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Objectives To describe trends in admissions to English hospitals and 30-day in-hospital mortality associated with a primary diagnosis of burns. Design Descriptive population-based study. Setting England. Participants Patients admitted to hospital with a primary diagnosis of burns between 1991 and 2010. Main outcome measures Age-specific and age-standardised admission rates, and 30-day in-hospital mortality percentages. Results During 1991–2010, there were 188,597 admissions to hospitals in England with a primary diagnosis of burns. Annual numbers of admissions decreased between 1991 and 2002, followed by a steeper increase up to 2010. Rates were higher in males, in the age groups 0–4 and ≥85 years, and in persons from deprived areas of residence, most ethnic minorities, and urban areas. There were 3196 in-hospital deaths within 30 days of admission for burns between 1991 and 2010. Between 2000 and 2010, this mortality decreased from 1.99% to 0.91%. The highest rates of 30-day in-hospital deaths occurred in the elderly and the lowest in children. Conclusion Although in-hospital mortality from burns has decreased in recent years, if the recent upward trend in hospital admissions is genuine, it will have resource implications for regional burns units, and also suggests the need for a renewed emphasis on primary prevention. Observed inequalities with respect to age, gender, deprivation, ethnicity, and urban-rural status provide a rational basis for targeting primary prevention initiatives.

Summary Background and aim There are limited studies that look at morbidities in patients who have undergone axillary lymph node dissection (ALND) for skin cancer. To date, there has been no study examining the functional status of the upper limb postoperatively. This study studies the disability in upper limb function of patients postoperatively and looks for factors that influence this. Methods Twenty-five patients who have undergone level I–III ALND were interviewed using the Disability of Arm, Shoulder and Hand (DASH) and European Quality of Life (EuroQol) questionnaires to determine their upper limb functional status and overall quality of life. These data were then compared with epidemiological and surgical factors collected from the patients' notes retrospectively to look for influencing factors. Results The majority of patients had low disability scores, with only 12% of patients having a score of 40 and above (out of 100). Age of patient, seniority of operator, surgery on the same side of hand dominance, seroma formation and physiotherapy had no significant effect on DASH scores. A higher DASH score was associated with the patients viewing themselves as ‘less healthy'. Conclusion ALND for cutaneous skin cancers does not result in a significant increase in upper limb disability in the majority of patients.

Abbreviations: AJCC, American Joint Committee on Cancer; CI, confidence interval; miRNA, microRNA

This study reports on 565 consecutive endoscopic carpal tunnel releases using the Agee one-portal technique of which 25 (4.4%) were converted to the open technique. The follow-up period was from 4 to 52 months. Immediate symptomatic relief was reported in 562 wrists (99.5%). There were 25 complications (4.4%) including pillar pain (8 wrists), digital neuropraxia (n = 6), median nerve contusion (n = 3), incomplete division of the flexor retinaculum (n = 3), superficial infection (n = 3), reflex sympathetic dystrophy (n = 1), and tenderness of the scar (n = 1). We describe the evolution of our selection of patients and surgical technique. We recommend caution in performing ECTR in short patients who are liable to have small wrists because of the risk of contusion of the median nerve. We present some technical modifications that may make the technique safer.

A 32-year-old man presented with chemical burns to his penis following accidental application of depilatory cream to the area. The gentleman consequently sustained deep dermal burns to his penis, experiencing genital swelling and dysuria. This injury was managed conservatively in our burns unit and the patient was discharged shortly after. We present this unusual case of penile burns which has not previously been described in the literature despite depilatory creams being inexpensive and relatively easy to use, and subsequently popular choice amongst available hair removal options.

Chromosome 22q11 deletion gives rise to various phenotypes, including cardiac malformations, velopharyngeal abnormalities, absent thymus, and neurological defects. We assessed, in a prospective study, chromosome 22q11 deletion in 50 of 144 patients with velopharyngeal incompetence in the absence of overt clefting. 18 (12.5% of the whole cohort and 36% of patients tested for the deletion) had the 22q11 deletion. This frequency differs from an estimated population prevalence of 0.025% and suggests a need for screening for the 22q11 deletion in these patients.