[Infections in burn patients].

Infection in patients with serious burns is usually linked to care procedures. It occurs beyond the 48th hour and is the leading cause of mortality. The risk of infection is higher in certain elderly patients or those in a precarious situation.

Antibiotics and the burn patient.

Infection is a major problem in burn care and especially when it is due to bacteria with hospital-acquired multi-resistance to antibiotics. Moreover, when these bacteria are Gram-negative organisms, the most effective molecules are 20 years old and there is little hope of any new product available even in the distant future. Therefore, it is obvious that currently available antibiotics should not be misused.

Cultured epithelial autografts in extensive burn coverage of severely traumatized patients: a five year single-center experience with 30 patients.

Objective: We report recent five-year experience in a large, single center series of severely burned and otherwise traumatized patients given cultured epithelial autografts (CEA) from a single commercial laboratory.

Summary Background Data: Initial optimism over CEA application has been tempered by subsequent reports asserting that this modality is unreliable and expensive. Discussion continues over its clinical role.

[Reflections on percutaneous tracheotomy. Regarding a retrospective study of 106 cases with major burns].

About ten years ago, a new technique for tracheotomy was invented in the United States and has tended to replace the surgical technique in intensive care units. Percutaneous tracheotomy is performed by the intensive care unit physician working in the unit at the patient's bedside. Progressive expansion seems to be the method of choice.

[Ambulatory treatment of burns in children].

A majority of burns in children may have an ambulatory management for which the paediatrician has an important role. He must assess the severity of the burn by quoting extent, depth and localization of the burn injuries and then send the most severe to a specialized burn centre. The circumstances and the social situation are important in the decision of either hospitalization or ambulatory care, remembering that the burn may correspond to child abuse.

Initial general management and surgery of six extensively burned children treated with cultured epidermal autografts.

Purpose: The aim of this study was to document the surgical and intensive care methods used in six extensively burned children (EBC), ie, total body surface area (TBSA) burned over 70% or TBSA with deep burns over 60%, treated with cultured epidermal autografts (CEA).

Methods: Six EBC, with a mean age of 7.5 years (range, 2.

[Objectives, results and future prospects of burn treatment in 1997].

When burn injuries to the skin are extensive, delays in wound closure contribute to multiple organ failure because the availability of donor sites does not allow early and permanent coverage of excised wounds. From 1991 to 1996, 30 patients with a mean burn size of 78% total body surface area (65% full-thickness) underwent skin grafting with autologous cultured epidermis (AEC) performed in the labs of Genzyme Tissue Repair Company. Twenty three were adults and seven children under 15 (mean age 29, range 2.

Evolution and significance of circulating procalcitonin levels compared with IL-6, TNF alpha and endotoxin levels early after thermal injury.

To determine the evolution and significance of circulating procalcitonin (ProCT), IL-6 TNF alpha and endotoxin levels early after thermal injury, we performed a prospective, single unit, longitudinal study. Forty burn patients with total body surface area (TBSA) > 30 per cent were studied, of whom 33 suffered an inhalation injury. Blood samples were taken on the day of admission, every 4 h during the first day and daily during the first week.

[Therapeutic monitoring of teicoplanin in a severely burned patient].

The authors report the study of the kinetics in serum and urine and the clinical safety of a high dose of teicoplanin administered in a 19 year-old patient with major burns (60% of body surface area, the half of which consisting of third-degree burns and UBS at 150) and S aureus meticillin-resistant infection. At day 1, he was given two loading infusions of 12 mg.kg-1 teicoplanin followed by 12 mg.

[Inhalation burns: apropos of 198 cases. Incidence of laryngotracheal involvement].

Inhalation burns and laryngotracheal involvement were studied in a retrospective series of 635 patients hospitalized for skin burns at the Center for Burn Treatment from January 1993 to January 1997. Inhalation burns were observed in 31.1% of the cases.

[Nosocomial infections in a burns unit. Results of a prospective study over a year].

Objectives: To assess nosocomial infections in a burn care centre, to identify patients' infection risk factors at the time of admission and factors of monthly variations of infection incidence.

Study Design: Prospective survey, from October 1992 to September 1993.

Patients And Method: The study included 140 patients staying for more than two days in a 22-bed burn unit.

[Role of autografts of cultured epidermis in the treatment of deep burns of the face. Preliminary results].

Deep burns of the face raise the problem of skin cover after surgical detersion to limit the serious functional and aesthetic sequelae which they can induce. Autologous cultured epidermal grafts currently occupy an important place in the surgical treatment of the early phases of facial burns. The authors present their preliminary results of the use of this graft technique in patients with burns of more than 60% of the body surface, including the face.

[Multiple trauma and burns].

In peace time, burn injury combined with traumatic, chemical or radioactive casualties is rarely encountered and often unrecognized; during disasters, burn injury is unlikely the only trauma. The authors try to bring out the main pathophysiological, diagnostic and therapeutic characteristics of changes induced by combined lesions on burn injury and vice-versa.

[Polytraumatized burnt patients].

In peace time, burn injury combined with traumatic, chemical or radioactive casualties, is rarely encountered and often unrecognised; during disasters, burn injury is unlikely the only trauma. The authors try to bring out the great physiopathologic, diagnostic and therapeutic principles of changes due to combined lesions on burn injury and vice-versa.