- Email: [email protected]
Epileptic burn patients profile
S102
Burns 3 3 S ( 2 0 0 7 ) S1–S172
The factors influencing the anxiety and depression of parents of children with burn injury Lee G.S. Hangang Sacred Heart Hospital Burn Center, South Korea E-mail address: [email protected]. Background: It was reported that parents of children with burn injury experience serious depression and anxiety not only because of the accident but also because of taking care of their children with burn injury. In this study, we estimated the prevalence of anxiety and depression for parents of children with burn injury and analyzed which factors influence their anxiety and depression. Method: Parents of 35 children with burn injury who were hospitalized at the Burn Center in H Hospital in Seoul, Korea were asked to reply Interpersonal Support Evaluation List (ISEL), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Parenting Stress Index (PSI), and Child Behavior Checklist (CBCL). The correlations of parents. doi:10.1016/j.burns.2006.10.236 The use of cartilage graft in reconstructing lower eyelid deformity in burn patients Silva-Villasentor J.A. a,b , Huang T. a,b a
Zapopan Hospital General, Mexico Shriners Burns Hospital, USA E-mail address: [email protected] (J.A. Silva-Villasentor).
b
Objectives: A downward pull of the lower eyelid are the common findings noted in individuals who had sustained extensive burns of the eyelids. The outcome of reconstruction is often unsatisfactory because of tarsal structures left unrepaired. Reconstruction, in this sense, must include tarsal replacement. The experience gained from managing three patients with five lid deformities formed the basis of this report. Material and methods: Three years between 2003 and 2005, a total of 45 patients underwent 62 lower eyelid reconstructions. Of these, 5 lower eyelid deformities required the use of cartilage graft and the nasolabial skin flap for reconstruction. The procedure consisted of releasing a contracted lid via an infraciliary line, placement of a conchal cartilage graft of 25-30YmmY(Y4-5Ymm in size in the defect to mimic a tarsal structure, and an oblong skin flap of 30Ymm in length and 5-10Ymm in width mobilized from the ipsilateral nasolabial area to make up the defect resulted from the lid release. Result: The structural integrity of the lower eyelid was restored completely in all patients. No residual deformity was noted. Conclusion: It is essential to replace all the missing structures in lower eyelid deformity reconstruction. This will include not only the skin but also the tarsal structure as well. A skin flap mobilized from the area adjacent is necessary to cover the cartilage graft and at the same time, to attain the contractural release of the eyelid. doi:10.1016/j.burns.2006.10.237 Epileptic burn patients profile ˆ Prospective and retrospective study of epileptic patients admitted at Pronto Socorro Para Queimaduras, Goiania, Brazil Meirelles R.P.C., Piccolo N.P., Piccolo P.P., Piccolo-Daher S., Piccolo-Daher R., Piccolo-Lobo R., Piccolo M.T.S., Piccolo M.S., Piccolo N.S. ˆ ´ Brazil Pronto Socorro P/Queimaduras LTDA, Goiania, Goias, E-mail address: [email protected] (R.P.C. Meirelles). Introduction: Epileptic patients may suffer severe trauma during seizures, including burns. This study aims at demonstrating the profile of epileptic burn victims, acknowledging the major risk factors, epidemiologic aspects and comparing a retrospective sample with a prospective one. The importance of preventative education in this group of patients cannot be overemphasized, since most of these accidents occur at home and can be easily avoided. Materials e methods: Patients with history of epilepsy were evaluated through a questionnaire. The retrospective sample included patients from the past 5 years and the prospective one, patients seen during 6 months. Results: From July 1st, 1999 to June 30, 2004, 66.467 patients were treated at our institution. Six hundred and one (0.9%) had a history of epilepsy. Of these, only 175 (29.1%) answered the questionnaire. Their average age was 30.2 years, being that 53.7% were working adults (15–44 year). One hundred and eight (61.7%) were females. Average burn surface area was 4.96%. Seventy six (43.4%) patients had their accidents during a seizure. Of these, 93.3% did not feel pain during the episode, 66.7% remember having another accident caused by a seizure and 81.6% had visual contact with the flame before the accident. Ninety nine (56.6%) patients injured themselves in an accident not related to a seizure. Of these, 84.4% felt pain during the accident, and only 12.1% remember having another accident caused by a seizure and 24.2% had visual contact with fire before the accident. From January
Burns 3 3 S ( 2 0 0 7 ) S1–S172
S103
1st, 2005 and June 30th, 2005, 7734 patients were treated at our institution. Of these, 24 (0.31%) had a history of epilepsy and all answered the questionnaire. Average age was 38.6 being that 87.5% were working adults (15–44 year) 19 (79.2%) were females. Average burn surface area was 5.83%. Twenty-three (95.8%) had their accident during a seizure; 87.5% did not feel pain during the accident, 87% remember having another accident caused by a seizure and 83.3% had visual contact with the flame before the accident. Twelve patients have already been victims of burns at least once, also related to a seizure. Discussion: Both samples demonstrated similar results. Females are more frequently injured probably because of their domestic activities. A significant amount of patients had visual contact with the flame prior to the accident, showing that the fire could possibly be a photostimulator for seizures. The education of epileptic patients is of paramount importance to prevent future or recurrence of accidents. doi:10.1016/j.burns.2006.10.238 Subdermal free fat cell implantation to alleviate palmar hyperesthesia and paresthesia in burned hands: A case report Silva-Villasentor J.A. a,b , Huang T. a,b a
Zapopan Hospital General, Mexico Shriners Burns Hospital, USA E-mail address: [email protected] (J.A. Silva-Villasentor).
b
Objectives: Complaints of persistent hyperesthesia and paresthesia experienced in the palm of hands are uncommon in patients with sever hand burns. The sensation of burning and tingling sensation in the palm, on the other hand, could be so severe to hinder the use of the hands. Desensitizing the palmar surface by creating a mechanical barrier was thought to be useful to control the problems. Clinical materials and method: Free fat cells aspirated manually from the buttock area were implanted into the subdermal layer of the palms of a male patient who had sustained extensive burn injuries that had involved both hands. He noted persistent burning and tingling sensation in the palm of the hands. The conventional approach in controlling this abnormal sensation was ineffective. 60–75 cc of fat cells aspirated with a syringe were implanted into the subdermal layer of the palm on both hands. Hyperesthetic and paresthetic sensation diminished immediately following the fat cell implantation and remained symptom free for the past 2 years. Tactile sensation was, however, preserved. Conclusion and summary: Hypersensitivity experienced in the palmar surface consequential to burn injuries could be reduced by implanting autologous fat cells. The procedure is technically simple and is effective in alleviating discomfort in the hands. doi:10.1016/j.burns.2006.10.239 Major depression and posttraumatic stress disorder symptoms following severe burn injury in relation to lifetime psychiatric morbidity Ekselius L. a,b,c , Wikehult B. a,b,c , Willebrand M. a,b,c , Dyster-Aas J. a,b,c , Gerdin B. a,b,c a
Department of Neurosciences, Psychiatry, Sweden Burn Unit, Sweden c Department of Neuroscience, Psychiatry, Sweden E-mail address: [email protected] (L. Ekselius). b
Background: Psychiatric history has been suggested to have an impact on long-term adjustment in burn survivors. This is a rigorous, prospective and longitudinal approach to study psychiatric history in a population based burn sample and its impact on symptomatology for depression and posttraumatic stress disorder (PTSD) at a 12 months follow-up. Methods: Seventy-three consecutive patients admitted to the burn Unit of Uppsala were assessed with Structured Clinical Interview for DSM-IV for psychiatric disorders, of which 64 were also assessed after 12 months. Results: Forty-eight patients (66%) presented with at least one lifetime psychiatric diagnosis, most prevalent were major depression (41%), alcohol abuse/dependence (32%), simple phobia (16%) and panic disorder (16%). At 12-months, 10 patients (16%) met criteria for major depression, 6 (9%) for PTSD and 11 (17%) for subsyndromal PTSD. Patients with lifetime anxiety disorder and with lifetime psychiatric comorbidity were more likely to be depressed at 12 months, while those with lifetime affective, substance use disorder and psychiatric comorbidity were more likely to have symptoms of PTSD. Conclusions: Two-thirds of burn survivors exhibit a history of lifetime psychiatric disorders. Those with a psychiatric history have a higher risk for postburn psychiatric problems. doi:10.1016/j.burns.2006.10.240
Burns 3 3 S ( 2 0 0 7 ) S1–S172
The factors influencing the anxiety and depression of parents of children with burn injury Lee G.S. Hangang Sacred Heart Hospital Burn Center, South Korea E-mail address: [email protected]. Background: It was reported that parents of children with burn injury experience serious depression and anxiety not only because of the accident but also because of taking care of their children with burn injury. In this study, we estimated the prevalence of anxiety and depression for parents of children with burn injury and analyzed which factors influence their anxiety and depression. Method: Parents of 35 children with burn injury who were hospitalized at the Burn Center in H Hospital in Seoul, Korea were asked to reply Interpersonal Support Evaluation List (ISEL), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Parenting Stress Index (PSI), and Child Behavior Checklist (CBCL). The correlations of parents. doi:10.1016/j.burns.2006.10.236 The use of cartilage graft in reconstructing lower eyelid deformity in burn patients Silva-Villasentor J.A. a,b , Huang T. a,b a
Zapopan Hospital General, Mexico Shriners Burns Hospital, USA E-mail address: [email protected] (J.A. Silva-Villasentor).
b
Objectives: A downward pull of the lower eyelid are the common findings noted in individuals who had sustained extensive burns of the eyelids. The outcome of reconstruction is often unsatisfactory because of tarsal structures left unrepaired. Reconstruction, in this sense, must include tarsal replacement. The experience gained from managing three patients with five lid deformities formed the basis of this report. Material and methods: Three years between 2003 and 2005, a total of 45 patients underwent 62 lower eyelid reconstructions. Of these, 5 lower eyelid deformities required the use of cartilage graft and the nasolabial skin flap for reconstruction. The procedure consisted of releasing a contracted lid via an infraciliary line, placement of a conchal cartilage graft of 25-30YmmY(Y4-5Ymm in size in the defect to mimic a tarsal structure, and an oblong skin flap of 30Ymm in length and 5-10Ymm in width mobilized from the ipsilateral nasolabial area to make up the defect resulted from the lid release. Result: The structural integrity of the lower eyelid was restored completely in all patients. No residual deformity was noted. Conclusion: It is essential to replace all the missing structures in lower eyelid deformity reconstruction. This will include not only the skin but also the tarsal structure as well. A skin flap mobilized from the area adjacent is necessary to cover the cartilage graft and at the same time, to attain the contractural release of the eyelid. doi:10.1016/j.burns.2006.10.237 Epileptic burn patients profile ˆ Prospective and retrospective study of epileptic patients admitted at Pronto Socorro Para Queimaduras, Goiania, Brazil Meirelles R.P.C., Piccolo N.P., Piccolo P.P., Piccolo-Daher S., Piccolo-Daher R., Piccolo-Lobo R., Piccolo M.T.S., Piccolo M.S., Piccolo N.S. ˆ ´ Brazil Pronto Socorro P/Queimaduras LTDA, Goiania, Goias, E-mail address: [email protected] (R.P.C. Meirelles). Introduction: Epileptic patients may suffer severe trauma during seizures, including burns. This study aims at demonstrating the profile of epileptic burn victims, acknowledging the major risk factors, epidemiologic aspects and comparing a retrospective sample with a prospective one. The importance of preventative education in this group of patients cannot be overemphasized, since most of these accidents occur at home and can be easily avoided. Materials e methods: Patients with history of epilepsy were evaluated through a questionnaire. The retrospective sample included patients from the past 5 years and the prospective one, patients seen during 6 months. Results: From July 1st, 1999 to June 30, 2004, 66.467 patients were treated at our institution. Six hundred and one (0.9%) had a history of epilepsy. Of these, only 175 (29.1%) answered the questionnaire. Their average age was 30.2 years, being that 53.7% were working adults (15–44 year). One hundred and eight (61.7%) were females. Average burn surface area was 4.96%. Seventy six (43.4%) patients had their accidents during a seizure. Of these, 93.3% did not feel pain during the episode, 66.7% remember having another accident caused by a seizure and 81.6% had visual contact with the flame before the accident. Ninety nine (56.6%) patients injured themselves in an accident not related to a seizure. Of these, 84.4% felt pain during the accident, and only 12.1% remember having another accident caused by a seizure and 24.2% had visual contact with fire before the accident. From January
Burns 3 3 S ( 2 0 0 7 ) S1–S172
S103
1st, 2005 and June 30th, 2005, 7734 patients were treated at our institution. Of these, 24 (0.31%) had a history of epilepsy and all answered the questionnaire. Average age was 38.6 being that 87.5% were working adults (15–44 year) 19 (79.2%) were females. Average burn surface area was 5.83%. Twenty-three (95.8%) had their accident during a seizure; 87.5% did not feel pain during the accident, 87% remember having another accident caused by a seizure and 83.3% had visual contact with the flame before the accident. Twelve patients have already been victims of burns at least once, also related to a seizure. Discussion: Both samples demonstrated similar results. Females are more frequently injured probably because of their domestic activities. A significant amount of patients had visual contact with the flame prior to the accident, showing that the fire could possibly be a photostimulator for seizures. The education of epileptic patients is of paramount importance to prevent future or recurrence of accidents. doi:10.1016/j.burns.2006.10.238 Subdermal free fat cell implantation to alleviate palmar hyperesthesia and paresthesia in burned hands: A case report Silva-Villasentor J.A. a,b , Huang T. a,b a
Zapopan Hospital General, Mexico Shriners Burns Hospital, USA E-mail address: [email protected] (J.A. Silva-Villasentor).
b
Objectives: Complaints of persistent hyperesthesia and paresthesia experienced in the palm of hands are uncommon in patients with sever hand burns. The sensation of burning and tingling sensation in the palm, on the other hand, could be so severe to hinder the use of the hands. Desensitizing the palmar surface by creating a mechanical barrier was thought to be useful to control the problems. Clinical materials and method: Free fat cells aspirated manually from the buttock area were implanted into the subdermal layer of the palms of a male patient who had sustained extensive burn injuries that had involved both hands. He noted persistent burning and tingling sensation in the palm of the hands. The conventional approach in controlling this abnormal sensation was ineffective. 60–75 cc of fat cells aspirated with a syringe were implanted into the subdermal layer of the palm on both hands. Hyperesthetic and paresthetic sensation diminished immediately following the fat cell implantation and remained symptom free for the past 2 years. Tactile sensation was, however, preserved. Conclusion and summary: Hypersensitivity experienced in the palmar surface consequential to burn injuries could be reduced by implanting autologous fat cells. The procedure is technically simple and is effective in alleviating discomfort in the hands. doi:10.1016/j.burns.2006.10.239 Major depression and posttraumatic stress disorder symptoms following severe burn injury in relation to lifetime psychiatric morbidity Ekselius L. a,b,c , Wikehult B. a,b,c , Willebrand M. a,b,c , Dyster-Aas J. a,b,c , Gerdin B. a,b,c a
Department of Neurosciences, Psychiatry, Sweden Burn Unit, Sweden c Department of Neuroscience, Psychiatry, Sweden E-mail address: [email protected] (L. Ekselius). b
Background: Psychiatric history has been suggested to have an impact on long-term adjustment in burn survivors. This is a rigorous, prospective and longitudinal approach to study psychiatric history in a population based burn sample and its impact on symptomatology for depression and posttraumatic stress disorder (PTSD) at a 12 months follow-up. Methods: Seventy-three consecutive patients admitted to the burn Unit of Uppsala were assessed with Structured Clinical Interview for DSM-IV for psychiatric disorders, of which 64 were also assessed after 12 months. Results: Forty-eight patients (66%) presented with at least one lifetime psychiatric diagnosis, most prevalent were major depression (41%), alcohol abuse/dependence (32%), simple phobia (16%) and panic disorder (16%). At 12-months, 10 patients (16%) met criteria for major depression, 6 (9%) for PTSD and 11 (17%) for subsyndromal PTSD. Patients with lifetime anxiety disorder and with lifetime psychiatric comorbidity were more likely to be depressed at 12 months, while those with lifetime affective, substance use disorder and psychiatric comorbidity were more likely to have symptoms of PTSD. Conclusions: Two-thirds of burn survivors exhibit a history of lifetime psychiatric disorders. Those with a psychiatric history have a higher risk for postburn psychiatric problems. doi:10.1016/j.burns.2006.10.240