Aim of treatment is to achieve skin cover to prevent infection and to allow early mobilization. Electrical injuries are a relatively uncommon. Adult electrical injuries usually occur as an occupational hazard, whereas children are primarily injured accidently. The spectrum of electrical injury is very broad, ranging from minimal injury to severe multiorgan involvement, with both occult and delayed complications and death. This is a prospective study from Indira Gandhi Government Medical College, Nagpur. A total of 98 patients presenting from June 2002 to September 2011 were included. Patients were treated with surgical excision 31 (31.63 %), fasciotomy 26 (26.53 %), escharotomy 87 (88.78 %), and amputation 12 (12.24 %). In all patients debridement was performed. After follow-up, there was 8.16 % (8 patients) mortality. Minimal mortality may be due to less surface area involved or no visceral injury. Patients survived with morbidity due to amputation. Initial management of electrical burn is imperative to optimize function and minimize long-term scarring. However, further studies are required regarding flap repair and microsurgery to minimize the rate of amputation.
Evaluation of platelet count and its significance in early detection of post burn septicemia for commencement of timely vigorous treatment against it. Studies investigating the role of platelets and platelet count in burn patients are rare, rather old and mostly presenting case reports. Septicemia is the most important cause of mortality in burns. Burn patients can only be saved if septicemia is detected early which requires very sensitive prognostic indicator. Total 594 adult burn patients were studied, by observing them for septicemia and studying their subsequent platelet counts using visual method. In non-survivors (256) gradual decline in platelet count was observed and minimal platelet count was observed before death of the patient, while in survivors (338) gradual rise in platelet count was observed. No significant variation observed in other laboratory parameters such as total neutrophil count and serum creatinine. In significant number of non survivor (62.11%) platelet count was low before their death and in significant number of survivor (86.09%) platelet count was normal before their discharge. Thus it is conclude that serial declining platelet count is a very sensitive prognostic factor in early detection of post burn septicemia.
Background: Pancreaticoduodenal injuries are considerably associated with high morbidity and mortality due to delayed diagnosis and subsequent delay in treatment. This makes the treatment of these injuries challenging. We have studied the presentation, diagnosis, management and outcome of these complex injuries. Methods: A prospective observational study was done at general surgery department, Government medical college Nagpur from October 2020 to September 2022. Mortality, morbidity, and various treatment modalities were evaluated. Results: Thirty two patients presented to the Trauma care center with history and symptoms suggestive of isolated pancreatic, duodenal, and combined pancreaticoduodenal injuries. Most of the injuries were blunt trauma cases. The ratio of hemodynamically stable: unstable was 1:1. Majority injuries were to pancreas followed by duodenum and combined organ injuries. Most of cases were diagnosed by CT scan. In this study 56% of cases had a non-operative line of treatment while 44% underwent surgical intervention. Among the patients operated 5 died, within 7 days of admission due to post-operative complications-hemorrhage, sepsis, aspiration pneumonia, and anastomotic leak. Two patients died due to delayed complications due to the development of pancreatic fistula and enterocutaneous fistula. Mortality rate was 27.2% in this study. Conclusions: Early presentation and prompt diagnosis is the key to the management of such injuries. Patients managed conservatively need close monitoring, repeated assessments, and long-term follow-up.
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