Periorbital lesions in severely burned patients

Abstract

Purpose: This study aimed to characterize the injuries involving periorbital region in our severely burned patients. Method: A 2 years retrospective study was conducted with a total of 210 severe burns admissions. Periorbital burn injuries (all produced in association with facial injuries) were encountered in 126 patients, representing the study group that was further analyzed for multiple parameters: demographics, mechanism of injury, TBSA (total body surface area), burn depth, inhalation injury, need for intubation and mechanical ventilation. The presence and severity of ocular injuries were also evaluated. Results: Analyzing our study group (n=126), we observed the presence of multiple negative prognosis factors: elderly patients, extensive burns, deep burns affecting functional areas, unfavorable mechanism (electric, chemical or explosions), inhalation injuries, need for intubation and mechanical ventilation, leading to severe morbidity and high mortality level. Ocular injuries were encountered in 37 patients (30 primary and 7 secondary lesions). The predominance of primary ocular lesions is explained trough high severity burns encountered in our patients with high mortality and lack of long-term clinical observations. Conclusion: The clinical outcome for periorbital burn injuries depends on patient characteristics, etiology, burn extension and depth, associated lesions, infectious risk and the quality of the treatment applied. Presence of ocular injuries in various severity degrees impose an adequate evaluation and specialized treatment, being associated with important morbidity. In severely burned patients, it is mandatory to apply preventive measures to avoid ocular complications. If exposure keratopathy is detected, prompt ophthalmologic treatment is essential to avoid functional impairment including loss of vision. Abbreviations: TBSA = total body surface area, MSOF = multisystem organ failure, OCS = orbital compartment syndrome, AION = anterior ischemic optic neuropathy

Scleral Contact Lens to Preserve a Corneal Graft in Chronic Lagophthalmos

“…Contraction and deformation of the periorbital soft tissue can lead to eyelid dysfunction, trichiasis cicatricial entropion or ectropion, and lagophthalmos, which pose a serious threat to the cornea. 3 , 4 Chronic desiccation and epithelial trauma can give rise to serious infections and permanent scarring, resulting in visual impairment. Long-term follow-up is often mandatory due to potentially significant medical and psychological problems.…”

“…If left untreated, exposure keratopathy due to lagophthalmos can result in corneal thinning, scarring, and ulceration, potentially leading to corneal blindness as well as perforation and endophthalmitis. 1 , 2 , 3 …”

“…Facial burn lesions lead to physical and psychosocial morbidities. 1 , 2 , 3 Periorbital and ocular injuries are present in 20% of facial burns. 4 Injury to the globe, eyelids, orbit, and ocular adnexa predispose these patients to eyelid deformities, conjunctival scarring, and corneal disease, leading to visual impairment and blindness.…”

Assessment of Human Skin Burns: A Deep Transfer Learning Approach

“…Burns are skin injuries caused by heat, radiation and other acute trauma. According to the World Health Organization (WHO), about 300,000 people are dying every year as a result of burn related injuries with a high number of incidences in developing countries [1]. In 2004, nearly 11 million people requiring medical treatment had been reported by WHO.…”

Non‐invasive medical imaging technology for the diagnosis of burn depth

“…3 Severe burns pose a serious challenge to healthcare systems worldwide, with approximately 300 000 people dying from burns each year, particularly in poorer countries. 4 The depth of a burn is one of the key factors influencing the severity of the injury and often determines the healing outcome of the burn wound. Clinical judgement of burn depth is currently mainly dependent on the assessment of physicians based on subjective indicators such as the colour of the wound, the size of blisters, the amount of exudate, the degree of moisture, the presence of eschar or thrombosed capillary networks and the sensitivity of pain perception.…”