Başkent Üniversitesi Yayınları

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Author: search.filters.author.Abbas AlbayatiSubject: search.filters.subject.Burn trauma

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    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.
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    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.