Background: One of the major challenges faced worldwide is management of burn wounds, particularly among the pediatric population. Immense research is going on to overcome the challenges associated with survival of these patients and healing of burnt areas. Newer dressing materials are being developed and one of them is collagen. The collagen is biocompatible. The aim was to achieve earlier and better healing of wounds, and to obviate the need for frequent change of dressings; which besides being painful, is quite troublesome in pediatric population.Methods: A prospective study was conducted in 38 patients of scald burns under-5 years of age, from October 2016 till July 2017. After thorough cleaning of burn wounds and thorough rinsing of collagen sheets with normal saline, the wounds were covered with sheets of collagen. Paraffin with chlorhexidine impregnated gauze dressing was applied over the sheet of collagen followed by dry gauze, cotton and bandage application. First dressing was opened after 5 days and then after 3 to 4 days.Results: The wounds healed in 10 to 14 days in most of them. Infection developed in one case, warranting removal of collagen sheet. None developed any adverse reaction to the application of collagen dressing.Conclusions: We conclude that collagen based dressing is a very good modality of treatment for the burn wounds with advantages of being cost effective, requiring lesser number of dressings and blood transfusions, and shorter duration of hospital stay.

Background: Soft tissue defects of the hands require coverage with soft, pliable full-thickness skin. The posterior interosseous artery (PIA) flap fulfils all these requirements and also has significant advantages over other flaps; it is a single-stage procedure that does not sacrifice major vascular axis of the hand. However, the dissection can be challenging and requires meticulous skill. The objective of the study was to evaluate the reverse PIA flap for coverage of hand soft tissue defects in terms of its safety, reliability, comfort, function and aesthetic appearance.Methods: Over a period of 3 years, patients with soft tissue defects over the dorsum of the hand and first web space were observed. A standard PIA flap was raised using loupe magnification under general or brachial anesthesia. The size and location of the defect were noted along with the size and success of the flap.Results: Twelve patients, including nine males and three females, were taken up for this procedure. All the flaps survived completely except one with marginal necrosis not requiring a secondary procedure. All patients were quite satisfied with the procedure and went on to resume their work within a month or two.Conclusion: PIA flap is a safe, reliable option with great versatility for coverage of hand defects, especially over the dorsum. A well-planned flap surgery done under loupe magnification affords excellent results. The entire treatment also requires a shorter hospital stay and allows the patient to return to work quickly.

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Background: Burn patients are at high risk of infections and burn wound infection is one of the most important factor responsible for their morbidity and mortality. Burn patients have increased incidence of fungal infection in comparison to others. Fungal infection is difficult to diagnose because it has similar symptoms like bacterial infections. Common fungal organism causing burn wounds infections are Candida sp., Aspergillus sp., non albicans Candida, Zygomycetes etc.Methods: This prospective study was carried out in Department of Burn, Plastic and Reconstructive Surgery, J.N.M.C.H., Aligarh Muslim University, India from December 2015 to June 2017. Patients having 20 to 60% body surface area involvement with more than 5 years of age with no comorbidity were included in this study.Results: In our study, total 126 patients were included, 9 male patients (18.37%) were found fungal culture positive whereas 14 females (18.18%) were culture positive. 12 patients (9.52%) were found to be positive for Candida albicans, 6 patients (4.76%) were Aspergillus flavus positive, 3 patients (2.38%) were positive for Non Candida albicans and 2 patients (1.59%) were positive for Aspergillus niger.Conclusions: Fungal burn wound infections are one of the most common cause of late onset morbidity and mortality in burn patients. So, high level of suspicion and tissue culture are essential in making early diagnosis and treatment. Judicious use of antibiotics are also necessary for decreasing its incidence.