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PubMed1979

Staphylococcal ophthalmia neonatorum and the staphylococcal scalded skin syndrome.

A 3-week-old infant had neonatal ophthalmia neonatorum, treated in a routine manner which rapidly developed into an advanced case of staphylococcal scalded skin syndrome. The infant had sudden onset of widespread erythematous and tender areas of skin with subsequent exfoliation of large surface areas. We emphasize the recognition of this syndrome and the understanding that it may rapidly become a serious consequence of staphylococcal ophthalmia neonatorum. We stress the need for initial microbiologic studies and early antibiotic therapy for ophthalmia neonatorum.

Anti-Bacterial Agents↗

PubMed1975

Plasma pyridoxal phosphate levels and tryptophan metabolism in children with burns and scalds.

Depression of the pyridoxal phosphate concentration in the plasma was observed in eight children after burning or scalding. The concentrations remained low for several weeks with the usual dietary supplements but could be restored rapidly with large doses of pyridoxine; this does not seem to alter the excretion of xanthurenic acid but causes an increased loss of kynurenic acid and kynurenine.

Burns↗

PubMed1975

Zinc and copper urinary excretions in children with burns and scalds.

The daily urinary losses of zinc and copper have been measured over periods of up to 12 days following thermal injury in 18 children. Comparison with measurements of zinc and copper excretions in 35 control children showed that after injury by burning or scalding, the urinary excretions of both metals were increased in many of the patients. After severe injury, high urinary outputs of zinc and copper persisted for up to two months following injury.

Adolescent↗

PubMed1977

Metabolism of nicotinic acid in children with burns and scalds.

The excretions of two metabolites of nicotinic acid, N1-methylnicotinamide and N1-methyl-2-pyridone-5-carboxamide have been measured at varying times after injury in a group of 27 burned or scalded children. Compared with control patients the excretions of both of these metabolites were significantly raised after injury, which suggests that the utilisation of nicotinic acid is increased.

Burns↗

PubMed1979

The urinary excretions of iron and chromium by children with burns and scalds.

There is a wide variation in the urinary output of chromium by children who have been burned or scalded. It seems possible that when the excretion of chromium is increased this may be related to an increased plasma concentration of glucose which may follow injury, and when the excretion of chromium is reduced this may be related to a low body content of chromium. During the first seven days after injury there is a significant increase in the excretion of iron. Likewise the iron/chromium ratio is also raised over the first seven days. The overall loss of iron during the first twelve days or thereabouts is probably not sufficient to require nutritional supplements over this period.

Burns↗

PubMed1995

Autonomic control of the regional hemodynamic response to scald.

Ultrasonic flow probes were placed around the ascending aorta and each femoral artery of dogs to record cardiac index and femoral blood flow, respectively. Intravenous hexamethonium (n = 5) produced 30% decreases in systemic mean arterial pressure and in cardiac index, and a 14% increase in femoral blood flow, effects that waned over time, consistent with the half-life of the agent. Without hexamethonium, hind paw scalding with boiling water for 5 sec (n = 5) caused a marked increase in ipsilateral femoral artery blood flow (70.7 +/- 8.9 ml/min pre-burn vs 243.7 +/- 23.7 ml/min 5 min post-burn) that persisted for the 3 hr observation period. Contralateral femoral blood flow, systemic mean arterial pressure, and cardiac index were unchanged. Compared to burn only dogs, pre-burn treatment with hexamethonium (n = 6) blunted the femoral vasodilator response to burn (78.8 +/- 9.7 ml/min pre-burn vs 116.5 +/- 7.5 ml/min 5 min post-burn). These data suggest that postganglionic autonomic nerves are at least partially responsible for mediation of the regional vasodilator response to thermal injury.

Animals↗

PubMed1986

Kinetics of lymphoproliferative responses following scald injury in a rat burn model.

Splenic lymphocytes from scalded and nonscalded rats were studied for their proliferative response to phytohemagglutinin, and to allogeneic cells in a one-way mixed lymphocyte culture (MLC). A significant suppression of the proliferation of lymphocytes in both these assays was observed as early as 4 days postinjury as measured by the [3H]thymidine uptake studies. The lymphocyte response to PHA returned to normal levels by Day 21 postinjury, whereas the MLC responses continued to be suppressed. The MLC responses between nonburned and burned animals could be restored by the addition of a lymphokine-rich culture supernatant obtained from concanavalin A-activated lymphocytes from normal nonburned rats, as well as by the addition of purified human interleukin 2 (IL-2) and rat interleukin 2. However, the addition of purified human interleukin 1 and human interferon gamma (Hu-IFN-gamma) did not bring about a significant change in the proliferation of burned rat spleen cells in MLC. Cells from burned rats were also tested for the development of suppressive activity by adding splenic lymphocytes from 2-week postburn rats to an ongoing one-way MLC. The addition of lymphocytes from burned rats resulted in significant suppression (81%) of MLC responses among normal nonburned rats. The data suggest that the development of suppressor cells following burn injury along with a defect in production and/or uptake of IL-2 may be partly responsible for immune suppression following burn injury. Since the proliferative response of lymphocytes from thermally injured rats is suppressed in a similar fashion as that found in thermally injured patients, the rat appears to be a good model for the study of kinetics of immune suppression following burn injury.

Animals↗

PubMed1984

Analysis of an outbreak of staphylococcal scalded skin syndrome: strategies for typing 'non-typable' strains.

Thirteen newborn babies were studied during an outbreak of scalded skin syndrome. Staphylococci isolated from seven babies were non-typable using the international set of typing phages; the remainder were of phage group II. In only one instance was there transmission of phage group II strains other than within families. However, 'heat treatment' and plasmid profiles of the non-typable strains showed that five of the seven babies were infected by strains which were indistinguishable. These five strains were more closely related to phage III staphylococci than to phage group II. The identity of the epidermolytic toxin has not been established.

Bacteriophage Typing↗

PubMed1984

Effects of hyperbaric oxygen on oedema formation after a scald burn.

Hyperbaric oxygen (HBO) has been advocated as an adjuvant in the therapy of thermal burns. One of the positive effects was reported to be a decrease in fluid requirements. The effect of HBO on oedema formation was evaluated in the burned area and in distant areas. Fifty-four mice were used in a standardized scald burn model, burning their left ear. Biopsies were taken from the left and right ear and from the quadriceps muscle 2, 6 and 24 hours after burn. Half of the group was treated with HBO immediately after burn. In the burned HBO treated group the oedema of the burned ear was not significantly different from that of burned untreated mice. With HBO treatment the water content in the contralateral ear was significantly (P less than 0.01) lower and in these animals the water content of the contralateral uninjured ear was not significantly different from that of uninjured untreated animals. In the burned HBO treated animals there was a significantly (P less than 0.05) lower water content of the quadriceps muscle 2 and 24 hours after burn compared to the burned untreated animals. This experimental study indicates a significant reduction of the general post-burn oedema with a HBO treatment.

Animals↗

PubMed1985

The effect of prompt local cooling on oedema formation in scalded rat paws.

A standardized, reproducible burn model on rat paw was used and the effect of prompt local cooling on the oedema formation was measured using a newly developed non-invasive method. A transient reduction in oedema formation was observed lasting for a longer period of time with decreasing temperature down to 0 degrees C and increasing cooling time up to 120 min. The decrease in oedema formation was followed by an increase towards or above the amount of oedema in untreated scald injury. This post-cooling increase in oedema formation was related to the temperature and the exposure time of the cooling fluid. The immediate effects of cooling are most likely due to local restriction of the blood flow as a result of cold-induced vasoconstriction. The increase of the oedema formation after the cooling period may be due to reactive hyperaemia.

Animals↗

PubMed1986

Changing patterns in the causes of scalds in young Dutch children.

The causes of burns in children who were treated as inpatients and outpatients were examined at a burn centre and a university hospital during the period 1972-85. In particular young children, from 0-5 years, were the victims of hot fluid burns caused mainly by coffee and tea. Over the years a change has taken place in the pattern of causes in spite of an increase in the consumption of tea and coffee. The number of coffee scalds has decreased markedly, probably as a result of the increasing use of electric coffee machines.

Accidents, Home↗

PubMed1986

Effect of non-lethal scalding on the amount of DNA and RNA in rat liver.

The quantities of DNA and RNA were measured in rat liver homogenate, supernatant and nuclei after scalding. Maximal increases of nuclear DNA and RNA were found 12 h after thermal injury. The RNA content in the rat liver supernatant and homogenate reached its maximum at 24 and 48 h, respectively. The results obtained in this study show that the thermal injury resulted in an activation of the genetic apparatus in rat liver cells. These findings correspond well with a significant role of the liver in post-traumatic metabolism.

Animals↗

PubMed1987

Extensive scalds following accidental immersion in hot water pools.

The scalds produced by immersion in hot water pools were extensive, usually of superficial depth on the upper parts of the body and deep dermal or full thickness skin loss on the lower parts. Blisters appeared rather slowly, within 2 days post-burn and often dispersed spontaneously. The estimated burned area on admission may thus be smaller than found subsequently. This study showed that the volume of fluid required for adequate resuscitation during the first post-burn day may be only 1.5 ml/kg/% BSA burned. Deep dermal burns were treated preferably by early tangential excision and grafting. The full thickness skin loss was treated by escharectomy and skin grafts.

Adolescent↗

PubMed1987

Absorption of glucose from the intestine following experimental scald injury in rats.

Experiments in vivo showed that absorption of glucose from the small intestine of rats was measurably decreased following scald injury. This phenomenon is probably secondary to other disturbances in metabolism, since the capacity of the intestine to transport glucose was not impaired when measured in vitro, Factors influencing the decreased capacity observed in vivo include disturbances in electrolyte metabolism and the hyperglycaemia produced as a result of the injury. The impaired capacity of the intestine to transport glucose in vivo could be partially restored to normal by administration of the mineralacorticoid deoxycorticosterone acetate, infusion with normal saline or the administration of insulin. The influences of alterations in mineral and glucose metabolism were confirmed by demonstrating an impairment of transport capacity in vivo in uninjured and adrenalectomized, or alloxan diabetic rats.

Adrenal Glands↗

PubMed1989

Omiderm treatment of scalds in children.

As a temporary dressing on scald wounds in children Omiderm was tried in 10 consecutive patients. Omiderm is a thin, transparent, hydrophilic polyurethane membrane, permeable to water and oxygen. It was applied on the wound when exudation was declining, about 4-10 hours postburn. The dressing formed a crust with the wound exudate and was removed when the wound had reepithelialized or at day 14 postburn before split skin grafting of the wound if the wound had not yet healed. The dressing had no advantages nor disadvantages compared to conventional exposure treatment with regard to healing time, rate of bacterial contamination, need for split skin grafting, quality of scars on spontaneously healed areas nor comfort to the patients.

Burns↗

PubMed1990

Fatal tapwater scald burns in the USA, 1979-86.

Four hundred and fifty-nine fatal tapwater scald burn injuries reported to the Injury Information Clearinghouse of the Consumer Product Safety Commission from 1979 to 1986 were studied. Data concerning the 459 deaths were abstracted from the death certificate file maintained by the Clearing house. Risk estimates were derived, using the resident population of the USA as of 1 July 1982 as the midpoint population estimate. Over half the deaths occurred in those over 75 years of age, while about one-fifth of the deaths occurred in children younger than 5 years of age. The crude mortality rate was approximately two deaths per million population over the 8-year period studied. In all age groups, black-skinned people experienced an approximate three-fold increase in risk (RR = 3.23, 95% CI: 2.87, 3.63). Among the elderly, males experienced an approximately 50 per cent increase in risk (RR = 1.47, 95% CI: 1.26, 1.72). One of every eight fatal injuries was sustained in a public building or residential institution. Implications of the current findings in terms of targetted prevention efforts are discussed.

Accidents, Home↗

PubMed1994

Long-term results of treatment of scalds in children with glycerol-preserved allografts.

A retrospective study followed by a clinical examination was carried out 2-5 years postburn to analyse the long-term results of the treatment of scalds in children (n = 45) with glycerol-preserved allografts. In 21 patients (47 per cent), the wounds healed spontaneously. In 24 patients, remaining defects were closed by a split skin autograft in the third week postburn. Healing without scar formation was seen in 24 patients (53 per cent), 9 patients (21 per cent) showed moderate, and 12 patients (26 per cent) severe scar formation. Transplanted areas showed hyperpigmentation, and donor sites depigmentation. The cosmetic results require further improvement, and classification of present and new methods of treatment. Clinical research is limited by the number of observations and the great variation in wounds. A well-standardized experimental animal model is, therefore, essential.

Adolescent↗

PubMed2004

Scalds in van drivers.

This report concerns 16 cases of patients admitted to our burns unit, between May 1997 and June 2003, for burns caused by the explosion of the heating system in their vehicles. In 15 of these cases, the vehicle in question was the same; the Renault Express van (P < 0.0001 in a Poisson test). While driving their vehicle, the patients suffered burns to the lower extremities and the genitals which in most cases, required surgery. Three patients suffered accidents after the scalding, due to loss of control of their vehicles. This type of injury is associated with significant complications.

Accidents, Traffic↗