Biomedical subjects

L Broz

Publications and source records attributed to L Broz.

At least 37 records · Page 2Linked to original sources

PubMed1999

Burn injury resulting in mutilation in childhood.

We present 3 cases of boys aged 5, 11 and 12 years who sustained very deep burn injury of their extremities. Their future lives were extremely limited. All the 3 boys had a strong emotional reaction to the injury. Two of them sustained amputation of upper extremities as a result from electrical injury, the youngest boy survived without the feet and with mutilated fingers on his hands. To encourage their survival and sense of life we admitted their mothers. Our aim was not only to secure psychological support to the patients but also to prepare the family to accept the sequelae of the injury. This accompaniment in the ward was very useful for both. The mothers were able to watch the progress in the treatment. In this way they were involved in the future care and they coped with the problems from a realistic point of view. The mothers helped the boys with physiotherapy under supervision. All the families were well prepared for discharge of their boys from the hospital without any fear of the following care. The significance of the family member influence upon the patient's resocialization we saw in early acceptance of the child to the society.

Amputation, Surgical↗

PubMed1998

Mortality in pediatric burns in the Prague Burns Centre (1994-1997).

The authors evaluate the mortality of severely burned children hospitalized in the Intensive Care Unit, Prague Burns Centre from 1994 till 1997. There were hospitalized 345 children (aged 3 months-15 years, 1%-88% TBSA, mixed superficial and deep burns). No child died from burn shock during the early postburn period. Five children who died suffered deep burns greater than 50% of TBSA and at necropsy there were identified signs of multiple organ system failure which was related to infection.

Adolescent↗

PubMed1998

Bacteriological monitoring in the Prague Burns Center.

The microbiological aspect of the prevention of nosocomial infections at the Burn Center consists primarily in the surveillance of bacterial flora and its antibiotical resistance. The Prague Burn Center is regularly monitoring the microbial flora. Patients are examined not only by the conventional methods of taking swabs of burned sites, but also by printing method, which allows a semiquantitative assessment of the colonization of burned areas. Simultaneously, investigation of bacterial contamination in the external environment of the department is carried out and the colonization of nursing staff is investigated. In all isolated strains the sensitivity to antibiotics is examined; this is significant from the point of view of current knowledge about therapeutic possibilities and for the antibiotic policy. The typing of bacterial strains makes possible to determine their epidemiological markers, and thus to investigate their spread within the department. The most frequent isolate is S. aureus and the prevalence of MRSA is relatively high. Among gramnegative rods the strains of P. aeruginosa, K. pneumoniae and E. cloacae are most often isolated. Various typing methods revealed endemic spread of particular strains of rarely isolated species (E. agglomerans, S. marcescens, A. baumannii, etc.).

Acinetobacter↗

PubMed1997

Treatment of burns and donor sites with human allogeneic keratinocytes grown on acellular pig dermis.

The absence of a dermal component predisposes cultured epidermal sheets to instability, contractibility, and makes them difficult to handle. In order to overcome these drawbacks, we developed recombined human/pig skin (RHPS) composed of human keratinocytes cultured on cell-free pig dermis. The original intention to prepare a permanent skin substitute composed of xenodermis and autologous epidermis was not achieved, but it has been proved that RHPS can serve as an effective, ready to use keratinocyte delivery system when applied 'upside-down', i.e. with epidermal cells facing the wound surface. The keratinocyte layer establishes a direct contact with the wound bed, while the dermal layer mechanically protects the wound. Twenty deep dermal burns were grafted with RHPS: 13 (65%) healed completely in 4-14 days, three (15%) healed partially and four (20%) did not heal. Of five full thickness burn wounds only one healed after repeated RHPS grafting within 18 days. Thirty-one (100%) donor sites treated with any of the three forms of RHPS, subconfluent, confluent meshed or confluent unmeshed, healed within 6-8 days compared with 14-18 days in control sites. Seven donor sites (100%) of immunodeficient patients with prolonged wound healing epithelialized in 7-10 days under RHPS compared with 32-90 days in areas treated with tulle gras and dry gauze.

Adolescent↗

PubMed1997

Combined technique of anesthesia in early and late neck reconstruction.

Once the notion of the "quality of life" has been used in deliberations about straight-forward cases, it may be given wider application. It may be invoked in intensive care, in care of the handicapped and in any of medicine's specialist areas. In severe burns to keep the patient alive occurs at the cost of a degree of discomfort and disability caused by scar formation and following deformities. Severe anterior neck burn scar contracture issues in serious functional embarrassment, requiring early neck reconstruction based on three principles: releasing shrinked area, restoring contour of the mento-collical angle and preventing recurrence. Performing the surgical procedure demands endotracheal intubation which is impossible to accomplish because of chin adherent to jugulum. Combined technique of anesthesia using intravenous introduction (Ketalar) with or without local infiltration of the anterior neck scarring and immediate cutting through to the healthy muscle layer is necessary. Then follows insertion of endotracheal tube. The interval between incision and insertion may be rather crucial, as will be demonstrated in one of the cases treated in the Prague Burn Center during the last two decades.

Adolescent↗

PubMed1995

Emergency care of severe burn children (an experience of Prague Burn Centre).

The control of a shock associated with burns has marked effects on the further course of burn injuries. In spite of the steadily increasing improvement of intensive care of severe burn children sometimes are not applied essential recommended procedures which are necessary during the first aid and the transport of burn cases to a burn centre. These procedures are determined by the assessment of a lot factors. A misinterpretation of these factors can lead to an insufficient or to an excessively aggressive therapy with their sequelae. This holds true both for a local and for a systemic therapy of severe burn children. The most important problems are documented by 2 case reports.

Adolescent↗

PubMed1994

Use of free flaps in burn trauma.

The present currently used method of treating and reconstructing injuries caused by electric current and deep thermal injuries is compared with the method of early reconstruction using free flaps. Brief summary of present experience substantiating this method is presented. The three presented clinical cases show subacute reconstruction in this type of injury by free flaps transfer.

Adolescent↗

PubMed1991

Unexpected gastrointestinal complications in severely burned children.

The authors refer to the frequently difficult diagnosis of gastrointestinal complications of major burns, particularly in childhood, to weight the factors co-responsible for the development of those complications and to stress the importance of the patient's history. They report on the case of three and a half year-old child to demonstrate the fatal course of a late diagnosed complications -- perforating cholecystitis. Autopsy showed the chronic nature of the disease with acute exacerbation in the course of treatment. No case similar to this one has yet been seen at the Prague Burns Centre in any age category.

Burns↗

PubMed1988