Introduction: High voltage electrical burn is one of the most devastating burn injuries involving upper limbs in Bangladesh. It causes serious disfigurement and may lead to loss of the whole upper limb. The aim of this study was to see the severity of electric burn injury involving upper limbs pausing amputations at different levels in two tertiary level referral hospitals of Bangladesh. Methods: A prospective observational study was designed to collect the data from Burn and Plastic Surgery Unit, Dhaka Medical College Hospital and Sheikh Hasina National Institute of Burn and Plastic Surgery from January 2019 to December 2019. One hundred and sixty-nine (169) patients with high voltage electrical burn injury involving upper limb underwent amputation were analyzed according to the severity based on clinical assessment. Results: Male predominance (89%) was observed where right upper limb was involved in 49% of the cases and in 11% cases amputation was bilateral. The most alarming finding was 57.4% patients were below the age of 21 years. Below elbow amputation was done in 48.5% cases followed by above elbow amputations in 32.54% cases. Conclusion: Male sex and younger age are the two most common association with electric burn and subsequent limb amputation. The incidence in higher in upper limbs. This study will help us to create the awareness and for prevention of electric burn. J Bangladesh Coll Phys Surg 2022; 40: 279-286
Background: Despite improvements in burn management, infection is still the biggest challenge in major burn cases globally. Burn causes extensive tissue destruction, immune dysfunction, increases the risk of infection and septicemia with high morbidity and mortality. The aim of this study was to observe the levels of serum fibrin degradation product (FDP), D-dimer and procalcitonin in patients with burn sepsis treated in intensive care unit (ICU). Materials & Methods: This observational study was carried out in Department of Burn and Plastic Surgery, Dhaka Medical College Hospital, Dhaka from February 2018 to January 2019. Forty (40) patients with major burns, from (15% to 50% total body surface area burn) with burn sepsis, were recruited for the study. In all cases, plasma level of fibrin degradation product (FDP), D-dimer and procalcitonin were measured and recorded. Result: Male predominance (57.5%) was observed in our study. Eighty five percent (85%) patients had total body surface area burn (TBSA) 20% to 50%. Sixteen patients (40%) suffered from flame burn, 13 (32.5%) patients from scalds and 11 (27.5%) patients had high voltage electric burn. The value of FDP was raised in 62.5% patients, D- dimer in 67.5% patients. Serum procalcitonin level was high (> 2ng/ml), indicating burn sepsis in 47.5% cases but it was not significant (2 sample t – test reveals no significant relationship between rise of serum level of procalcitonin and presence of burn sepsis) Conclusion: Fibrin degradation product (FDP) and D- dimer were raised in two-thirds of burn cases while procalcitonin in two-fifths cases. Measurement of serum level of FDP, Ddimer and procalcitonin may give an idea regarding early onset of bacterial infection and burn sepsis and can serve as an indicator for burn sepsis. J Bangladesh Coll Phys Surg 2023; 41: 193-197
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