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Showing 10 results for Burns

Kamran Aghakhani , Saeed Mohammadi , Amir Molanaei, Azadeh Memarian , Maryam Ameri ,
Volume 71, Issue 7 (10-2013)
Abstract

Background: Damages caused by scald burns are common and can cause severe complications and death. The purpose of this study was to define risk groups and then methods of prevention and treatment is designed to fit.

Methods: Data for this retrospective study of hospitalized patients in Shahid Motahari Hospital in Tehran from 2007-2011 were compiled. Data including age, sex, cause of burn, and degree of burn and ultimate fate of the victims were collected from scald burns. Burns caused by boiling water and hot food (Scald) , in two age groups : 12 and under 12 years ( children) and more than 12 years ( adults) were compared in terms of statistics .

Results: A total of 1150 patients consisting of males (57.9%) and females (42.1%) were studied. The most common age was 1 year old and 50% of patients were under 3 years of age. 87.9% burned with boiling water and 12.1% had experienced burns with hot food. Incentive to burn was 0.3% cross burning and 99.7% incident. A maximum number of burns in children 12 years and younger males (42.1%) and a minimum number in men over 12 years (15.7%) were observed. Mean percentage of burns was 11% in over 12 years group and 30.9% in 12 and under 12 years group. The average hospital stay was 11.4 days and the mortality rate was 4.8%. The final status of the patients was as fallows: full recovery 904 cases (78.6%), partial recovery 134 (11.7%), clearance with personal consent 41 (3.6%), death 55 (4.8%) and 16 cases (3.1%) were among other reasons.

Conclusion: In general it can be said, scald burns incidence in individuals aged 12 and younger were more than the older ones and the mean of burns was lower in individuals with over 12 years old. There was a sexual preference for males under 12 years. Mortality rate in the two groups has not any statistically significant difference. There was no statistically significant association between sex and mortality rate. Some of our findings are depending on cultural, social and economic conditions, so generalized this findings to other geographical areas should be done with caution.


Shima Javadinia , Ramin Asgarian , Samileh Noorbaksh , Behnam Soboti , Mohammad Reza Shokrollahi , Azardokht Tabatabaee ,
Volume 72, Issue 2 (5-2014)
Abstract

Background: Toxic shock syndrome (TSS), a dangerous consequence of Toxic shock syndrome toxin-1 (TSST-1) caused by Staphylococcus aureus. The early detection for infections of Staphylococcus aureus in burned children is very important, also the pre-vention for consequences of TSST-1. Fever is one of the most noticeable sign in burned children. On the other hand, fever is one of the important consequences of TSST-1 pro-duction. Methods: This study aimed to assess the toxic shock syndrome toxin-1 level in the wound’s specimens of two groups febrile and afebrile in the hospitalized burned chil-dren in Motahari hospital Tehran, Iran in the year 2013. In this case-control study, 90 children who admitted to the burn unit, divided in two groups of 45 patients: febrile (cases group) and afebrile (control group). All of burned children under went wound biopsy, and then all of wound’s specimens were tested by PCR for specific primer of toxin producing genome. Finally all of data collected and statistically analyzed. This data include group febrile and afebrile, demographic characteristics, percentage of burned surface severity and result of PCR. Results: The positive result for PCR test, production of TSST-1 in febrile burned chil-dren (cases group) was 37.7% and in afebrile burned children (control group) was 11.1% that this different was statistically significant (P=0.003). The mean and stan-dard deviation for percentage of burned surface (severity) in samples with positive re-sult for PCR test was 30.9±16.93 and in samples with negative result for PCR test was 20.09±11.02 that this different was statistically significant (P=0.01). There was no dif-ference between positive PCR result and negative PCR result of age and sex. Conclusion: Direct association was approved between the production of TSST-1 and the occurrence of fever in burned children. Increased surface severity of burns also re-lated to the production of TSST-1. Further research is recommended.
Rasoul Yousefi Mashouf, Rasoul Esmaeili, Mohammad Yousef Alikhani , Mehdi Ghanbari ,
Volume 72, Issue 3 (6-2014)
Abstract

Background: Pseudomonas aeruginosa is a gram-negative pathogens opportunism which causes severe infections in human beings. The most common infection include: endocarditis, meningitis, septicemia and chronic lung infections in cystic fibrosis pa-tients. This bacterium has many pathogenic factors including exotoxin A, lipopoly-sacharide, phospholipase C, pili, elastase and alkaline protease. The purpose of this study was to evaluate the frequency of exotoxin A gene (ETA) as a strong virulence factor and sensitivity determination of polymerase chain reaction (PCR) in pseudomonas aeruginosa isolated from second and third-degree burn patients. Methods: This study has performed in Besat University Hospital in Hamadan from January to December 2012. We used 170 isolated samples. The samples were isolated from blood and skin biopsy in second and third-degree burn patients. We had 79 strains positive culture of pseudomonas aeruginosa. Forward and reverse primers used for PCR were designed by DNASIS and Oligo software. Then genomic of known strains were extracted by DNA purification kit and indentified by PCR. The quality and quantity of the extracted DNA was determined using spectrophotometry. For determination of PCR sensitivity was used culture test as gold standard. DNA of pseudomonas aeruginosa (ATCC 27853) was used as a positive control. Finally data was analyzed using SPSS software. Results: Out of 170 isolated samples, 79 strains of pseudomonas aeruginosa isolated from burn patients had positive culture. PCR of isolated positive culture demonstrated that 5 strains (6.33%) were with out this virulence factor and 74 strains (93.67%) had ETA gene. So the sensitivity of test based on sensitivity formula was 94.04%. Conclusion: Our results showed that sensitivity of PCR mediated ETA gene in detection of pseudomonas aeruginosa strains is considerable and this factor can be used as a good factor identifying of pseudomonas aeruginosa. It seems more studies with larger sample size is necessary in this area.
Leyla Soleymani , Rahim Hobbenaghi , Aram Mokarizadeh , Samad Zare , Nowruz Delirezh ,
Volume 72, Issue 7 (10-2014)
Abstract

Background: Recently, bone-marrow-derived cells have introduced new therapeutic approaches to the management of wound healing in severe skin injuries. Bone marrow-derived stromal cells are described as a heterogeneous population, including mesenchymal stem cells, hematopoietic stem cells, and fibro-blast cells. Results derived from several studies indicate that these cells may contribute to tissue regeneration whether through producing variety of bioactive growth factors and/or by differentiation into mesoderm lineage. The aim of the present study was to investigate the effect of subcutaneous administration of bone marrow-derived stromal cells in repairing or regeneration of skin wounds induced by third-degree burn in a mouse model. Methods: In an experimental study that was performed in Urmia University research center from December 2011 to June 2012, The third-degree skin burn was induced on the shaved backs of healthy 7-8 week old male mice (N=18) using a metal rods heated in boiling water. After 1 hour, based on the equal physical condition mice were randomly divided into two separate groups and then subcutaneously administered with phosphate buffered saline (PBS 400 µl) or bone marrow-derived stromal cells (106 cell in 400µl PBS) at the burn site. 7, 14 and 21 days after induction of burn injury, biopsies were taken from burn wounds and then the sections were prepared. Subsequently the prepared sections were stained with hematoxylin/eosin and Masson's trichrome to explore histopathological changes evoke by administration of bone marrow derived stromal cells in comparison with control subjects. Results: Considering investigated parameters including formation of granulation tissue (respectively on days 7, 14 and 21 P≤ 0/007, P≤ 0/0013 and P≤ 0/001), angiogenesis (on day 21 P≤ 0/002) and collagen deposition, in mice treated with bone marrow-derived stromal cells the rate of healing of third-degree thermal burns was significantly accelerated when compared to the PBS-treated mice. Conclusion: This experimental modulation of wound healing suggests that bone marrow-derived stromal cells can significantly enhance the rate of wound healing possibly through stimulation of granulation tissue, angiogenesis, fibroblast proliferation and collagen deposition.
Abolfazl Abbas Zadeh, Tayebeh Mahzooni , Seyed Abolhasan Emami , Hossein Akbari , Mohammad Javad Fatemi , Mohsen Saberi , Tooran Bagheri , Mitra Niazi , Shirin Araghi ,
Volume 73, Issue 9 (12-2015)
Abstract

Background: Coriander with the binominal name of Corianda Sativum, is one of the oldest medicinal plants ever known to man. Anti-inflammatory, anti-microbial, and anti-fungal effects of its oil has been mentioned in numerous studies. This study examines the impact of coriander cream on wound healing of the second-degree singe burn.

Methods: In this experimental study which was performed in the animal lab of the Hazrat Fatemeh Hospital in Tehran, 48 adult male rats with an approximate weight of 250-300 grams, with deep burns of 2 cm 4×2 dimensions were prepared and divided into 4 groups of 12. We used silver sulfadiazine cream, alpha ointment, coriander cream and vaseline gauze (control group) dressings in burn wound of the groups 1 to 4 respectively. At the end of the study (30 days), rats were euthanized with a high dose of thiopental and the wounds were evaluated on days 10 and 17 with a punch biopsy. Samples were fixed with 10% formalin on histopathology slide using haematoxylin and eosin (H&E) staining (to assess and determine the presence of inflammatory cells). The amount of fibrin and collagen at the site were evaluated using a software program ImageJ, version 1.45 (National Institutes of Health, Bethesda, Maryland, USA).

Results: The mean of wound surface area in the first photography was no significant (P= 0. 135). The rate of wound healing in alpha ointment and coriander cream had better outcomes than either of the other two groups (P= 0.000). The healing of the wound in silver sulfadiazine group was significantly less than other groups. Pathology results showed a statistically significant difference between the four groups (coriander, alpha, SSD and control), based on the Kruskal-Wallis test. These relate to (1) polymorphonuclear in the first (P= 0.032) and the second series (P= 0.003), (2) Angiogenesis in the second series (P= 0.004). (3) Fibrosis in the first series (P= 0.024) and the second series (P= 0.000).

Conclusion: The results of this study showed that wound healing improvement in coriander cream group was better than the control group and silver sulfadiazine group and similar to alpha ointment group.


Mohammad Mehdi Soltan Dallal , Mohammad Kazem Sharifi Yazdi, Abbas Rahimiforoushani , Mohammad Reza Akhoondinasab ,
Volume 74, Issue 5 (8-2016)
Abstract

Background: Burns and its complications are regarded as a major problem in the society. Skin injuries resulted from ultraviolet radiation, radioactivity, electricity or chemicals as well as respiratory damage from smoke inhalation are considered burns. This study aimed to determine the epidemiology and outcome of burn patients admitted to Motahari Hospital, Tehran, Iran.

Methods: Two hundred patients with second-degree burns admitted to Motahari Referral Center of Burn in Tehran, Iran. They were studied during a period of 12 months from May 2012 to May 2013. During the first week of treatment swabs were collected from the burn wounds after cleaning the site with sterile normal saline. Samples were inoculated in blood agar and McConkey agar, then incubation at 37 C for 48 hours. Identification was carried out according to standard conventional biochemical tests. Treatment continued up to epithelial formation and wound healing. Results of microbial culture for each patient was recorded. Healing time of the burn wounds in patients was recorded in log books. Chi-square test and SPSS Software v.19 (IBM, NY, USA) were used for data analysis.

Results: Our findings indicate that the most causes of burns are hot liquids in 57% of cases and flammable liquid in 21% of cases. The most cases of burns were found to be in the range of 21 to 30 percent with 17.5% and 7% in male and female respectively. Gram-negative bacteria were dominated in 85.7% and among them pseudomonas spp. with 37.5% were the most common cause of infected burns, followed by Enterobacter, Escherichia coli, Staphylococcus aureus, Acinetobacter and Klebsiella spp.

Conclusion: The results of this study showed that the most cause of burns in both sex is hot liquid. Men were more expose to burn than women and this might be due to the fact that men are involved in more dangerous jobs than female. Pseudomonas aeruginosa was the most common organism encountered in burn infection.


Maryam Roham , Mohammad Javad Fatemi , Mitra Niazi , Mahnoush Momeni ,
Volume 75, Issue 5 (8-2017)
Abstract

Background: Albumin is one of the most important proteins in the body by several important functions, it is essential in the maintenance of normal plasma colloid oncotic pressure and is the primary serum binding protein responsible for the transport of various substances in the circulation including fatty acids, hormones, and drugs. Decrease in the amount of serum Albumin (Hypoalbuminemia) is a common finding in the burn patients, but its relationship with mortality is not accurately clear. Our purpose of this study was to measure the amount of Albumin serum in burn patients and find out its relationship between the burned area and length of hospital stay.
Methods: This cross-sectional study was conducted on patients aged over 16 years who referred to the Motahari Hospital of September 2014 to February 2015 in the first 24 hours of their referral. The amount of Albumin was measured in two groups of discharged patients and patients who died while hospitalized, one week after hospital stay and in the time of discharge and death; and its relationship in terms of each other was determined by statistical analysis. We also assessed the relationship between burn and duration of hospital stay with the amount of Albumin on the day of patient’s admission.
Results: This study showed that the average amount of albumin in the group of discharged patients in the time of admission, one week after and during admission was significantly higher than the group of expired patients (P<0.0001). Also there was a significant relation between the burned area and the amount of albumin (P<0.0001). The more the burned area, the less the amount of Albumin. But there was no significant relationship between the amount of albumin with age and length of hospital stay.
Conclusion: Measuring the level of Albumin is one of the yardsticks that can be used for prognosis of recovery or death of burn patients, and its assessment at regular intervals in burn patients is essential.

Tooran Bagheri , Mohammad Javad Fatemi , Seyed Aboozar Hosseini , Seyed Jaber Mousavi , Shirin Araghi , Mitra Niazi ,
Volume 75, Issue 9 (12-2017)
Abstract

Background: High costs of treatment and rehabilitation lead to increased tendency of researchers in complementary therapies and using the compounds which have natural origin and are cheaper. Sheep ghee, known as yellow oil, is one of the compounds used in many parts of Iran for wound healing. Considering that few studies have been performed on the effect and rate of these materials on burn wound healing, the present work is aimed to investigate the effect of ghee on burn wound healing in rats.
Methods: In this experimental study which was performed in the animal lab of the Hazrat Fatemeh Hospital in Tehran, 36 adult male Sprague-Dawley rats with the relative weight of 250-300 g were selected and second-degree burn with the area of 2×4 cm was induced in them. Then, they were randomly divided into 3 groups, 12 in each. To dress the burn point in 1 to 3 groups, silver sulfadiazine cream, ghee, and Vaseline were used, respectively. The evaluation process was monitored by photography with 5 days intervals using an accurate ruler and ImageJ software, version 1.45 (National Institutes of Health, Bethesda, Maryland, USA). On the 17th and 30th days, Tissue biopsies was performed for the epithelialization rate, degree and arrangement of collagen, and chronic and acute inflammatory cells, the sample of burn wound was sent for pathological investigation.
Results: Results showed that, wound area was significantly reduced in ghee, and Vaseline groups compared with silver sulfadiazine cream on days 5th, 15th, and 25th (P= 0.001). however, the difference between ghee and Vaseline group was not significant. In the 17-day time period, results of collagen arrangement (P= 0.000) and epithelialization results (P= 0.04), acute inflammatory cells (P= 0.001), and fibroplasias (P= 0.000) in 30th day were significantly better in ghee, and Vaseline groups.
Conclusion: This study showed that, in contrast to the public belief in some regions in Iran, ghee could not accelerate healing of burn wound and promote histopathological indices. Therefore, they are not recommended.
 

Mohammad Mehdi Saghafi, Mohammad Javad Fatemi , Tooran Bagheri , Mohammad Hasan Hablolvarid, Mitra Niazi, Mohsen Saberi, Shirin Araghi ,
Volume 75, Issue 11 (2-2018)
Abstract

Background: Burns is a major health problem due to severe side effects and limited financial resources. Some herbs are cheap and available, such as Arnebia euchroma can be effective treatment of burn wounds and reduce recovery time. The aim of this study was to evaluate the effect of Arnebia euchroma ointment on healing of deep second-degree burn wound in rats.
Methods: This experimental study was conducted in animal laboratory of Hazrat Fatemeh Hospital in 2015, Tehran. In this study 24 male Sprague-Dawley rats weighing approximately 300 to 350 g were selected. After general anesthesia, back of each rat was shaved with clipping device. Then second-degree burn with the area of 2×4 cm was induced on them. Rats were randomly divided into 2 groups, 12 in each. The surface of the wound in the first group was covered with Arnebia euchroma ointment and in the second group with Vaseline. Dressing was done daily until complete recovery and the wound healing process was monitored by photographing every five days. On day 20, the samples were sent for pathological evaluation of the amount of collagen and inflammatory cells.
Results: Results showed that, during days from 5 to 15 the extent of the wounds reduced in both groups (P= 0.000). The reduction of wound size was significantly higher in Vaseline group compared to Arnebia euchroma ointment group (P= 0.040). The results of the pathological examination showed no significant difference in the amount of collagen and inflammatory cells in the two groups.
Conclusion: It seems Arnebia euchroma ointment to some extent reduced the extent of the wound especially in superficial burns compared to other dressings. However, it is better to conduct more similar studies with a larger sample size and different method and change in timing of dressing.

Mahnoush Momeni , Mohammd Javad Fatemi , Bita Kamranfar , Mohsen Saberi , Tooran Bagheri , Mitra Niazi ,
Volume 77, Issue 6 (9-2019)
Abstract

Background: Rapid repair of skin donor sites in partial-thickness skin grafts in burn is critical to the patient. Severe pain during dressing change and scarring also reduce the quality of life and treatment. Recently, nano-silver particles are available which have a high surface to volume ratio and remain effective even at a very low concentration and minimize the chance for tissue toxicity due to silver. Our aim in this study was to evaluate the effect of nano-silver dressings on increasing the rate of repair and reduction of complications in non-infectious wounds of skin graft donor sites.
Methods: This was comparison study that involved patients admitted to a single-center burn unit who required a skin graft donor site. 10 burn patients with thermal injury and 10-30% of total body surface area (TBSA) who referred to Shahid Motahari Hospital, Tehran, in 2016 were studied. Each patient was compared to herself. After anesthesia, the site of the skin graft was randomly divided into three sections in each patient and was covered with Agicoat®, Mepitel and vaseline gauze. On the 4th and 8th of the day, the pain was recorded during the dressing change on the basis of the visual analogue scale (VAS). After 6 months, the patients were evaluated for the remainder of the scars based on VSS (Vancouver scar scale).
Results: The mean time to repair in both groups were similar and significantly shorter than that of vaseline (P=0.005). The pain comparison between groups showed that on the fourth day, the mean pain in the Agicoat group and Mepitel was significantly less than the Vaseline group (P=0.004). Also, the mean pain of the epileptic group was significantly lower than that of the Vaseline group (0.002). However, there was no significant difference between the duration of regeneration and pain between the two groups of Agicoat and Mepitel, but there was no significant difference between the mean pain on the 8th day and the mean VAS 6 months after the graft.
Conclusion: Agicoat dressing has been effective in reducing pain and increasing the repair speed, but this effect was similar to that of the silver-free Mepitel dressing. Expensive silver nano-crystal dressings limit their use. The silver nanocrystal did not have much effect on improving the remaining scar. However, more studies are needed in this regard.
 


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