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PubMed2002

[The change of the gene expression of NMDA receptor subunits in rat hippocampus after scalding].

OBJECTIVE: To observe the change of the gene expression of N-methyl-D-aspartate receptors (NMDAR) subunits in rat hippocampus after scalding. METHODS: The backs of the rats were shaved and immersed in warm water for 10 sec. to make control group (C), and the backs shaved and immersed in hot water (90 degrees C) for 10 sec to make 30% full skin scalding model as the scalding group (S). The mRNA expression of the subunits of rat hippocampus NMDAR-NMDAR1, NMDAR2A, NMDAR2B, NMDAR2D was determined with RT-PCR technique in C group and at 0.5, 1, 2 and 4 postburn hours (PBHs) in S group. RESULTS: (1) There exhibited no obvious change of the mRNA expression of all the subunits of NMDAR at 0.5 and 1 PBH in S group when compared with that in C group. But the mRNA expression of NMDAR1 increased for 24.3% and 20.9% and that of NMDAR2A increased for 27.8% and 27.6% at 2 and 4 PBHs respectively when compared with that in C group (P < 0.05). In addition, the mRNA expression of NMDAR2B and NMDAR2D revealed no change after scalding. CONCLUSION: The receptor channel constructed by NMDAR1/NMDAR2A demonstrated increased mRNA expression at 2 PBH, which might lead to the further opening of NMDAR after scalding which might participate in the maladjustment of HPA axis during scalding stress and the following pathophysiological changes.

Animals↗

PubMed2002

[An experimental study on the influence of inhibition of postburn stress on inflammatory reaction in severely scalded rats].

OBJECTIVE: To investigate the influence of hibernation drugs on postburn stress and inflammatory reaction in severely scalded rats. METHODS: Sprague-Dawley rats inflicted with 30% TBSA deep partial thickness scalding were employed as the model. The rats were divided into A (scalding with immediate resuscitation), B (scalding with immediate resuscitation and lytic cocktail), C (scalding with delayed resuscitation), D (scalding with delayed resuscitation and lytic cocktail) and E (sham injury) groups. The rat plasma levels of NE (norepinephrine), E (epinephrine) and DA (dopamine) were determined by HPLC (high performance liquid chromatography) at 3, 6, 12, 24 and 48 postburn hours (PBHs), and the plasma IL-1alpha and PGE(2) levels were detected by ELISA (enzyme-linked immunosorbent assay) and RIA (radioimmunoassay) methods. The NF-kappaB activity in PBMCs (peripheral blood mononuclear cells) was determined by laser scanning confocal microscope. RESULTS: The plasma NE and E levels reached summit at 6 PBH, while those in B group were lowest. But the plasma DA level was similar among all groups at all time points. The plasma IL-1alpha and PGE(2) levels increased continuously, however, the levels were were lower in B than A groups at the same time points, and also that of D were lower than C groups. At the same time points, the levels in B group were lower than those in D group. The NF-kappaB was located in the cytoplasma of PBMCs in E group and in the nucleus in A group at 6 PBH. Furthermore, the NF-kappaB was concentrated more in the cytoplasm than that in the nucleus in B group, while it was more concentrated in the nucleus in C and D groups. CONCLUSION: The secretion of stress hormones could be attenuated by hibernation drugs. The plasma cytokine levels and the nuclear translocation of NF-kappaB in PBMCs could also be modulated by the drugs.

Animals↗

PubMed2002

[Effects of clonidine on myocardial Gs alpha mRNA expression after scalds in rats].

AIM: To explore the role of clonidine (Clo) on myocardial Gs alpha mRNA expression after scalds in rats. METHODS: A 30% skin-full-thickness scald was produced by immersing rats in 95 degrees C water for 10 s. The myocardial Gs alpha mRNA expression level, cyclic AMP content and adenylyl cyclase (AC) activity were determined with dot blotting hybridization, in situ hybridization, radioimmunoassay and indirect method. RESULTS: Three hours after scalds, the myocardial Gs alpha mRNA was significantly decreased to (61 +/- 20)% of the control group (P < 0.01). AC activity and cAMP content were also decreased. Clo (0.3, 1.0 and 3.0 mg.kg-1, i.p.) was shown to increase myocardial Gs alpha mRNA expression level (P < 0.01 or P < 0.05) after scalds to (131 +/- 28)%, (142 +/- 51)% and (139 +/- 48)% of the scald group, respectively, which were correlated with the Clo dose (gamma = 0.597, P < 0.05). Clo 1.0 mg.kg-1 and 3.0 mg.kg-1 (i.p.) promoted AC activity and increased cAMP content, but Clo 0.3 and 0.1 mg.kg-1 showed no significant effect (P > 0.05). Selective I1-imidazoline receptor antagonist efaroxan (Efa) (10, 5 mg.kg-1, i.p.) was found to partially reverse the effect of Clo, while Efa 2.5 mg.kg-1 showed no significantly influence. The reduced quantity of Gs alpha mRNA expression level correlated well with the Efa dose (gamma = 0.900, P < 0.05). The change of AC and cAMP was similar to Gs alpha mRNA. CONCLUSION: Clo increased the myocardial Gs alpha mRNA expression, AC activity and cAMP content after scalds in rats.

Adenylyl Cyclases↗

PubMed2004

[The protective effect of supplementation of probiotics combined with riboflavin on the intestinal barrier of the rats after scald injury].

OBJECTIVE: To investigate the effect and its possible mechanism of the supplementation of probiotics combined with riboflavin on the intestinal barriers of the rats after scald injury. METHODS: Seventy Wistar rats were used in the study and were randomly divided into scald control (SC, n = 30), scald and treatment (ST, n = 30) and normal control (NC, n = 10) groups. The rats in SC and ST groups were subjected to 30% TBSA III degree scald. 1.5 ml of isotonic saline suspension containing 5 x 10(12) CFU/L of Bifidobacteria, 5 x 10(10) CFU/L of Bacillus cereus and 5 mg/L of riboflavin was given to rats by gavage in ST group twice a day. For the rats in SC and NC group equal amount of isotonic saline was fed twice a day. The changes in the incidence of bacterial translocation, the amount of intestinal membranous flora, the synthesis and secretion of SIgA in the ileum, and the repair of injured intestinal mucosa were observed. RESULTS: The incidence of bacterial translocation in ST group was significantly lower than that in SC group (P = 0.000 - 0.025). The plasma level of endotoxin in ST group was markedly lower than that in SC group on 3 post-scald day (PSD) (P < 0.05). The amount of bifidobacteria in caecal membrane flora increased by about 20 to 40 fold, whereas the amounts of E. coli and fungi significantly decreased (P < 0.01). The membranous injury scoring was 3 to 0 on 5 PSD (P < 0.05), and the SIgA content in intestinal mucus returned to normal value on the 5th PSD (P < 0.01) in the ST group. CONCLUSION: Supplementation of probiotics together with riboflavin could ameliorate translocation of bacteria and endotoxin in rats with scald injury, implying that the intestinal barrier function was effectively protected.

Animals↗

PubMed2004

[Effects of topical emu oil on wound healing in scalded rats].

OBJECTIVE: To observe the effect of topical emu oil on wound healing in scalded rats. METHODS: Thirty Wistar rats with second degree scald were randomized into emu oil group, povidone iodine group and liquid paraffin group. The times of twisting of the rat body, water content and effusion of the scald wound and the percentage of wound healing were observed. RESULTS: Compared with povidone iodine and liquid paraffin, emu oil reduced the times of body twisting of the scalded rats, the water content and effusion of the scald wound, and increased the percentage of wound healing. CONCLUSION: Emu oil can alleviate inflammation in the scald wound and promote wound healing in rats.

Administration, Topical↗

PubMed2004

[Influence of escharectomy during shock stage on the systemic and intestinal immune function in scalded rats].

OBJECTIVE: To investigate the influence of escharectomy during shock stage on systemic and intestinal immune function and its mechanism in scalded rats. METHODS: Ninety-six Wistar rats were employed in the study of which 8 were used as normal control group. The donor skin from the trunk in twenty-four rats were preserved in liquid nitrogen. The other 64 rats were subjected to 30% full-thickness scalding, and they were randomly divided into A (n = 24, no treatment after scalding), B (n = 24) and C (n = 16) groups. Physiological saline was intraperitoneally injected (50 ml/kg) on the 24 post-scalding hours to the rats in the B and C groups. The rats in B group underwent escharectomy during shock stage, and the excision wounds were covered with the cryo-preserved alloskin. The rats in C group received the same treatment as in B group but at 72 post-scalding hours. The change in the proliferative ability of splenic lymphocytes, the plasma and intestinal tissue content of interleukin 2 (IL-2), the contents of sIgA in intestinal mucus, and the content of DAO in the intestinal tissue were observed on 2, 4 and 8 post burn days (PBD) in A and B groups and also on 4 and 8 PBD in C group, respectively. RESULTS: The splenocytic proliferative ability, IL-2 level in the plasma and intestinal tissue, and the sIgA content in intestinal mucus in the rats in A, B and C groups were lower than that in control group at all time points (P < 0.05). The proliferative ability of splenic lymphocytes in B group on 4 and 8 PBD and in C group on 8 PBD respectively was similar to that in control group. Whereas the IL-2 content in plasma and in intestinal tissue was higher in B and C groups than that in A group (P < 0.01). The sIgA content in intestinal mucus in B group was twice of that in C group respectively [(3.51 +/- 2.14) mg/g vs (1.40 +/- 0.64) mg/g, (3.03 +/- 0.95) mg/g vs (1.52 +/- 1.26) mg/g (P < 0.05 or P < 0.01)] on 4 and 8 PBD. The DAO activity in the intestinal tissue in A group was lower than that in control and B group (P < 0.05) on 4 and 8 PBD. CONCLUSION: Escharectomy during shock stage might be beneficial to the recovery of the systemic and intestinal immune functions in rats with scalding injury.

Animals↗

PubMed2005

[An experimental study on the prevention of enteral bacterial translocation in scalded rats by smectite powder].

OBJECTIVE: To explore the preventive and treatment effects of smectite powder on enteral bacterial translocation in scalded rats. METHODS: Fifty-four Sprague-Dawley (SD) rats were randomly divided into three groups, i.e. normal control (A, n = 6), burn control (B, n = 24), and burn treatment (T, n = 24) groups. The rats in B and T groups were fed with tracing bacteria JM109, which was transfected with PUC19 plasmid in advance. The rats were subjected to 30% TBSA scald injury after the plasmid was shown to have colonized in the intestine. Smectite powder (0.6 g/day/kg) was fed to rats of T group immediately after the scalding, while those in B group received no smectite powder. Bacterial translocation in blood and mesenteric lymph nodes in all groups was observed and identified by enzyme digestion at 12 post scald hour (PSH) and on 1, 3 and 5 post-scald days (PSD). The contents of malondialdehyde (MDA) and superoxide dismutase (SOD) were determined in rat intestinal tissue. And the degree of injury to the entire small intestine was observed pathologically. The villus height of intestinal mucosa was measured, and the rate of epithelial nuclear splitting of mucosal crypts was calculated. RESULTS: The number of rats with positive blood bacterial culture in B group was obviously higher than that in A and T groups (P < 0.05) on 1 and 5 PSD. The bacterial quantity in mesenteric lymph nodes (MLN) in T group on 1 PSD (38 +/- 16 CFU/g) and 5 PSD (68 +/- 20 CFU/g) were obviously lower than those in B group (228 +/- 67 vs 183 +/- 29 CFU/g, P < 0.05). There was significant difference in the intestinal contents of MDA and SOD between B and T groups at each time point (P < 0.05). The rat jejunum villus height and the epithelial nuclear splitting in the small intestine mucosa in T group were evidently higher than those in B group (P < 0.05 or 0.01). CONCLUSION: Smectite powder is beneficial to the protection of the intestinal mucosa in scalded rats, and can effectively prevent postburn intestinal bacterial translocation in rats.

Animals↗

PubMed2005

[The influence of lipopolysaccharide on adipose metabolism in liver during shock stage of scalded rats].

OBJECTIVE: To investigate the influence of lipopolysaccharide (LPS) on adipose metabolism in liver during shock stage of scalded rats. METHODS: Sixty adult Wistar rats were inflicted with 30% TBSA full thickness scald and were randomly divided into 3 groups: i. e. sham group (control, n = 20), simple scald group [(n = 20) and LPS group (n = 20, with intra-peritoneal injection of 3.0 mg/kg LPS at 2 postscald hour (PSH)]. The contents of LPS, tumor necrosis factor alpha (TNF-alpha), free fatty acids (FFA) in plasma and adenosine triphosphate (ATP), triglyceride (TG), malonaldehyde (MDA) in liver in each group were determined at 24 and 48 PSH. The histological changes in hepatic tissue in each group were also observed. RESULTS: The plasma contents of FFA in LPS group at 24 and 48 PSH were 2.3 +/- 0.3 mmol/L and 2.5 +/- 0.4 mmol/L, respectively, which were obviously higher than those in control (0.4 +/- 0.3 mmol/L, 0.5 +/- 0.3 mmol/L) and scald (0.9 +/- 0.3, 1.2 +/- 0.5 mmol/L, P <0.01) groups. Meanwhile, there was obvious difference in the contents of TG and ATP in liver between LPS group (TG: 530 +/- 30 mmol/g, ATP: 1.7 +/- 0.5 micromol/g) and scald group (TG: 242 +/- 27 mmol/g, ATP: 6.0 +/- 2.4 micromol/g, P < 0.01). Pathological examination revealed that adipose denaturalization and injury to mitochondria in hepatocytes in scald group were significantly milder than those in LPS group. The morphology of hepatocyte in control group appeared normal. CONCLUSION: LPS challenge to burn subjects could induce impairment in utilizing fat derived energy, and it would aggravate adipose denaturalization in the liver.

Adenosine Triphosphate↗

PubMed2005

[The influence of non-peptide NK1 receptor antagonist L-703, 606 on the early tissue edema formation in rats with deep partial-thickness scald].

OBJECTIVE: To investigate the influence of non-peptide neuro-kinase 1 (NK1) receptor antagonist L-703, 606 on the early tissue edema formation in rats with deep partial-thickness scald. METHODS: One hundred and fifty-two SD rats were enrolled in the study and were randomly divided into normal control (NC, n = 8), scald control (SC, n = 48, with 20% TBSA deep partial thickness scald), L-703, 606 treatment (LT, n = 48, with 20% TBSA deep partial-thickness scald 20 minutes after caudal vein injection of 250 nmol/kg L-703, 606) and beta-aescin treatment (AT, n = 48, with 20% TBSA deep-partial-thickness scald 30 minutes after caudal vein injection of 1.8 mg/kg beta-aescin) groups. The rats were sacrificed at 1, 4, 8, 24, 48 and 72 post scald hours (PSHs), with 8 rats at each time point. The peri-wound tissue and jejunum samples were harvested for the detection of vascular permeability and tissue water content with modified Evans blue extravasation method and average water content assay. RESULTS: The vascular permeability was significantly higher in the peri-wound tissue and jejunum in SC, LT an AT groups than that in NC group (P < 0.01) at 1 PSH, and it decreased gradually at 4 PSH. The vascular permeability in the peri-wound tissue in LT and AT group was significantly lower than that in SC group (P < 0.01), and that in LT group was markedly higher than that in AT group (P < 0.01) at 48 and 72 PSHs. The vascular permeability of jejunum tissue in LT group was lower than that in SC group within 24 PSH (P < 0.01), while that in AT group was lower than that in LT group at the early postscald stage (P < 0.01), but no obvious difference was found between the two groups after 72 PSH (P > 0.05). The change in the tissue water content was as follows: Dehydration was observed in peri-wound tissue in SC, LT and AT groups at 1 PSH. The tissue water content increased gradually thereafter and reached the peak at 8 and 24 PSH. Certain degree of dehydration was observed in jejunum tissue in SC, LT and AT groups at early postscald stage. The water content in jejunum tissue in LT group was evidently higher than that in SC and AT groups (P < 0.05 or 0.01), edema was evident at 8 PSH, and it became more obvious at 48 PSH, then it subsided gradually. Edema was less evident in LT group. CONCLUSION: Nonpeptide NK1-receptor antagonist L-703, 606 was able to mitigate the vascular permeability and reduce tissue water content in peri-wound and jejunal tissues.

Animals↗

PubMed1991

Bath scalds in children in the south-east of Scotland.

Scalds caused by domestic hot tap water constitute a significant but preventable hazard in childhood. We have reviewed some of the factors contributing to such injuries, and the experience of a regional paediatric burn unit in their treatment. There were 91 children with bath water scalds and 667 children with thermal injuries from other sources included in this study. In the former group, scalds were more common on the limbs, including the hands and feet. Scalds involving over 40% of body surface area were more common in children with bath water injuries; however, there was no difference between the groups with regard to hospital stay or requirement for skin grafting. Parents ran the bath responsible for scald production in most cases, but single parenthood did not appear to be a risk factor. First aid application made no significant difference to eventual burn area or hospital stay. It appears from this study that reduction of domestic hot water temperature is necessary. Statutory control is likely to offer the best solution to the problem of domestic hot tap water scalds in childhood.

Baths↗

PubMed1980

Comparative investigations of in vitro and in vivo scalding of mouse skin.

Mouse skin was scalded in vitro by the wet (immersion) method and dry (metal stamp) method. For in vivo scalding only the dry method was used. The content of dry mass of skin was investigated. In extracts of scalded skin the content of soluble components: protein, collagen, albumin and IgG was determined. The analyses and statistic estimation revealed that with respect to the observed effects the in vivo scalding of skin is similar to the ion vitro dry scalding but different from the in vitro wet method. Moreover, it is suggested that protein substances which are products of thermic denaturation of skin can penetrate from scalded skin into the surrounding tissues.

Albumins↗

PubMed1995

[Induction of HSP70 mRNA in the brain and liver of rats after scalding].

Induction of hsp70 mRNA in rats after scalding was analysed using 32P labeled hsp70 cDNA. The results showed that the expression of hsp70 mRNA in brain and liver was induced markedly after scalding. Time course of the increase showed that induction took place within 5 min and subsided 24 h after scalding. In the liver, induction took place still earlier, i.e. within 1 min and lasted for more than 24 h. The induction of hsp70 mRNA in rats after scalding did not seem to be due to elevation of core temprature since the increase of temperature of rat brain and liver after scalding was not more than 1 degree C. Western blot anlyses further showed that the induction of hsp70 occured within 5 min and lasted for more than 3 h in the brain of rats after scalding. The above results demonstrated that the hsp expression in internal organs could be induced by local injuries and was not necessarily dependent upon the direct effect of stimuli in intact animals.

Animals↗

PubMed1995

[Effect of glucocorticoid receptor blockade on pulmonary and renal vascular permeability in scalded rats].

With glucocorticoid receptor (GR) blockade by RU38486, a competitive antagonist of GR, the change in contents of FITC labeled albumin (FITC-albumin) in pulmonary and renal tissue in scalded rats have been measured to study the changes in vascular permeability. The result showed that the contents of FITC-albumin in pulmonary and renal tissue in the scalded rats were markedly higher than those of the controls (lung: P < 0.05, kidney: P < 0.001). When the scalded rats were given GR blockade, the contents of FITC-albumin in pulmonary and renal tissue were significantly higher than those of rats with scald only (P < 0.05). The results indicated: (1) the pulmonary and renal vascular permeability in scalded rats was markedly enhanced; (2) GR blockade might aggravate the increase in vascular permeability caused by scald, so that the protective effect of glucocorticoid (GC) on vascular permeability seemed to be reversed.

Animals↗

PubMed1996

[Scalds in children caused by water from toppled electrical kettles. Mechanisms, costs and preventive measures].

Since 1988 a new type of burns in children has been recorded at the Burns Centre at Hvidovre Hospital in Copenhagen, being scalds caused by water from toppled electrical kettles (el-kettles). The children with el-kettle scalds were younger and their injuries more severe than those of children whose scalds had other causes. During the six year period 1988 to 1993, a total of 29 children (0-3 years) have been admitted with scalds caused by el-kettles, 15 children alone in 1993. The costs for treatment have been more than 3 million Danish kroner, 1.8 million DKK alone in 1993. From 1993 preventive measures were taken to reduce the number of this type of scalds. Since the number of households with el-kettles in Denmark is on the increase, an increasing number of toddlers with severe scalds could be anticipated. However, a fall in the number of children admitted was registered in 1994 (four children) and 1995 (six children).

Accidents, Home↗

PubMed1998

Alpha-trinositol reduces edema formation at the site of scald injury.

BACKGROUND: The effects of alpha-trinositol (1D-myo-inositol-1,2,6-triphosphate, IP3) on burn-induced edema formation were investigated. METHODS: Lymph flow (QL; microliter/min) and lymph-to-plasma protein ratio (CL/CP) were monitored in groups of five to six dogs before and 4 hours after (1) a 5-second 100 degrees C or 90 degrees C foot paw scald; (2) IP3 (45 mg/kg intravenous bolus, then a 20 mg/kg/hr infusion) 30 minutes before or after 100 degrees C scald, or 30 minutes after 90 degrees C scald. Hind paw venous pressure was elevated and maintained by outflow restriction until reaching steady state QL and (CL/CP)min. Macromolecular reflection coefficient (1-CL/CP) was measured. Fluid filtration coefficient (Kf; ml/min/mm Hg/100 gm) was calculated. Relative paw weight gain (%) was measured. RESULTS: Compared with preburn values, scald uniformly produced significant increases in QL, CL/CP, and Kf, IP3 significantly (p < 0.02, ANOVA) reduced paw weight gain when given before, but not after, 100 degrees C burn (41% +/- 5% versus 18% +/- 7% preburn IP3 and 31% +/- 3% postburn IP3). Compared with 90 degrees C burn animals, postburn treatment significantly (p < 0.017) attenuated 4-hour increases in QL (550 +/- 87 versus 252 +/- 29 microliters/min), Kf (0.016 +/- 00 versus 0.007 +/- 00 microliter/min/mm/Hg/100 gm), and relative paw weight gain (28% +/- 3% versus 12% +/- 5%). CONCLUSIONS: alpha-Trinositol given after a 90 degrees C scald blunted edema formation at the site of scald, likely through reduced transmembrane fluid flux.

Analysis of Variance↗

PubMed1994

Histopathological evaluation of scalds and contact burns in the pig model.

A method was developed to inflict standardized scald burns in the New Yorkshire pig. The tissue damage was compared to a standardized contact burn model. On each flank, six localizations were marked in a symmetrical way. Eight scald burns covering 45 cm2 were inflicted by exposing the prepared skin to 500 ml tap water in an applicator at 80 degrees C for 10, 20, 30 and 40 s. Four contact burns were inflicted by applying a brass block of 45 cm2 area, weight 450 gram, with a temperature of 170 degrees C for 10 and 20 s on the skin without exerting pressure. The right flank was used for macroscopic observation, the left flank for histopathological evaluation. Full thickness biopsies were taken at postburn days (PBD) 0, 1, 2, 3 and 21. In the contact burns, a clear demarcation zone of viable and necrotic dermal tissue and vascular damage was observed. The tissue damage in the scalds showed an intermingled pattern of intact and damaged collagen. The more severe scald burns showed a structurally intact superficial vascular plexus, in combination with destruction of the deep vascular plexus. Current and new methods of scald treatment can be classified in this standardized animal model.

Animals↗

PubMed2005

Should dermal scald burns in children be covered with autologous skin grafts or with allogeneic cultivated keratinocytes?--"The Viennese concept".

The treatment of scald burns in children is still under discussion. The aim of the present study was to evaluate an optimised treatment regime for scald burns in children. Between 1997 and 2002, 124 children underwent surgical intervention due to burn injuries. Thirty-six out of these 124 children were enrolled into the evaluation of our recent treatment protocol. Twenty-two children with scald burns covering an average body surface area (TBSA) of 18.5% were treated by early excision and coverage with allogeneic keratinocytes in case of partial thickness lesions (keratinocyte group). Fourteen children with a TBSA of 17.2% were treated with autologous skin grafts alone (skin graft group). Both groups were comparable according to age, burn depth and affected TBSA. The complete clinical follow-up examination of at least 17 months was performed in 12 out of 22 children of the keratinocyte group and in 9 out of 14 patients of the comparative group. Visible scar formations were classified according to the Vancouver Scar Scale (VSS) in each patient. The use of allogeneic keratinocytes led to complete epithelialisation within 12 days in 20 of the 22 cases. No secondary skin grafting procedures had to be done. Skin take rate at the sixth postoperative day was 100% in the skin graft group. Blood transfusions were administered intraoperatively according to the clinical need of the patients by the responsible anaesthesiologist. The mean volume of blood, which had to be transfused was 63.9 ml in the keratinocyte group and significantly lower than the volume of 151.4 ml, which was administered in the skin graft group (p=0.04). At follow up the VSS observed in areas covered by keratinocytes was 2.33 on the average and therefore, significantly lower than the VSS of 5.22 in skin grafted areas of the comparative group (p=0.04). In children the use of cultivated keratinocytes in partial thickness scald burns is a procedure, which renders constantly reliable results. It minimizes the areas of autologous skin harvesting and reduces the amount of blood transfusions. The fact that less scarring is observed after keratinocyte grafting leads to the conclusion that skin grafting in children should be restricted to scalded areas, which have to be excised to the subcutaneous fat tissue.

Blood Transfusion↗

PubMed2006

Scalding in Turkish children: comparison of burns caused by hot water and hot milk.

INTRODUCTION: Our aim in this study was to compare the clinical differences and etiologic risk factors for hot water and hot milk scald burns in Turkish children. METHODS: The retrospective study examined the cases of 140 children aged 0.1-7 years who had scald burns treated in three burn units of a Turkish hospital network between March 2000 and December 2004. The patients were categorized in two groups: hot water burns or hot milk burns. RESULTS: Ninety-five (67.9%) patients had hot water burns and 45 (47.1%) had hot milk burns. The proportion of patients with hot milk burns who lived in rural areas was significantly higher than the corresponding proportion for the hot water cases (75.6% versus 52.6%, respectively; p<0.01). In 20 (44%) of the hot milk cases, the burn was caused by milk being boiled in large pots outdoors for cheese production. The other 25 hot milk cases were caused by milk being boiled in the kitchen. The mean (+/-S.D.) percentage total body surface area burned in the hot milk cases was higher than that in the hot water cases (33.6+/-2.24% versus 21.42+/-1.43%, respectively; p<0.001), and the corresponding mean percentages of TBSA with full-thickness burns were 9.2+/-2.52% versus 3.13+/-0.83%, respectively; (p=0.083). The mean percentages of TBSA with second-degree burns showed the same trend (29.0+/-12.39% versus 18.8+/-1.47%, respectively; p<0.001) higher percentage of the children with hot milk burns required antibiotics (78% versus 52.8%, respectively; p<0.006). Seven (7.4%) of the hot water burn patients and 15 (33.3%) of the hot milk burn patients died during the study period (p=0.025; overall mortality rate 15.7%). CONCLUSION: Children scalded with hot milk tend to have more extensive burns, and thus have higher mortality, than those scalded with hot water. To create effective programs for preventing scald injuries in Turkey and elsewhere, it is essential to consider ethnic and cultural issues based on these characteristics. Simple precautions should be explained and methods of using liquids such as hot milk should be researched in different geographic locations in order to formulate good prevention strategies.

Animals↗