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PubMed2005

The enhancing effects of a chicken-meat extract on serum Ig concentrations in normal and scalded animals.

The aim of the study was to investigate the effects of a chicken-meat extract known as Essence of Chicken (EOC) on immune function in a normal and scalded animal model. In this experimental study, 120 rats were randomly allocated into three groups: a SHAM group (inflicted with a sham wound), a BURN group (inflicted with a full-thickness scald wound covering 30 % of total body surface area) and a CONTROL group. Rats in the SHAM and BURN groups were further divided into normal saline (NS)-fed and EOC-fed groups. They were fed by force-feeding with a feeding needle and blood samples were taken from each group on days 1, 8, 15 and 22 postburn. Serum IgG, IgA and IgM concentrations were determined by ELISA and the results of the EOC-fed and NS-fed cohorts of both the SHAM and BURN groups were compared. The level of significance was set at P<0.05. Serum IgG level of both SHAM-EOC and BURN-EOC cohorts showed significant elevation on day 8. IgA exhibited a significant increase in the SHAM-EOC group on day 15 and in the BURN-EOC group on day 22. A significant increase of IgM level was found on days 1 and 22 for the SHAM-EOC group and on day 15 for the BURN-EOC group. Conclusively, EOC was shown to have an enhancing effect on serum Ig levels for both normal and tissue-stressed rats. It is suggested that EOC may help improve immune function when the immune system is at normal status or when it faces a challenge.

Animals↗

PubMed2000

Scalding injuries in immigrant families.

From 1990 to 1996, 214 patients aged up to 6 years were treated at our inpatient burns unit. Ages ranged from 3 to 70 months. Scalding was the cause in 186 cases. The median size of the burned areas was 5.0% (range 0.5%-40%). One hundred and nine were deep dermal burns that required surgical treatment, but this was refused in seven instances. Duration of hospital stay was 11 days (2-45). The number of follow-up visits ranged from 0 to 17. Secondary reconstructions for scarring have been done for seven children so far. Ninety-eight (46%) came from immigrant families, mostly from the Middle East and the Balkans. Of the 186 scalded children, 94 (51%) were immigrants, and they also had a tendency to have more severe injuries. Explanations might be that they were more likely to cook with water and oil, they were unfamiliar with Swedish safety standards and measures, and they had difficulty in communicating (language) and a limited social network. The ensuing scar also may disturb or delay the child's adaptation to the new environment. Our preventive work is now based on a model that states that frequency, type, and severity of injury is dictated by the variables: risk, personality, supervision, and education.

Burns↗

PubMed2000

School-based scalds prevention: reaching children and their families.

Preventing children's thermal injuries requires changes to both the home environment and the behaviour of family members. Two pilot studies were undertaken of a school-based programme that taught children aged 7-11 years about burns and scalds hazards, and encouraged changes to the home environment and family practices through a take-home exercise. Both studies took place at ethnically diverse schools from low/middle-income areas of Waitakere City, New Zealand. Study 1 involved 55 children who received the programme, and Study 2 involved 64 children who received the programme and 71 children from a control school. The children's ability to identify the burns and scalds hazards illustrated in a series of pictures was measured before and after the programme. Children who received the programme showed considerable improvement in hazard identification at the post-test, while children at the control school showed minimal improvement. The take-home exercise was completed by 85% of the children and their families in Study 1, and 61% of the participants from the intervention school in Study 2. In both studies families reported positive safety changes as a result of the programme. The programme appeared equally effective with all the ethnic groups involved. Future development of the programme is discussed.

Analysis of Variance↗

PubMed2003

Bacterial recovery from breast skin of genetically feathered and featherless broiler carcasses immediately following scalding and picking.

Genetically feathered and featherless sibling broilers selected for matched BW were killed, scalded, and defeathered to determine the consequences of feathers and empty feather follicles on the recovery of bacteria from carcass breast skin. In trial 1, the vents of all carcasses were plugged and sutured before scalding to prevent the expulsion of cloacal contents during picking. In trial 2, half of the carcasses had their vents plugged and sutured. Immediately after defeathering, breast skin was aseptically removed, and bacteria associated with it were enumerated. In trial 1, the levels of bacteria recovered did not differ between feathered and featherless carcasses: Campylobacter log10 1.4 cfu/mL of rinse, coliform log10 1.8, Escherichia coli log10 1.6, and total aerobic bacteria log10 3.1. In trial 2, the carcasses that had vents plugged and sutured had lower levels of all four types of bacteria (differences of Campylobacter log10 0.7 cfu/mL, coliform log10 1.8, E. coli log10 1.7, and total aerobic bacteria log10 0.5) than those carcasses with open vents. The lower levels of bacteria recovered from carcasses with the vents plugged and sutured during picking enabled detection of small but significant differences between feathered and featherless carcasses. The level of coliform and E. coli recovered was slightly higher by log10 0.7 cfu for feathered carcasses, but featherless carcasses had marginally higher levels of total aerobic bacteria by log10 0.4 cfu. Feathered and featherless carcasses with open vents during picking did not differ in the levels of recovery of coliform, E. coli, and total aerobic bacteria from breast skin.

Animals↗

PubMed1986

Scald burns complicated by isopropyl alcohol intoxication. A case of fatal child abuse.

Scald burns are the most common type of thermal injury in child abuse. Death associated with nonaccidental burns, however, is uncommon. We recently investigated the case of a 4-year-old child who died from extensive body burns due to scalding. A contributory cause of death was isopropyl alcohol intoxication resulting from application of this chemical to the burns.

1-Propanol↗

PubMedDate not supplied

The optimal time for excision of scald burns in toddlers.

During the past decade, morbidity and mortality have been shown to be decreased by early excision and grafting in treatment of moderate and large burns. Because of the lack of data on the efficacy of such treatment in scald burns, a retrospective study was done of children under age 4 who were admitted to a burn unit within three days of scald injury. Four groups were examined according to day of first surgical procedure: (1) sooner than five days; (2) 6-10 days; (3) 11-20 days; and (4) later than 20 days. The four groups (similar in age, weight, and percent of TBSA burn) were also analyzed for differences in percent of excised area, blood loss, and length of hospital stay. The amount of excised area in group 1 was significantly larger than in groups 2 and 3, and group 1 also had a significantly greater blood loss. Only in group 4 was the length of stay significantly increased. If excision could be delayed until after day 5, the area excised and the blood loss might be decreased without prolonging hospital stay.

Burns↗

PubMedDate not supplied

Use of Biobrane in management of scalds.

A scald burn is a superficial to mid second-degree burn with a viable dermis beneath the blisters and a good blood flow. However, the burn may be incapacitating because of pain and fluid and heat loss. Biobrane adheres very well to this depth of burn and mechanically and biochemically closes the wound. We have used Biobrane on scald burns for the last 5 years and have found it to be an excellent method of treating superficial second-degree burns.

Anti-Infective Agents, Local↗

PubMedDate not supplied

Prospective, randomized study of the efficacy of Mepitel on children with partial-thickness scalds.

We performed a randomized clinical trial in which children with partial-thickness scald burns of less than 15% total body surface area were assigned treatment with either Mepitel (Mölnlycke Health Care) or silver sulfadiazine. Data were collected on time to wound healing, pain at dressing change, infection, and resource use. Student's t and chi-square tests were used to determine differences in the two groups. Healing times were compared using Kaplan-Meier survival curves. Wounds of children treated with Mepitel healed significantly faster than did controls' (p < 0.001), exhibited less eschar formation (p < 0.05), and experienced less pain at dressing change (p < 0.05). They also had significantly lower mean daily hospital charges ($1937 vs $2316; p = 0.025); as well as significantly lower charges for dressing changes and narcotics. There was no significant difference in wound infection. We believe the use of Mepitel represents a significant advance in the treatment of partial-thickness scald wounds in children.

Burns↗

PubMed1991

A one-year prospective ED cohort of pediatric burns: a proposal for standardizing scald burns.

During a 12-month period ending on 11/30/88, data were collected on 143 pediatric patients visiting a pediatric emergency department with burns. Sixty-four percent were males. Common causes of the burns included hot water (17%), hot food (23%), hot appliances (18%), and charcoal and grills (9%). Sixty-six percent of the burns took place at home. The hospitalization rate was 8%. A suggestion for standardizing scalds based on fluidity and function is proposed, since there is ambiguity regarding definition of a scald.

Adolescent↗

PubMed2004

The role of oxygen-free radical in the apoptosis of enterocytes in scalded rats after delayed resuscitation.

BACKGROUND: This study aimed to evaluate the relation between apoptosis of enterocytes and oxygen-free radical injury in scalded rats with delayed resuscitation as well as the role of antioxidants in the prevention of enterocyte apoptosis. METHODS: For this study, 150 male Wistar rats were divided randomly into four groups representing early resuscitation (ER), delayed resuscitation (DR), N-acetylcysteine (NAC) treatment, and allopurinol (Allo) treatment. The animals were subjected to a 30% total body surface area, full-thickness scald. Fluid therapy was started 6 hours after the injury in the DR and treatment groups. Apoptosis of enterocytes was identified by DNA fragmentation (ap%), DNA agarose gel electrophoresis, and terminal deoxynucleotidyl transferace (TdT)-mediated dUPT-biotin nick end labeling (TUNEL). The contents of malondialdehyde (MDA), total sulfhydryl (TSH), and nonprotein sulfhydryl (NPSH) and the activity of xanthine oxidase in intestinal mucosa were determined after the burn in the four groups. RESULTS: Apoptosis of enterocytes increased significantly in all the groups. The animals in the DR group showed an earlier and greater increase in ap% than the animals in the ER group. Similar results were seen for electrophoresis, TUNEL assay, and levels of MDA, xanthine oxidase (XO), TSH, and NPSH. Treatment with NAC was associated with a decrease in ap% and MDA, but not XO, as compared with the levels in the DR group, whereas treatment with Allo was associated with a decrease in MDA and XO, but not ap%. Delayed resuscitation was associated with significant decreases in TSH and NPSH, as compared with the levels in the ER group, whereas both the NAC and Allo groups had significantly higher levels of TSH and NPSH than the DR group. CONCLUSIONS: Significant apoptosis of enterocytes was induced by oxidative stress in the intestinal mucosa after a burn in rats. The findings show that NAC blunted intestinal apoptosis induced by oxygen-free radical, which was generated in the process of ischemia-reperfusion injury after a burn because of delayed resuscitation.

Acetylcysteine↗

PubMed1987

Effects of capsaicin pretreatment on the inflammatory response to scalding injury in the rat.

The oedema formation after scalding injury to the rat paw was studied by means of the Evans blue exudation technique. An early and a delayed oedema formation were demonstrated after severe and light scalding, respectively. It was shown that the delayed, but not the early, form was reduced by capsaicin pretreatment, suggesting an involvement of chemosensitive primary sensory neurons in this reaction.

Animals↗

PubMed2001

Burns and scalds in pre-school children attending accident and emergency: accident or abuse?

OBJECTIVES: To assess how frequently and adequately information relating to the possibility of non-accidental injury (NAI) is documented and considered by doctors assessing pre-school children with burns and scalds in the accident and emergency (A&E) department, and to determine the effect of introducing a routine reminder mechanism into the A&E notes, coupled with an improved programme of NAI education and awareness. METHODS: The records of 100 pre-school children attending an A&E department with a burn or scald were reviewed against nine pre-determined standards. Changes in policy were instituted, through a programme of education and the use of a reminder checklist, and the next 100 cases re-audited against the same checklist. RESULTS: Groups one and two were similar in their demographic characteristics. The reminder checklist was included in 60% of group two notes, and when included was completed in 97%. The child protection register was rarely consulted. There was a statistically significant increase in recording the following: time that the injury had occurred, the consistency of the history, the compatibility of the injury with the history given, the consideration of the possibility of NAI, the general state and behaviour of the child and the presence or absence of any other injuries. The rate of referral for a further opinion regarding the possibility of NAI increased from 0 to 3%, but failed to reach statistical significance. CONCLUSIONS: Prevailing awareness and documentation regarding the possibility of NAI was found to be poor, but a programme of intervention combining education and the use of a reminder checklist improved both awareness and documentation of NAI, as well as referral rates for further assessment. This strategy may prove applicable to children of all ages and injury types, reducing the number of cases of child abuse that are overlooked in the A&E department.

Burns↗

PubMed2003

Evaluation of Safe Kids Week 2001: prevention of scald and burn injuries in young children.

OBJECTIVE: To evaluate Safe Kids Week 2001-a national public awareness campaign on scald and burn prevention-run by Safe Kids Canada. DESIGN: Random digit dial telephone survey. SETTING: Canada. SUBJECTS: Parents or guardians of children under 9 years. Two groups of parents were compared, those "exposed" to the campaign (defined as having "seen, heard, or read anything about scald and burn prevention during the period 28 May to 3 June 2001") and those "unexposed" to the campaign. INTERVENTION: Burn safety information was disseminated via the media, 5000 retail stores, and 348 community partners across Canada. The campaign emphasized four key messages: (1). Lower your water temperature, hot tap water could burn your child! (2). Make sure your child is safe in the kitchen. (3). Keep hot drinks away from your child. (4). Check your smoke alarms regularly. OUTCOME MEASURES: Change in parental knowledge and behavior. RESULTS: A total of 29871 telephone numbers were called, with a household refusal rate of 27%. Nationally, 14% of parents were exposed to the campaign and 504 parents were interviewed, 251 in the "exposed" group and 253 in the "unexposed" group. Parents exposed to Safe Kids Week 2001 were 1.5-5 times more likely to be aware of key campaign messages, and 2-3 times more likely to test and lower the water heater temperature, compared with unexposed parents. CONCLUSION: Safe Kids Week 2001 reached a significant proportion of parents of young children. In addition, the campaign appeared to increase burn safety knowledge and lead to behavior changes among exposed parents, compared with unexposed parents.

Accidents, Home↗

PubMed1979

Factors in child burn and scald accidents in Bradford 1969-73.

A study has been undertaken of burn and scald accidents to children in Bradford. In the first part, 1577 accidents treated in the Bradford Royal Infirmary between 1969 and 1973 were analysed by city ward of residence of the patient and these were correlated with 14 social and demographic characteristics of the wards. A correlation was found between burn and scald accidents and New Commonwealth immigrants and overcrowing. In the second part, 78 families at the burns clinic were interviewed. Similar patterns to those in the larger study were found. Although clinical impressions emerged concerning the details of the accidents the interviews did not provide any explanation for the main findings.

Burns↗

PubMed1990

A study of scalds in Birmingham.

The causes of serious domestic scald injuries in Birmingham were studied for one year. Seventy-eight people sustained such scalds, 11 adults and 67 children. Only 51 of the patients received satisfactory first aid. Most accidents could have been avoided and the severity of the injury would have been less if appropriate first aid had been given.

Accident Prevention↗

PubMed1984

Structural and biochemical aspects of liver cell nuclear organization in normal and scalded rats.

The response of rat liver nuclei to thermal injury was studied at the ultrastructural and biochemical levels using nuclei isolated in the presence of either Mg2+ or polyamines and metal chelators. The extent of chromatin condensation, as revealed by electron microscopy, increased in the order: nuclei in situ, Mg-stabilized nuclei, polyamine-stabilized nuclei. In addition, we observed that thermal injury caused an increase in the number of nuclear pores, an enlargement of nucleoli and an accumulation of ribonucleoprotein material. Along with this, greater amounts of protein, DNA and RNA were retained in nuclei from scalded rats. The salt-resistant residue from Mg-stabilized nuclei was a spherical proteinaceous structure of the nuclear matrix, whereas that of the polyamine-stabilized nuclei was amorphous and deprived of three major constituents of the spherical matrix, the 60-70 X 10(3) Mr lamina proteins. However, exposure of the polyamine-stabilized nuclei to Ca2+ and Mg2+ rendered the 60-70 X 10(3) Mr proteins salt-insoluble and thus enabled the extraction of a spherical residual nuclear structure. This structure was highly enriched in DNA, RNA and non-histone proteins and, hence, more like dehistonized nuclei than the minimal residual nuclear structure. It retained 70% of DNA in the controls but virtually all the DNA in scalded rats. This difference was interpreted to reflect activation-related changes in chromatin organization.

Animals↗

PubMed2003

Accidental scald burns in sinks.

Scald burns to the feet and lower extremities in children are described in the literature as often resulting from forced immersions. This report illustrates 3 cases of burns whose distribution and historical factors identify them as accidental. The location of these accidental burns is similar to those found in inflicted injury, but the patterns were indicative of flowing water burns, not forced immersions. Burns in these locations may be confused with abuse. Medical providers need to be aware of information that may enable them to distinguish the 2 causes. Effective caregiver education regarding the importance of lowering the temperature of water heaters and discouraging play in household sinks is critical to prevent additional tap water scald burn injuries.

Accidents, Home↗

PubMedDate not supplied

Prevention of scald injury on the peritoneo-serosal surface in advanced gastric cancer patients treated with intraperitoneal hyperthermic perfusion.

In attempts to avoid the side-effects derived from a scald on the peritoneo-serosal surface during intraperitoneal hyperthermic perfusion (IPHP) for advanced gastric cancer, a randomized study using cimetidine, a histamine H2-receptor antagonist, was carried out on 18 patients with advanced gastric cancer. Cimetidine, 50 mg/kg, was administered intravenously and immediately before IPHP. The background characteristics of the patients and the types of surgical treatment used were almost the same between each group of patients, whether or not cimetidine was given. The perfusion time in the cimetidine and control groups was 123 +/- 9 and 117 +/- 9 min, respectively. The inflow and outflow temperatures of the perfusate were 46.3 +/- 0.4 and 44.2 +/- 0.1 degrees C in the cimetidine group, respectively, whereas in the control group the temperatures were 46.0 +/- 0.3 and 44.1 +/- 0.2 degrees C, respectively. In the nine patients who were given cimetidine, the histamine concentrations in the peripheral blood increased significantly, compared to those in the nine controls; this resulted from the release of histamine into the circulating blood. Higher concentrations of protein were observed in the post-hyperthermic intraperitoneal exudate of the control group for 3-24 h after IPHP and, consequently, post-hyperthermic hypoproteinaemia was remarkable in the control group. These data suggest that when pre-IPHP cimetidine was prescribed for patients with gastric cancer treated with IPHP, the peritoneo-serosal surface was protected from scald injury and the side-effects of IPHP were reduced.

Blood Proteins↗