Browsing by Author "Mehmet Haberal"

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A Case of Falling Into an Acid Tank From Height After High-Voltage Electrocution
(Başkent Üniversitesi, 2024-12) Burak Özkan; Abdullah Kızmaz; Uğur Bak; Khalid Zeynalov; Süleyman Savran; Abbas Albayati; Çağrİ A. Uysal; Mehmet Haberal
In this case report, we present the management of a dramatic and rare combination of injuries: high-voltage electrical injury, chemical burn, and open tibial and calcaneal fractures resulting from a fall from height. The patient underwent early fasciotomies. After treatments administered by a multidisciplinary team consisting of plastic surgeons, general surgeons, orthopedic specialists, anesthesiologists, and physiotherapists, the patient was discharged without extremity loss after a 135-day hospital stay. This case report discusses the importance of early fasciotomy and debridement in management of extensive burns and fall-related injuries, the potential for extended hospitalization for reconstruction, and the necessity of a multidisciplinary approach.
A Case of Progressive Mortal Thrombosis: Phlegmasia Cerulea Dolens
(Başkent Üniversitesi, 2023-03) Khalid Zeynalov; Burak Ozkan; Tankut Akay; A. Cagri Uysal; Mehmet Haberal
ABSTRACT Phlegmasia cerulea dolens is a very rare set of conditions associated with acute, massive venous thromboembolism. Medical and surgical options can be combined in treatment. Patients may experience sudden onset and severe leg pain, edema, cyanosis, compartment syndrome, and post-venous gangrene amputation and death. Medical and surgical treatments can be combined in treatment. Anticoagulants, thrombectomy, percutaneous procedures and amputations are among the treatment options. We present a 60-year-old female patient with a diagnosis of diabetes mellitus with swelling, pain, and discoloration in the left lower extremity who died due to progressive venous thrombosis despite various treatment modalities. Wound debridement and thrombectomy were performed. On day 10 of hospitalization, the patient was intubated to treat resistant low saturation. Despite the interventions, the patient died on day 10 of hospitalization due to cardiopulmonary arrest. Early diagnosis and treatment are vitally important. As in the case we presented, sometimes patients die as a result of rapid clinical progression and side effects, despite the use of different medical and surgical treatments.
Burn Care Strategies and Precautions in the Care of 698 Burn Patients During the 15-Month COVID-19 Period in Our Burn Center
(Başkent Üniversitesi, 2021-12) Emre Karakaya,; Cem Aydoğan,; Ayşe Ebru Abalı,; Mehmet Haberal
ABSTRACT OBJECTIVES: The novel 2019 coronavirus disease (COVID-19) was detected for the first time in China and quickly spread globally. Because of its high contagiousness, disruptions occurred in the activities of many health care providers. However, a delay of care for patients with burn injuries is unacceptable. Here, we assessed our burn care strategies and precautions during the COVID-19 pandemic. MATERIALS AND METHODS: Since the start of the pandemic in our country and up to now (March 2020 to August 2021), we have successfully treated 698 patients with burn injuries. We created a 3-degree protection protocol. We also isolated patients who were diagnosed or suspected of having COVID-19 by reducing the number of beds. RESULTS: Of 698 burn patients, 411 were male and 287 were female patients. There were 452 adult and 246 pediatric patients, with 591 of total patients treated as outpatients and 107 who were hospitalized. The patients were mostly injured by scalding burns. Mean total burn surface area of hospitalized patients was 26.2% in adult patients and 9.8% in pediatric patients. We diagnosed only 2 patients with COVID-19. Both patients were successfully treated and discharged. CONCLUSIONS: If burn centers create protection protocols, disruptions can be minimized so that necessary and successfully care to burn patients is provided, even during pandemic periods.
Burn Prevention Strategies at Baskent University Facilities
(Başkent Üniversitesi, 2021-06) Mehmet Haberal
CASE REPORT Role of Burn Teams in Management of Inflammatory Skin Reactions: Report of 2 Cases
(Başkent Üniversitesi, 2022-06) A. Ebru Abali; Cem Aydogan; Santiago J. Santelis; Nesibe Deren Ozcan; Ozlem Ozbek; Mehmet Haberal
ABSTRACT Several manifestations of inflammatory skin reactions have been described. Toxic epidermal necrolysis is an acute skin inflammatory reaction. It is generally triggered by upper respiratory tract infections or by medications such as nonsteroid anti-inflammatory drugs, antibiotics, and anticonvulsants. It is associated with a significant mortality of 30% to 50% and long-term sequelae. Here, we present 2 cases of toxic epidermal necrolysis who were treated by a multidisciplinary team involving burn professionals.
Chemical Contact Burn With Ready-Mixed Concrete: A Case Report
(Başkent Üniversitesi, 2021-06) Emin Turk; Erdal Karagulle; Halil İbrahim Taşcı; Mehmet Haberal
Chemical burns, and particularly alkali burns, constitute a very small fraction of burn unit admissions. It is generally unknown that ready-mixed concrete can cause chemical burns. However, prolonged contact with ready-mixed concrete may cause serious burns. Raising awareness of the need for taking necessary measures against burns from ready-mixed concrete among workers would be effective for the prevention of this type of burn. Here, we report a case of a full-thickness burn that occurred in a worker who was working unprotected with ready-mixed concrete.
Clinical Presentation and Outcomes of Burn Patients With Diabetes: A 5-Year Single-Center Experience
(Başkent Üniversitesi, 2022-09) Santiago J. Santelis; Cem Aydogan; Ayse Ebru Abali; Hasan Turkoglu; Mehmet Haberal
ABSTRACT OBJECTIVES: Diabetes mellitus is one of the most important independent risk factor for poor outcomes in patients with burn injuries. In this study, we aimed to determine the demographics characteristics, clinical presentation, and outcomes of burn patients with preexisting diabetes mellitus seen over the previous 5 years at a single burn center. MATERIALS AND METHODS: We conducted a retrospective study that included all burn patients ≥18 years of age with a diagnosis of diabetes who were admitted to our unit over the previous 5 years (2018 to 2022). We collected demographics and relevant clinical data from medical records. Patients were evaluated by age subgroups and time interval between occurrence of injury and admission to a medical center. RESULTS: Our study included 52 patients, with male-to-female ratio of 0.86:1 and mean age of 62.7 ± 12.4 years (range, 33-85 y). Scalding was the most common cause of the burn injury. A total of 32.7% of the patients had burns affecting their hands, either as part of a more extensive burn or as an isolated injury. The median extent of burns was 1.0% total body surface area (range, 0.05%-10%). We found an association between age and burn etiology and age and burn site. A high number of patients with injuries in the lower extremity sought medical care after day 1 but before day 4 postinjury. Delayed admission was found to be an important factor causing an increase in complication frequency. CONCLUSIONS: There are many factors associated with age that affect the incidence and outcomes of burn injuries. Risk factors leading to burns are preventable, and the physical and psychological consequences of people who survive burn injuries can be life-threatening and often devastating. The best way to treat a burn is to prevent it from happening in the first place.
Did COVID-19 Pandemic Conditions Change the Features of Pediatric Minor Burn Injuries? A Single-Center Experience
(Başkent Üniversitesi, 2021) Ayse Ebru Abali; Mehmet Haberal; Nigar Turkmen; Semra Kamilova; Cem Aydogan
ABSTRACT OBJECTIVES: Social life changes during the COVID-19 pandemic may have influenced burn injury characteristics among children. Here, we compared features among pediatric burn outpatients who were treated at our burn center before and during the COVID-19 pandemic. MATERIALS AND METHODS: We compared medical records of 217 patients treated between March 2018 and May 2019 (pre-pandemic; group I) and 212 patients treated between March 2020 and May 2021 (during the pandemic; group II). P < .05 was significant. RESULTS: In group I versus group II, mean age was 4.19 ± 0.4 versus 4.25 ± 0.3 years, male-to-female ratio was 0.9:1 versus 1.1:1, and mean total surface area burned was 1.87 ± 0.2% versus 1.93 ± 0.3%, respectively (P > .05). Most patients in both groups lived in urban settings, had mostly day-time injuries, and were under the umbrella of the social security system, with cause of burns being mostly scalds (P > .05). Injuries occurred mostly at home in both groups, but more patients in group II had outdoor burns (P < .05). Hands, head, and neck regions were more commonly involved in group I than in group II (P < .05). Group II patients were more frequently admitted on the same day as injury (P < .05), but rates of direct burn center admission were similar with resembling numbers of other medical center admissions before reaching to our burn-center (P > .05). CONCLUSIONS: The COVID-19 pandemic did not change primary burn injury features among our pediatric outpatients. Decreases in burns to hands, head, and neck and increases in admissions on the same day as injury during the pandemic may be a clue for enhanced caregiver precaution against injuries to children during lockdowns. Increased admissions on the same day as injury may reflect our uninterrupted burn care service, because many other medical centers had to serve COVID-19 patients rather than burn victims.
Effects of a Fat-Rich Diet in the Pancreas of Rats During the Acute Phase of Burns
(Başkent Üniversitesi, 2022-06) Neslihan Başçıl Tütüncü; Ayse Ebru Abali; Santiago J. Santelis; Özlem Turhan İyidir; B. Handan Ozdemir; Gonca Ozgun; Nilüfer Bayraktar; Meriç Çolak; Mehmet Haberal
ABSTRACT OBJECTIVES: Oversupply of nutrients overstimulates beta cells in standard conditions, and severe burn injuries increase the metabolic needs. In this study, we investigated the effects of fat-rich nutrients on the endocrine pancreas during the acute phase of severe burns.
Electrical Burns: A Special Type of Burn Injury
(Başkent Üniversitesi, 2024-03) Cem Aydogan; Murathan Erkent; Ebru Abali; Abbas Albayati; Afig Gojayev; Adem Safak; Mehmet Haberal
ABSTRACT OBJECTIVES: Electric burn injuries are one of the most devastating types of trauma. Compared with other skin burns, electric burn injuries are more complex and associated with higher morbidity and mortality. The trauma resembles an iceberg; the burn is not only related to skin or deep tissues but has serious systemic hazardous effects to the body, which cause other associated complications. MATERIALS AND METHODS: We retrospectively examined medical records to review electric burns treated at Baskent University Hospital burn centers across Türkiye between January 2008 and October 2023. We reviewed 361 electric burn injuries. We analyzed patient demographic characteristics, epidemiology of the injury, mechanism of injury, size and depth of burn, treatment methods associated with electrical burns, and complications. RESULTS: Of 361 patients, 88% were male patients, and most damage was caused by high voltage (76%). Many accidents occurred at work (48%) but 19% occurred at home. Many accidents occurred in summer and spring (60%). Mean age, percent total body surface area, hospitalization time, creatine phosphokinase, and myoglobulin were 28.9 years (range, 2-89 y), 21.1%, 25.5 days, 8722 U/L, and 1924 ng/mL, respectively. Percentages of debridement, grafting, fasciotomy, amputation, and flaps were 62.2%, 54.6%, 33.7%, 15.1%, and 14.2%, respectively. CONCLUSIONS: Public education and governmental legislation are important for preventing work-related accidents. Coexisting traumas have to be considered in this type of injury. Resuscitation is important at the beginning of treatment. Early fasciotomy can prevent limb salvage or can prevent extensive amputations. After resuscitation, early debridement and reconstruction via grafting or flaps are important. Physiotherapy is crucial after reconstruction.
Electronic Protocol for Systematic Data Collection of Burn Patients: A Proposal to Standardize Burn Patient Data
(Başkent Üniversitesi, 2022-09) Santiago J. Santelis; Gerardo Elem; Mehmet Haberal; Fortunato Benaim
ABSTRACT OBJECTIVES: Burn patients usually present with a long medical history and require a prolonged management that makes the process of collecting and storing information complex and confusing. Electronic health records have been deployed to replace or supplement existing paper-based records and can improve the quality of health care. A system that completely addresses the needs of patient care providers and researchers probably does not exist, and this integration would reduce redundant data collection. Here, we share our experiences with a customizable and standardized electronic protocol with the ability to systematize, store, and analyze relevant information from burn patients that can be used worldwide since it contains a universal codification and can be easily adapted to any specific requirement by the user or legal/regulatory authorities. MATERIALS AND METHODS: The database was developed based on medical literature searches on burn injuries. A web platform was designed using Microsoft.NET framework technology with C# and MVC programming languages. The data collection items were selected and grouped into 2 main categories that contained 7 subcategories each, with a unique code assigned to each customizable item for universal comparability in the collection, processing, categorization, and presentation of the data. An SQL server stored data to ensure encryption, protection, and invulnerability. RESULTS: The system recognized the user by identifying a predefined security authorization and allowed the creation, storage, organization, combination/aggregation, analyses, exportation, and editing of collected information. The protocol has been successfully verified in a medical institution by the Benaim Burn Foundation. CONCLUSIONS: A new validated electronic database protocol focusing on burn patients was successfully created, resulting in a substantial improvement of medical record standardization. This system has laid a solid foundation for future data mining, medical records sharing, and academic purposes.
Flap Options in Reconstruction of a Burned Hand
(Başkent Üniversitesi, 2021-12) Abbas Albayati; Mehmet Haberal; Cagri A. Uysal; Suleyman Savran; Burak Ozkan
ABSTRACT Hand burns are commonly seen in large burn injuries. Although the mortality of hand burns is imperceptible, morbidity can be of great importance. The possible disabling outcomes of hand burns necessitate a precise and accurate management, at both early and late stages, to allow optimal functional outcomes. The main goal of management is to maintain a favorable function that also preserves esthetics. Commonly used reconstructive options are skin grafts, skin flaps, and myocutaneous flaps. In this article, we discuss skin flap options in the reconstruction of a burned hand.
Impact of Severe Burns on Pancreatic Islets: An Experimental Model in Rats
(Başkent Üniversitesi, 2022-03) Santiago J. Santelis; Ayse Ebru Abali; Gonca Ozgun; B. Handan Ozdemir; Neslihan Basci Tutuncu; Mehmet Haberal
ABSTRACT OBJECTIVES: Severe burn victims experience a systemic inflammatory response and a hypermetabolic response that can generate adverse effects on many distant organs and systems. Our aim in this study was to describe the histopathological changes in the pancreatic islets secondary to severe burns in an experimental animal model. MATERIALS & METHODS: Fourteen Wistar albino rats were randomly divided into 2 groups: the sham group and the burn group. A full-thickness burn model was designed to induce a burn of 25% total body surface area. Seven days after burn induction and sham procedure, pancreatectomy was performed. Pancreatic tissues were examined under light microscopy, and islet size and cellularity were calculated. RESULTS: The histopathologic examination was unremarkable, but the mean number of islets per pancreatic tissue was lower in the burn group than in the sham group. We observed a significant difference in the mean number of cells per one islet between the 2 groups, with the cell count higher in the burn group (P < .05). CONCLUSIONS: During the acute phase of burn injury in rats, we observed a decrease in the number of pancreatic islets with remarkable hypercellularity. Further studies are needed to determine the histological and cellular basis of these changes.
Infectious Features of Burn Wounds and Their Influence on the Course of Clinical Outcomes in Burn Victims
(Başkent Üniversitesi, 2023-06) Ayse Ebru Abali; Cem Aydogan; Burak Ozkan; Elif Unlu; Mehmet Haberal
ABSTRACT OBJECTIVES: This study sought to determine the interactions between infectious features of burn wounds and in-hospital clinical outcomes among patients treated at our burn center. MATERIALS AND METHODS: Our study group included 192 inpatients seen from 2020 to 2023. We collected data on age, sex, etiology, total body surface area burned, length of hospital stay, documentation of isolated microorganisms at admission and during hospitalization, requirement of antibiotic therapy, and mortality. We evaluated data among 3 subgroups: group 1 (length of hospital stay of 0-10 days), group 2 (length of hospital stay of 11-30 days), and group 3 (length of hospital stay of >30 days). RESULTS: Mean ± SE age was 32.2 ± 1.6 years (range, 0-86 y), and male-to-female patient ratio was 2.1:1. Mean ± SE total body surface area burned was 12.6 ± 1.3% (range, 1%-85%). Scalds were the most common burn cause. Mean ± SE length of hospital stay was 17 ± 2.4 days (range, 1-363 d). Among the 27 positive wound swab cultures at admission, 9 were resistant. Gram-positive bacteria were the most common at admission. During hospitalization, microorganisms were isolated in wound swabs or tissues in 48 cases. Staphylococcus epidermidis and multidrug-resistant Acinetobacter baumannii were the most common bacteria. Therapeutic antibiotherapy was needed for 83.3% of group 3, 53.1% of group 2, and 20.2% of group 1. Mortality rate was 3.6% (n = 7/192 patients), with 3 patients in group1, 2 patients in group 2, and 2 patients in group 3 who had at least 1 microorganism at admission. CONCLUSIONS: Evaluations of microflora in burn centers and precautions against wound contamination during emergency and transport phases can contribute to informed decisions at burn centers.
Knowledge and Attitude of Health Care Staff in First Aid for Minor Burns
(Başkent Üniversitesi, 2022-09) Ayse Gul Atay Doygaci; Ayse Ebru Abali; Elif Unlu; Santiago J. Santelis; Eylem Gul; Mehmet Haberal
ABSTRACT OBJECTIVES: This study aimed to assess the level of knowledge and awareness of first aid for minor burns of health care workers in a university hospital. MATERIALS AND METHODS: A total of 402 subjects including nurses (n = 163), medical technicians (n = 94), technicians/patient care support personnel (n = 145) participated. Data were collected by face-to-face interview technique using our 2 evaluation forms (characteristics of participants was form 1 and first aid knowledge on minor burns was form 2) (P < .005). RESULTS: Mean age was 29.7 years. Female to male ratio was 1:0.7. Form 2 was correctly answered by 76.9% of participants. Participants who stated that they have received first aid training on burns was 41.5%, but only 38.3% of the subjects felt confident for providing first aid. Running water was preferred by 85.6%. High education level, receiving first aid training, and seniority in the profession and in the institution were the effective factors for providing proper first aid (P < .005). Female (58.5%), single (59.8%), child-free (61.7%) participants and those who had attended first aid education programs more recently were prone to providing proper first aid than the others (P < .005). CONCLUSIONS: In the present study, many participants had basic knowledge about first aid for minor burns, but they felt unconfident. Health care staff need periodical educational programs specific to them in addition to the basic awareness programs for burn injuries.
Necrotizing Fasciitis Due To Mosquito Bite
(Başkent Üniversitesi, 2022-09) Burak Ozkan; Abdullah Kizmaz; Orkhan Sahpazov; Cem Aydogan; Cagri A. Uysal; Mehmet Haberal
ABSTRACT Necrotizing fasciitis more often occurs in patients with diabetic vasculopathies, in those who are immuno-compromised, or in those exposed to blunt or penetrating trauma. Aggressive debridement and salvage of the relevant extremity are important in the treatment to prevent patients from entering sepsis. In this case report, we describe a 66-year-old male patient with diabetes mellitus who developed necrotizing fasciitis after a mosquito bite.
Never Give Up for Salvaging Extremities: A Case of High-Voltage Electrical Burn
(Başkent Üniversitesi, 2021-12) Suleyman Savran; Burak Ozkan,; Abbas Albayati; Cem Aydogan; Cagri A. Uysal; Mehmet Haberal
ABSTRACT High-voltage electrical injuries pose unique challenges. Here, we report a complicated third-degree bilateral hand and forearm high-voltage burn injury that underwent reconstruction with several free flaps and a pedicled flap to salvage the upper extremity. Maximum efforts to save an extremity and lengthen an amputation stump should be given to patients with high-voltage electric injuries.
Our Experience on Topical Usage of Acetic Acid in Pediatric Major Burns
(Başkent Üniversitesi, 2022-12) Ayse Ebru Abali; Burak Ozkan; Cem Aydogan; Ahmet Cagri Uysal; Mehmet Haberal
ABSTRACT OBJECTIVES: We discuss the0 topical usage of acetic acid in pediatric patients with major burns and wound infections caused by multidrug-resistant bacteria. PATIENTS AND METHODS: Patients were 5 boys; mean age was 11 years (range, 4-16 years), and mean total body surface burn area was 45.2% (range, 15%-74%). Two patients had high-voltage electrical injuries (with 1 patient having concomitant flame burns), 2 patients had flame burns, and 1 patient had scald injuries. Systemic treatment with topical 3% acetic acid application was started as soon as the septic conditions due to isolated bacteria were identified. RESULTS: Mean length of elimination period was 12 ± 5.1 days for multidrug-resistant Acinetobacter baumannii. For 2 patients who had concomitant Pseudomonas aeruginosa isolation, colonization of Pseudomonas aeruginosa continued during a longer period, although infectious findings regressed. Septic conditions regressed, and burn wounds totally healed after surgical debridement, split-thickness grafting, and amputation plus flap surgeries during mean length of hospital stay of 59.8 days (range, 35-90 days). CONCLUSIONS: Topical acetic acid (3%) administration is feasible for clearance of multidrug-resistant Acinetobacter baumannii and for reduction of Pseudomonas aeruginosa quantity in the burn wounds.
Our Experience With Free Microvascular Tissue Transfer in Burn Reconstruction
(Başkent Üniversitesi, 2021-12) Burak Ozkan; Abbas Albayati; Suleyman Savran; Cem Aydogan; Cagri A. Uysal; Mehmet Haberal
ABSTRACT OBJECTIVES: Free microvascular tissue transfer can provide excess tissue in 1 stage for extensive injuries when locoregional flap options cannot be performed. Free flaps are an important reconstructive option in burn reconstruction whenever neurovascular and skeletal structures are exposed. This sophisticated technique needs surgical expertise and an understanding of burn physiology. Here, we have shared our experiences in burn reconstruction with free flaps. MATERIALS AND METHODS: Between 2017 and 2021, our center performed 26 free flap procedures in 20 burn patients. Fifteen flaps were performed in 12 patients at an early phase (first 21 days postinjury); 11 free flaps were performed in 8 patients for postburn contracture sequelae. Among these procedures, 60% were skin flaps (anterior lateral thigh, radial forearm, superficial circumflex iliac artery perforator flap, parascapular), 20% were musculocutaneous flaps (latissimus dorsi, vastus lateralis), 10% were fascia flaps (temporal fascia, serratus anterior), and 10% were pure muscle flaps (gracilis, latissimus dorsi). RESULTS: Two free flaps for early-phase reconstruction and 1 free flap for postburn contracture release were lost. Reasons for flap loss were venous congestion in 2 cases, with arterial occlusion due to hematoma formation in 1 case. All patients with flap loss had high-voltage electric burns. Debridement of the necrotic flaps was delayed until demarcation formation settled and until subflap granulation formation started. Skin grafts were performed after debridement of these flaps. All other flaps survived, with no recurrence of contractures or defects encountered in these patients. CONCLUSIONS: Although free flaps have changed the reconstructive ladder to a reconstructive elevator, performing these flaps have unique challenges in burn reconstruction, such as risk of thrombosis in those with electric burns, hemodynamic instabilities, and difficulties in patient positioning due to sedation. Meticulous care should be taken and the patient’s general condition should be well evaluated before free flap surgery.
Pediatric Burns During the COVID-19 Pandemic: A Single-Center Experience
(Başkent Üniversitesi, 2021-06) Ayse Ebru Abali; Cem Aydogan; Nigar Turkmen; Mehmet Haberal
OBJECTIVES: We documented children treated at our burn center during the COVID-19 pandemic period to investigate the features of pediatric burns and burn care modalities within the influence of pandemic conditions. MATERIALS AND METHODS: Medical records of 248 new admissions and 54 telemedicine visits were collected (March 2020-May 2021). Data collected included age, sex, burn cause, burn extent, affected body site, environment, time of day when injury occurred, time interval between injury and arrival at the burn center, and direct or indirect admissions from other centers. Collected data were also compared according to 2 different subgroups (age and treatment modality [outpatient/inpatient]). P ˂ .05 was considered significant. RESULTS: Male-to-female ratio was 1.07:1. Scalds were the most common burn cause (83.8%), most burns occurred at home (87.1%), and burn injuries mostly occurred between 1200 and 2400 hours (72.2%). Most children were brought to our burn center in the initial 3 days postburn (82.7%). The rate of direct admissions was 60.5%. Most patients were in the 0- to 2-year-old age group (53.6%). The number of admissions on the same day as injury was significantly greater for this age group compared with older groups. Outdoor burns were increased in older children (7- to 11-year-old group and 12- to 18-year-old group) (P ˂ .05). Outpatients and inpatients comprised 87.5% and 12.5%, respectively. The mean total body surface area burned (minimum, maximum) was 2.0 ± 0.3 (0.1%, 50%) for outpatients and 10.4 ± 2.3% (1%, 72%) for inpatients; mean length of hospital stay for inpatients was 9 ± 2.6 days (1, 77 days). CONCLUSIONS: During the pandemic, burn injuries in children continued at the same rate. Meticulous COVID-19 protection is essential for continuity of expected quality in pediatric burn care. Telemedicine is advantageous, and progress on basic burn care guidelines, including telemedicine facilities, should be supported.