMed. This process narrowed the attention to the most common terms or phrases used by the academics with their published work.
Thus, this work focused on measuring what specific terms are being used today and their frequency of use in the peer reviewed papers indexed in the PubMed system. It is difficult to focus on the unique aspects of any given profession when there is confusion surrounding a common vocabulary. By identifying and noting in the academic literature, what labels are most commonly used can create a point of reference for future work. Furthermore, having a common and accurate set of labels that are uniformly applied across the profession is critical for academia to include in training and education programs for physicians, nurses, and paramedical staff.

Burn injuries in low and middle income countries still remain a significant health problem, even though numbers of burn injuries in high income countries have decreased showing that such events are not &quot;accidents&quot; but are usually preventable. WHO states that the vast majority (over 95%) of fire-related burns occur in low and middle income countries. Burn injuries are a major cause of prolonged hospital stays, disfigurement, disability, and death in Africa Region. Evidence shows that prevention strategies can work. However prevention strategies need to be tailored to the specific environment taking into account local risk factors and available resources. An examination of the patterns and causes of burns should allow site specific recommendations for interventions. This literature review, specific to the United Republic of Tanzania, was conducted by researching PubMed, SafetyLit, and African Journals on Line data bases for primary sources using key words plus . Two sets of ...

''I am an out-and-out believer in preventive measures against diseases as contrasted with what are called curative agencies."-Oliver Wendell Holmes Although great strides have been made in the basic understanding of trauma management and wound physiology over the past two decades, burn injury remains one of the leading causes of death and disfigurement in the United States and abroad. The medical and scientific communities understand the devastating nature of burn trauma and have intellectually realized the need for injury prevention. Unfortunately, this knowledge has not been effectively communicated to the public and legislative sectors, and casualties continue. A proactive, national campaign to promote public awareness, inspire legislative reform, and prevent injury is long overdue. At present, there is no active national data collection center to track burn injury and death statistics in the United States. It is interesting that neither the Centers for Disease Control and Prevention (CDC) in Atlanta nor the American Burn Association tabulates and reports the annual incidence and temporal trends for this major cause of morbidity and mortality. It is known from regional studies and extrapolated data, however, that the magnitude and impact of burn trauma is far greater than the public or medical profession generally realizes and it demands our attention.

Burn injuries are of great matter of concern because of their impact not only on the body but on the soul as well. Burn injuries are also significant because they are not confined to any particular age group or gender. Globally, an appreciable proportion of population suffers from burn injuries resulting in morbidity and mortality. Khyber Pakhtunkhwa (KP) is one of the four major provinces of Pakistan and shares its borders with Afghanistan and China. The current review article has been drafted with an effort to highlight this issue in the context of the province of Khyber Pakhtunkhwa.

Burn injuries are one of the most common types of trauma worldwide, and their unique physiology requires the development of specialized therapeutic materials for their treatment. Here, we report the use of synthetic, functional and biodegradable peptide nanofiber gels for the improved healing of burn wounds to alleviate the progressive loss of tissue function at the post-burn wound site. These bioactive nanofiber gels form scaffolds that recapitulate the structure and function of the native extracellular matrix through signaling peptide epitopes, which can trigger angiogenesis through their affinity to basic growth factors. In this study, the angiogenesis-promoting properties of the bioactive scaffolds were utilized for the treatment of a thermal burn model. Following the excision of necrotic tissue, bioactive gels and control solutions were applied topically onto the wound area. The wound healing process was evaluated at 7, 14 and 21 days following injury through histological obser...

Burn injuries (BIs) result in both local and systemic responses distant from the site of thermal injury, such as skeletal muscle. The purpose of this study was to investigate the expression of cyclooxygenase-2 (COX-2) and hydroxy-2&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;-deoxyguanosine (8-OHdG) as a result of inflammation and reactive oxygen species production, respectively. A total of 16 male rats were distributed into two groups: control (C) and submitted to BI. The medial part of gastrocnemius muscle formed the specimens, which were stained with hematoxylin and eosin and were evaluated. COX-2 and 8-OHdG expressions were assessed by immunohistochemistry, and cell profile area and density of muscle fibers (number of fibers per square millimeter) were evaluated by morphometric methods. The results revealed inflammatory infiltrate associated with COX-2 immunoexpression in BI-gastrocnemius muscle. Furthermore, a substantial decrease in the muscle cell profile area of BI group was noticed when compared with the control group, whereas the density of muscle fibers was higher in the BI group. 8-OHdG expression in numerous skeletal muscle nuclei was detected in the BI group. In conclusion, the BI group is able to induce skeletal muscle degeneration as a result of systemic host response closely related to reactive oxygen species production and inflammatory process.

Thermal injury is associated with biochemical changes. The present study was undertaken to investigate relation of oxidative free radical generation and related biochemical parameters in burn trauma. The specific aim was to compare the levels of serum lipid peroxide, Ceruloplasmin and Uric Acid in burn patients during treatment with Silver Sulfadiazine Cream and honey therapy. It is a single blind prospective controlled study involving comparison of biochemical changes after treatment with silver sulfadiazine and honey treatment in burn injury. In burn trauma, there is excessive activity of free radicals at the site of injury. This is reflected in elevated blood levels of Lipid peroxide, Ceruloplasmin & Uric Acid. Honey therapy was was shown to decline the levels of serum Lipid peroxide, while there was mild increments in serum Ceruloplasmin levels whereas there was no significant effect on serum Uric Acid levels as compared to silver sulfadiazine treatment. Honey therapy seems to accelerate the process of healing. It has positive effect in reducing oxidative stressful state in burn trauma than the silver sulfadiazine treatment that results in rapid wound healing.

Thermal injury is associated with biochemical changes. The present study was undertaken to investigate relation of oxidative free radical generation and related biochemical parameters in burn trauma. The specific aim was to compare the levels of serum lipid peroxide,