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In contrast to tangential excision, enzymatic debridement with NexoBrid® selectively removes non-viable tissue, allowing some deep dermal burn woundsto still heal conservatively. In thisretrospective study, we investigated the reduction in surgery and associated scarring following enzymatic debridement in definitely deep burns as proven by laser Doppler imaging. One hundred two exclusively laser Dopplerimaging-blue regions of interest where there was no doubt at all about the surgical indication, were selected for analysis in 32 patients treated with NexoBrid®. The total surface area of the 102 exclusively blue regions of interest was 5,086.4cm². NexoBrid® resulted in a substantial reduction in the need for autografts as 1,986.9cm² (39%) healed with conservative treatment. This corresponded with a significant reduction in patients(56.3%) requiring surgery. Exclusively laser Doppler imaging-blue regions of interest treated surgically with split thickness skin grafts required significantly more time to heal compared to conservative treatment (37.8±17.5 vs. 27.0±10.5 days). Avery limited rate of hypertrophic scarring (16.7%) was observed. Thisisthe first paper demonstrating a proven and significant reduction in the extent of autografting as well asin the number of surgical procedures afterselective enzymatic debridement in objectively laser Doppler imaging-defined and therefore proven deep burns. Even after extended conservative treatment with prolonged healing timesfollowing NexoBrid®, hypertrophic scar formation waslimited (5/54 regions of interest, 9.3%). Also in operated patients, the incidence of hypertrophic scarring following a strict regimen of aftercare was low (12/48 regions of interest, 25%). [ABSTRACT FROM AUTHOR]

Drug-induced acute pancreatitis (AP) associated with tigecycline (TGC) is considered a rare complication (incidence between 1, and 1%). In this paper, we report five cases of AP occurring after the administration of TGC in septic patients hospitalized in intensive burn care in Tunisia over 9 years. The diagnosis of AP was based on clinical and/or biological signs. Among 303 cases treated with TGC, AP occurred with an incidence of 1.65%. The mean age was 28±6 years. Only one patient had a history of chronic alcoholism. The prescribed dose was 200 mg as a loading dose, followed by 100 mg twice a day. The time to onset of symptoms after initiation of TGC was 5.4 days [2-7]. PA was suspected due to abdominal pain associated with nausea and vomiting (n=2), occlusive syndrome (n=1) and fortuitously increased pancreatic enzymes in 2 patients under mechanical ventilation. The mean lipase level at diagnosis was 447 IU ± 135 IU (4.5 to 10 times the normal). All the aetiologies of AP were ruled out, including gallstones, hypercalcemia, hypertriglyceridemia, trauma and infections. The mean time to symptom resolution after stopping TGC was 4±2 days [5-7] and to the normalization of pancreatic enzymes it was 9 days [2-20 days]. In conclusion, clinical and biological monitoring was necessary in patients treated with TGC in order to avoid severe forms, especially in at-risk patients. [ABSTRACT FROM AUTHOR]

The COVID-19 disease pandemic, representing a worldwide problem, has moved the world population into a position it has not experienced since World War II. However, there is one difference: the problem has stricken not only Europe but the whole American continent, Asia and Africa. Solution to the problem can be divided into two levels, namely medical and social. At the social level, the only solution is crisis management, or simply prevention and crisis activities carried out by representatives of the governments, and the willingness of citizens to follow specific regulations. However, a combination of the estimate of risk and efficient regulations in compliance with medical care must pursue the sole aim, namely to stabilise and stop the spread of the coronavirus. One part of crisis management is represented by the proper documentation of particular procedures and the drawing of conclusions for the future. This paper is the result of conducting an institutional project at the University of Security Management in Košice, and characterizes the position of the crisis management and rescue units in solving the pandemic in the Slovak Republic. In addition, the paper compares starting points of crisis management and measures taken by selected countries, and identifies the problem of the crisis management both at state and individual levels in Slovakia. [ABSTRACT FROM AUTHOR]

The aim of this paper is to identify the legislative basis referring to the position and activities of the Rescue and Fire Brigade Corps, the Medical Rescue Service and the Voluntary Municipal Fire Brigade in Slovakia. The paper deals with the results of an analysis based on a questionnaire research focusing on cooperation between professional and voluntary fire brigades and the Medical Rescue Service during common interventions. The research includes answers from 97 respondents. The analysis shows that cooperation between the afore-mentioned rescue units is in general good, however it has some shortcomings and problems, such as poor communication and insufficient common training. In favour of improving cooperation, members of the rescue units recommend not only frequent tactical training focusing on particular situations, but also professional training and other similar common meetings. [ABSTRACT FROM AUTHOR]

Excessive axillary sweating is a frequent reason for seeking consultation in aesthetic medicine. Botulic toxin therapies have been used for years for this condition. A microwave-based treatment (MiraDry®) has been used in France since 2011. We present the case of a patient who developed complications following such a treatment for excessive axillary sweating, namely dermal detachment, subcutaneous collections, dermal thickening, retractile scars responsible for pain and limitation of axillary amplitudes. These complications mimic the natural evolution of deep axillary burns. In this paper, we propose a management method for patients with this type of complication. [ABSTRACT FROM AUTHOR]

This paper takes the form of a case study of forest fires that occurred in Indonesia from 2014 to 2019 and were reported on the social media of Twitter. The study was a corpus-assisted discourse study (CADS) using data scraping or text mining on Twitter based on the keyword "kebakaran hutan" [forest fire] and discourse analysis. The actor-network theory was used to map the actors involved. This study concludes that five discourses show a consistently large pattern of Twitter users responding to the problem of forest fires in Indonesia. Regarding the actors, the government takes an essential role of leadership and information arbitrage on Twitter. Seeing as it is the state's responsibility to ensure the safety of all people, the government must appear to be the main holder of control in managing disaster information traffic to avoid irresponsible information or hoaxes disseminated by parties or actors. These results indicate that the availability of information obtained from every conversation of Twitter users can be used as a study or input in the formulation of evidence-based policy about forest fires. It should be given more attention as an alternative means of solving the issue of forest fires, which has become an annual problem in Indonesia. [ABSTRACT FROM AUTHOR]

When a paramedic embarks on the process of providing health care, he or she starts a long and difficult journey of professional and personal growth. The high level of complexity and responsibility inherent in the coordinated operation of rescue services while securing and carrying out activities and measures related to the provision of emergency care brings many unforeseen situations. By analyzing the risks of paramedic work, this paper seeks to identify the extent of necessary protective measures with the potential of increasing the safety of the profession. [ABSTRACT FROM AUTHOR]

Numerous burn mortality indicators and prognostic scores are necessary to classify with priorities severely burned patients in order to predict outcome. The purpose of this paper is to evaluate mortality predictors on admission, in order to determine Lethal Area 50 and to validate burn prognostic scores. The study is retrospective, clinical and analytical. The data utilized were accessed by investigating the medical charts of 5033 patients hospitalized with severe burns within the Intensive Care Unit of the Service of Burns in Tirana, Albania over the period 1992-2019. Descriptive and inferential statistics were performed using PSS 23 software. Statistical significance is defined as p<0.05. The incidence rate of hospitalization of patients with severe burns initially increased from 4.1 to 7.9 persons per 100,000 population/year in the period 1992 to 1999, followed by a decrease from 7.9 to 4.8 in 2019. Mortality was 12.2% and the average burn crude death rate was 0.7 patients per 100,000 population/year. Lethal Area 50 for the second decade (2010-2019) was 82.2%. All tested burn prognostic scores had good predictive values. In addition to the commonly used outcome predictors such as age, burn size and inhalation burn, we concluded that additional determinants like depth of burn and etiology of burns determined an unfavorable outcome. Fatality risk was 4 times higher in patients with full-thickness burns, 2.6 times higher in patients with flame burns, and 4 times higher in patients with inhalation injury. [ABSTRACT FROM AUTHOR]

Burns are a global public health problem with a large number of psychosocial and psychological problems that may ensue after burn injuries. One of the commonest psychological problems seen after burn injuries is depression, anxiety and post-traumatic stress disorder (PTSD). The following paper reviews the existing literature on PTSD following burn injuries. The concept of PTSD is explained for the non-psychiatrist involved in burn rehabilitation. The various psychosocial factors that determine the causation and course of PTSD following burn injuries are discussed. PTSD following burn injuries in special populations like women, children and adolescents, intentional burns and self immolation are also discussed. The role of cultural factors in the development of PTSD are elucidated and future research needs are laid out. PTSD is a very common occurrence after burn injuries and needs a multidisciplinary team evaluation for its management. [ABSTRACT FROM AUTHOR]

The aim of the paper is to compare the safety awareness and preparation of children and adolescents for an extraordinary event, with an emphasis on fire protection. The Fire Prevention Programme in Poland is a unique preventive and educational initiative developed by a team of fire and rescue experts in Poznan. These experts have worked with colleagues in the UK for many years and have benefited from their experience with similar programmes that have produced measurable results in improving the safety of local communities. The priority of the pre-school fire prevention programme in Hungary is to contribute to the active learning of the surrounding world of children, to the formation of safe lifestyles. In the Czech Republic, the preventive programme "Education of children in the field of fire protection and protection of the population" is implemented to a good level. There is absolute inadequacy and out-dated study materials in the area in the Slovak Republic. There is no separate subject dealing with emergencies. Fire protection and extraordinary events are only dealt with in "Protection of Man and Nature", whose content only complements other teaching subjects. [ABSTRACT FROM AUTHOR]

Pediatric burn injuries are frequently complicated by burn scar contractures that often create functional limitations. Usually release followed by skin grafts, local flaps or tissue expansion is adequate. In rare instances, when the contracture is severe and simpler forms of reconstruction have failed, microsurgical free tissue transfer becomes essential. Even though in pediatric patients it can be technically more demanding and there is a reported risk of vasospasm, free tissue transfer has proven to be a good alternative. It is a one-stage procedure that guarantees decent functional outcomes. The perforator anterolateral thigh flap is a workhorse flap in microsurgery. The versatility of this flap allows it to be used in various anatomic locations. In this paper we report its use in neck, wrist, foot and face reconstructions. Flap success rates were 100%, with no cases of partial or complete flap loss. No acute or chronic complications were noted. Only one patient required reoperation for thinning of the flap to allow proper shoe fitting. All patients had good functional outcomes and the contractures were fully released. Joint function was regained in all patients except one that required wrist fusion. When indicated, the free perforator ALT flap is an excellent option for challenging reconstructions. [ABSTRACT FROM AUTHOR]

The paper describes the presentation and management of patients presenting with crack cocaine induced upper airway injury. The study involved a retrospective clinical series of six patients with crack cocaine induced upper airway injury. Demographics, symptoms, physical exam, flexible laryngoscopy findings, treatment and intervention were recorded. All patients with crack cocaine induced thermal injury presented with mouth or throat pain plus at least one other laryngeal symptom, such as globus sensation, dysphagia or throat tightness. On physical exam, the supraglottis was the most common subsite of endolaryngeal injury. The only statistically significant finding was the number of subsites on initial physical exam and flexible laryngoscopy and need for airway intervention (p = 0.001). Airway intervention was required in one patient, while the remaining patients were closely observed until resolution of symptoms. Upper airway injury should be suspected in patients who present with pain and laryngeal symptoms after smoking crack cocaine. [ABSTRACT FROM AUTHOR]

Traumatology is an old specialty, and most knowledge about it was developed during wars. On the other hand, burn care is much more recent and knowledge has been acquired in particular from civilian disaster casualties. This paper aims to describe some of the disasters that led to progress in burn care. [ABSTRACT FROM AUTHOR]

Plastic surgery involves the restoration, alteration or reconstruction of the human body. It includes reconstructive and aesthetic surgery. This paper discusses the authors' experience introducing new reconstructive, microsurgical and aesthetic surgeries in the Gaza Strip. We analyzed 192 cases of reconstruction carried out in the Al-Alamy Burns Center in Al-Shifa Hospital from August 2017 to July 2018 and at the European Gaza Hospital during a one-month delegation, as well as 38 aesthetic surgeries performed in the author's private clinic. We highlight challenges hindering the development of reconstructive and plastic practices in the Gaza Strip and propose solutions. Plastic surgeries have greatly evolved at Al-Shifa Hospital. Despite obstacles limiting the development of reconstructive surgery, we were able to treat complicated cases requiring microsurgical procedures. In one year we performed 192 reconstructive surgeries, in addition to 38 hair transplants. Overall success rate was 97.8%, with five failed flaps documented. Wound infection was the main cause of failure. However, the failed flaps were repaired by various approaches. The hair transplant patients went home the same day with no complications. Plastic surgeries have improved significantly and staff competencies have increased with frequent exposure to different cases. Moreover, the physicians' skills and knowledge have been imbedded in practice following the educational development of the authors. Establishing specialized training programs in plastic and reconstructive surgery is crucial to enhancing and reinforcing the physicians' skills and knowledge and guaranteeing high quality care. [ABSTRACT FROM AUTHOR]

Despite a considerable decrease in their incidence worldwide, burn injuries remain one of the commonest forms of trauma and account for a weighty proportion of trauma cases in health-care emergencies around the globe. Although the latest data reveal a substantial decline in burn-related mortality and hospital admissions in the US over the past three decades, severe thermal injuries continue to trigger devastating morbidity and significant mortality while their management remains a dynamic challenge for the entire medical and paramedical community. Concrete evidence continues to be established regarding burn-associated pathophysiologic responses, and their destructive sequelae and deleterious effects in survivors at cellular, systemic as well as socio-economic level. Better understanding of these responses have contributed to advances in therapeutic strategies, improved long-term outcomes and catalyzed the reintegration of victims back into society. This paper describes the current understanding of the pathophysiology of a burn injury and characterizes both local and systemic pathophysiologic responses in terms of metabolic, hemodynamics, cardiac, renal, hepatic, gastro-intestinal, immunologic, endocrine as well as male reproductive systems in an attempt to understand the corresponding treatment modalities for this unique patient population. [ABSTRACT FROM AUTHOR]

It is estimated that 13.000 to 22.000 individuals suffer from inhalational burns each year in the United States alone. Despite these high numbers, inhalational burns remain a major challenge to otolaryngologists. In this paper, a review of literature is presented in order to provide otolaryngologists with a systematic approach to patients with inhalational burns to optimize treatment, cost, morbidity and, most importantly, mortality. For this purpose, a broad PubMed search was conducted. The available literature was found to highlight the importance of airway management in terms of the timing of intubation, method of intubation, trachea-esophageal (TE) fistula formation and TE rupture. It also emphasizes the importance of carbon monoxide intoxication and prompt correction. Drugs such as heparin sulfate, N-acetylcysteine and albuterol have been proven to help in the treatment of patients with inhalational burns, and more research is currently underway with the purpose of developing chelating drugs that scavenge the toxic substances in the smoke before they can damage the airway. [ABSTRACT FROM AUTHOR]

The 2016 SFB congress focused on 'non-thermal burns', and this session lasted the whole day of Thursday 2nd June. While the reports on radiation-induced burns are currently being prepared by the presenters themselves, this paper on chemical and electrical burns was put together by the above-mentioned authors using notes taken during the session and video of the presentations. Any reader desiring further information on a topic can contact the author of the relevant presentation directly. [ABSTRACT FROM AUTHOR]

The article offers information on Annals went online, as per an MBC-SFB agreement the paper version of the journal is sent only to the members of SFB. Topics include the number of problems regarding the delivery of the journal, recently aggravated by the pandemic, MBC and SFB have agreed on the hypothesis to have the copies for SFB members has printed in France.