RESUMEN
Analysis of an unusual cause of burn injury together with assessment of long-term end results was carried out. The 'tandir' is a kind of oven buried underground and resembles a big hole full of embers and surrounded with sheet iron. Most of the burn victims were children. 68 major burn cases have been admitted to our units in a 3 year period, 32 (47%) of them due to a 'tandir'. In most of the cases burn injuries included the head and both hands as a result of the specific characteristics of the 'tandir'.
Asunto(s)
Quemaduras/etiología , Culinaria , Accidentes Domésticos , Adulto , Quemaduras/epidemiología , Quemaduras/cirugía , Preescolar , Traumatismos Craneocerebrales/epidemiología , Traumatismos Craneocerebrales/etiología , Traumatismos Craneocerebrales/cirugía , Estudios de Seguimiento , Traumatismos de la Mano/epidemiología , Traumatismos de la Mano/etiología , Traumatismos de la Mano/cirugía , Humanos , Incidencia , Reoperación , Trasplante de Piel , Colgajos Quirúrgicos , Índices de Gravedad del Trauma , Resultado del Tratamiento , Turquía/epidemiologíaRESUMEN
Neuroma formation at the proximal end of a divided nerve is a common problem in peripheral nerve surgery. Forty-eight nerve endings in 23 patients with traumatic or post-elective surgery amputation stumps were capped with either an epineural ligature, epineural flaps or an epineural graft. Each technique was used on 16 nerve endings. After at least 6 months follow-up, pain at the nerve endings was assessed by tapping the treatment sites and asking the patients to score their pain on a visual analogue scale (VAS) from 0 to 10. The mean VAS scores were 5.18 for epineural ligatures, 4.25 for epineural flaps and 2.06 for epineural grafts. Epineural grafts were significantly more effective in preventing neuroma pain (ANOVA: F = 11.4, P < 0.05).
Asunto(s)
Amputación Quirúrgica/efectos adversos , Amputación Quirúrgica/métodos , Amputación Traumática/complicaciones , Brazo/inervación , Neuroma/prevención & control , Adolescente , Adulto , Dedos/cirugía , Estudios de Seguimiento , Mano/cirugía , Humanos , Ligadura/métodos , Persona de Mediana Edad , Neuroma/etiología , Nervios Periféricos/cirugía , Nervios Periféricos/trasplante , Colgajos Quirúrgicos/métodosRESUMEN
In this study on patients with thermal trauma, we examined the effects of standard therapy plus prophylactic polyclonal immunoglobulin G (IgG) treatment on humoral and cellular contents, cell phenotype and function of the immune system, and compare these with those found in patients receiving only standard therapy. The quantitative, peripheral-blood mononuclear cell panel shows a decrease in the total number of T-lymphocytes and an increase in the natural killer (NK) cells of standard therapy patients 3 weeks following the burn. We found that intravenous IgG treatment does not have an important effect on T lymphocytes and the proportion of their subpopulations, but rather causes a significant decrease in the number of B lymphocytes and an increase in the number of NK cells. When comparing the DNA synthetic response to mitogenic and antigenic stimuli in patient's T and B lymphocytes using phytohaemagglutinin, pokeweed mitogen or allogenic mixed cells in separate in vitro cell cultures, the highest suppressive effect of thermal trauma is seen in the cells derived from the patients who had been given prophylactic IgG therapy. The presented data confirm that thermal trauma causes an immunosuppressive effect and indicate that prophylactic polyclonal IgG therapy increased the quantitative and functional suppression of the specific immune system while additionally increasing the cellular levels of the non-specific immune system, each system having been previously stimulated by thermal trauma.