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PubMed · 2096036

[Cutaneous expansion in burns sequelae].

S Baux·M Mimoun·P Hilligot
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Abstract

This technique of skin expansion with inflatable balloons has rapidly become generally used since Neuman's and Radovan's work. It offers new prospects for the treatment of the sequellae of burns as it allows increasing the surfaces of the remaining unaffected skin and using them to cover the excision of scar lesions by local or remote flaps. Experience with more than 500 implanted balloons is assessed, demonstrating very satisfactory general results in spite of a still too high number of complications, which increasingly refined techniques aim at reducing.

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BurnsHumansSurgery, PlasticSurgical FlapsTissue ExpansionTissue Expansion DevicesEnglish AbstractJournal Article

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S Baux, M Mimoun, P Hilligot. 1990. [Cutaneous expansion in burns sequelae].. https://pubmed.ncbi.nlm.nih.gov/2096036/

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Blood transfusions are associated with increased risk for development of sepsis in severely burned pediatric patients.

OBJECTIVE: To determine the risk of developing sepsis following transfusion of blood products in severely burned pediatric patients. DESIGN: Retrospective, cohort study. SETTING: Shriners Hospital for Children and University Hospital. PATIENTS: Severely burned pediatric patients with >30% total body surface area (TBSA) burn. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Two hundred seventy-seven pediatric burn patients over a period of 7 yrs (1997-2004) were included in the study, with 25 patients being septic at admission and therefore excluded. Patients were stratified according to TBSA burn and presence or absence of inhalation injury. The amounts of packed red blood cells (RBCs) and fresh frozen plasma (FFP) were recorded during hospital stay before the development of sepsis. Blood product administration was normalized for the number of surgeries and divided into two groups: high (RBCs>20/FFP>5) or low (RBCs<20/FFP<5) amount of blood products. Sepsis was diagnosed based on the criteria set by the Society of Critical Care Medicine in conjunction with positive blood culture or presence of organisms in the organs at autopsy. By stratifying the groups into low and high blood transfusion, we found that patients with >60% TBSA burn with inhalation injury have an 8% risk of developing sepsis in the low RBC group, which increases to 58% in the high RBC group (p<.05). Similar results were found for RBCs per operation, FFP, and FFP per operation (p<.05). There were no differences in age and gender between groups. CONCLUSIONS: Pediatric burn suffering from a 60% TBSA burn with concomitant inhalation injury are more likely to develop sepsis if they are given high amounts of blood products, indicating an immunocompromised state following blood transfusion.

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