Biomedical subjects
Publications and source records attributed to Y Ben Yakar.
Of 5934 patients admitted to our Burns' Unit at the Soroka University Hospital, Beer-Sheva, Israel between the years 1965 and 1986, 22 had attempted suicide by fire (0.37 per cent). Seventeen of them (77 per cent) died from their burns. The use of flammable liquids was the most common method of immolation. Fifty per cent of the victims were known to have previous mental disorders.
This report describes the burns caused by an electric hot plate which is used by orthodox Jews for keeping food and liquids warm during the Sabbath (Saturday). An illustrative case is presented and the preventable aspects of this particular burn are discussed.
Our experience with early tangential excision and grafting for burns of the hands is presented. The advantages of the early surgical approach are proven by comparing this technique with the 'old' conservative treatment in two different populations. It is clearly concluded that early excision and grafting, combined with adequate physiotherapy and pressure garments, offer favourable results for the burned hand. Early excision of the burn eschar, before the appearance of contamination, may prevent infection, long and unfavourable delay in healing, scar formation with its incapacitating sequellae and a non-aesthetic appearance. Such a delay was characteristic of the 'conservative period', which was dominated by 'fibroblast', 'good granulation tissue', and hypertrophic scarring. Early surgery, as described and advocated here, shortens the healing time, lessens the hospital stay, minimizes reconstructive surgery and leads to a good functioning hand with a reasonable aesthetic appearance, enabling the affected patient to return quickly to work and normal routine life.
A chemically treated bovine skin, Dermodress, is presented as a long-term skin substitute. Dermodress was applied over denuded surfaces of debrided deep burns and was kept in place for up to 56 days. Dermodress adheres to all contours of the debrided surfaces, has hemostatic effect and does not present any signs of infection or rejection. Dermodress can be removed in stages according to the availability of autografts, which may be applied immediately, since the exposed areas are clean and suitable for immediate grafting. Our clinical experience shows that Dermodress has most of the required properties of a long-term temporary skin substitute.