The performance of clinical risk scores in the diagnosis of necrotising fasciitis.

Objective: Necrotising fasciitis (NF) is a quickly progressing and potentially life-threatening infection, involving the fascia and subcutaneous tissues. The diagnosis of this disease is challenging, especially due to a lack of specific clinical signs. In order to ensure a better and quicker identification of NF patients, a laboratory risk indicator score has been developed for NF (LRINEC).

Characteristics and outcomes of patients with grill-related Burn injuries admitted to the Cologne Burn Center, Germany.

Background: Grilling has become increasingly common in Germany. Although grilling is considered a non-negligible household burn hazard, few reports have assessed this type of injury. This study aimed to determine the patterns and characteristics of grill-related burn injuries and to compare these with other types of burn injuries.

Comparison of the characteristics of hot tap water scalds and other scalds in Germany.

Background/aim: Mortality associated with hot tap water scalds remains significant, owing to a lack of up-to-date regulations on tap water temperature. We aimed to evaluate the effect of hot tap water scalds on patients admitted to our adult burn intensive care unit (BICU), and compare them to those with other scald types.

Methods: We enrolled patients treated for scalds at the BICU of Cologne-Merheim Medical Center from 1989 to 2014, and retrospectively analyzed their age, sex-specific differences, characteristics, length of hospital stay, number of operations, and mortality.

Antigen Titer Elevation and Mortality in Burn Patients.

Background: Mortality in burn patients has several contributing factors as sex, age, degree of burns, or inhalation injuries. Usefulness of antigen (CAG) titer is still being under debate to predict mortality. This study assessed correlation between CAG titer and mortality in burn patients.

Etiology, incidence and gender-specific patterns of severe burns in a German Burn Center - Insights of 25 years.

Introduction: Burns often require special treatment in specialized burn centers. One of the specialized German burn centers is located in Cologne-Merheim. Only little is known about the etiology of burns in Germany, their monthly distribution and changes over the past 25 years.

Pseudomonas aeruginosa bacteremia after burn injury: the impact of multiple-drug resistance.

To evaluate the clinical impact of multiple-drug resistance in burn patients with Pseudomonas aeruginosa (Pa) bacteremia. A retrospective cohort study in a 10-bed burn intensive care unit (BICU) was performed. Univariate and multivariate analyses were used to analyze the influence of multiple-drug resistance on mortality and length of BICU stay in Pa bacteremic patients.

Deep sternal osteomyelitis: an algorithm for reconstruction based on wound width.

Patients with sternum osteomyelitis are transferred to plastic surgery departments for wound coverage. Several options of flap coverage are known; however, various wound diameters need different flaps. In a retrospective study, 135 patients from 2006-2010 with deep sternal wound infections were evaluated.

Staphylococcus aureus bacteremia after thermal injury: the clinical impact of methicillin resistance.

Objective: To evaluate the impact of methicillin resistance in Staphylococcus aureus bacteremia (SAB) on mortality and length of stay in burn patients.

Design: Retrospective cohort study.

Setting: A 750-bed tertiary care university hospital in Cologne, Germany.

Early single-shot intravenous steroids do not affect pulmonary complications and mortality in burned or scalded patients.

Background And Objectives: Inhalation injury, especially in combination with cutaneous burns, is the major cause of morbidity and mortality in patients admitted to burn care centers. Either with or without the presence of a cutaneous burn, inhalation injury contributes to high risk for developing severe pulmonary complications. Steroids may reduce a prolonged and destructive inflammatory response to toxic or allergic substances.

Incidence and treatment of burns: a twenty-year experience from a single center in Germany.

Objective: To analyze trends in incidence and treatment of thermal injuries over the last two decades.

Methods: We retrospectively reviewed our local single center database of patients with thermal injuries admitted to the burn intensive care unit (BICU) of the Cologne-Merheim Medical Center (University Hospital of Witten/Herdecke). The cohort was divided into two groups according to the decade of admission and the epidemiology and clinical course of the patient sample admitted during the period 1991-2000 (n=911) was compared to that of 2001-2010 (n=695).

Failure of secondary wound closure after sternal wound infection following failed initial operative treatment: causes and treatment.

Background: Patients transferred to Plastic Surgery Departments for sternum osteomyelitis have a high morbidity of about 3%. Despite several known options for sternal wound coverage and salvage operations, wound dehiscence or wound necrosis can occur, increasing patient morbidity.

Patients And Methods: One hundred thirty-five patients admitted between January 2007 and December 2010 were evaluated in a retrospective study for wound dehiscence after salvage wound coverage at our institution.

Histometric and histomorphologic comparison of combustion and ambustion using in vivo reflectance-confocal microscopy.

Background: When combustion and ambustion induce a superficial injury, they are summarized as superficial burns, regardless of the underlying cause. Reflectance-confocal microscopy (RCM) allows noninvasive imaging of the human skin on morphological features. We hypothesized that combustion and ambustion have different histomorphological effects on the human skin.

New multifactorial burn resuscitation formula offers superior predictive reliability in comparison to established algorithms.

Unlabelled: The Parkland-Baxter formula is a widely utilized resuscitation guideline for the initial management of fluid deficits in burn victims. Implementation of resuscitation formulas has helped to reduce the incidence of shock and hypovolemic organ failure such as acute renal failure in the setting of burn trauma. However, it has been shown that indiscriminate implementation of these formulas may inappropriately suit individual patient's requirements.

Severe brain damage by current flow after electrical burn injury.

Patients sustaining high-voltage electrical injury may experience neurological sequelae. The exact mechanism of nervous cell destruction is an ongoing subject of research, frequently a combination of both thermal and nonthermal causes. In this report, brain damage of the entire right hemisphere according to the current flow with isolated affection of pre- and postcentral gyrus of left hemisphere is described.

One year ago not business as usual: wound management, infection and psychoemotional control during tertiary medical care following the 2004 Tsunami disaster in southeast Asia.

Introduction: Following the 2004 tsunami disaster in southeast Asia severely injured tourists were repatriated via airlift to Germany. One cohort was triaged to the Cologne-Merheim Medical Center (Germany) for further medical care. We report on the tertiary medical care provided to this cohort of patients.

The long-distance tertiary air transfer and care of tsunami victims: injury pattern and microbiological and psychological aspects.

Objective: On December 26, 2004, a giant earthquake shocked Southeast Asia, triggering deadly flood waves (tsunami) across the Indian Ocean. More than 310,000 people have been reported dead and millions left destitute. Shortly thereafter, European governments organized airborne home transfer of most severely injured tourists using MedEvac aircraft.