Multiple trauma and the burn patient

Article Abstract:

Care of the burn patient is greatly complicated when the patient has other injuries; multiple injuries occur in about 5 percent of burn patients. Similarly, burns complicate the diagnosis and treatment of multiple trauma. One burn center admitted 3,550 consecutive acute burn patients, and of these, 176 (5 percent) had associated injury. The average patient age was 29, and average length of stay in the hospital was 24 days; 37 patients (21 percent) died. The causes of injury included: motor vehicle accidents (70), escaping from a fire (32), electrical burns with falls (24), scald burns associated with assault (22), and explosions (18). Fourteen (20 percent) of the burns related to motor vehicle accidents occurred in motorcycle accidents. Types of associated injuries were: orthopedic, including fractures, dislocations and open joints (80); soft tissue injuries (91); head injury (30); chest injury (27); and abdominal injury (15). Patients who are either trapped or unconscious as a result of an accident often sustain severe inhalation injury to the respiratory system; this often results in rapid death. There were 17 patients with inhalation injury, and 13 died. A major contributor to death was unstable orthopedic injuries; early fracture fixation allowed for the best mobilization and wound care. Treatment of the traumatic injuries take precedence over burn care in burn/multiple injury patients; however, it is the burn that is the ultimate factor determining length of hospital stay and survival. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Burns, Injuries, Burns and scalds, Burn therapy

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Operative management of rural trauma over a 10-year period

Article Abstract:

Much of the information available on the treatment of trauma in the United States is generated by large trauma centers and is based upon their experience. This experience differs from that of rural areas. A report is presented of 10 years' experience at an 86-bed community hospital in the treatment of abdominal and vascular trauma. This hospital serves a sparsely populated area of the northern Rocky Mountains. There were 83 patients who required formal operative treatment. Most of the patients were healthy, young white men, usually with blunt abdominal trauma. These patients usually sustained multiple injuries from motor vehicle (37 percent) or recreational vehicle (36 percent) accidents. Major complications occurred in 21 patients, and two patients died. Major vascular injuries occurred in 20 percent of the patients. Each small community and region has its own problems and solutions. Surgeons in isolated towns occasionally encounter a critically injured patient; most surgeons will do the best job they can. Many rural hospitals function as trauma centers. The results of this experience suggest that it is reasonable that many critically injured patients be managed locally, provided the surgeon is committed to good trauma care, teaching and self- education. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Medicine, Rural, Rural medicine, Emergency medicine

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Current Use of skin and wound cleansers and antiseptics

Article Abstract:

During the last eight hundred years, a system of surgical skin and wound cleansing methods has been developed that serves as a basis for comparison for new procedures. Alcohol is still the most effective skin antiseptic, although its good bacteria-killing ability is rapidly lost by the quick drying of the alcohol. However its bactericidal property can be extended by mixing alcohol with an emollient or with longer-acting antiseptic agents. Today, combinations of cleaners, alcohol and heavy metal or halogen (a group of chemicals which include iodine) compounds exist. This paper reviews pharmacological literature and presents an update on the available products.

Analysis, Anti-infective agents, Antiseptics, Wound healing

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