Başkent Üniversitesi Yayınları
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Item 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 HaberalABSTRACT 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.Item 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 HaberalABSTRACT 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.Item The Impact of Fat Rich Enteral Feeding on the Histopathological Changes of Liver in Third Degree Burns: An Experimental Study(Başkent Üniversitesi, 2022-12) Santiago J. Santelis; Ayse Ebru Abali; Gonca Ozgun; Binnaz Handan Ozdemir; Burak Ozkan; Mehmet HaberalABSTRACT OBJECTIVES: This study aimed to describe the histo-pathological changes in the liver secondary to severe burns and to investigate the effects of a fat-rich diet during the initial 7 days post burn in a rat model. MATERIALS & METHODS: We randomly assigned 21 Wistar-albino rats into 3 groups: sham group, burn + standard-diet group, and burn + fatty-diet group. A full-thickness burn wound was induced on the dorsa of the animals in both burn groups. Seven days after sham procedures/burn induction, hepatic tissues were examined under light microscopy; hepatocyte size, portal-triad size, and binuclear hepatocyte numbers were calculated. RESULTS: The mean number of binuclear hepatocytes was higher in burn + standard-diet group than in the sham group. Mean hepatocyte area and mean portal-triad area were narrower in the burn + standard-diet group compared with the sham group (P < .05). Mean hepatocyte area and mean portal-triad area in the burn + fatty-diet group were closer to those shown in the sham animals, and binuclear hepatocytes number in the burn + fatty diet group was slightly higher than in the burn + standard diet group(P > .05). CONCLUSIONS: Liver damage was mildly influenced by fat-rich enteral feeding in the 7 days postburn. Further studies must focus on dynamic feeding protocols designed according to the phases involved in the burn trauma instead of seeking a stable suitable protocol.Item 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 HaberalABSTRACT 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.Item 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 HaberalABSTRACT 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.Item 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 HaberalABSTRACT 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.Item Two Cases of an Unusual Presentation of Electrical Burn Injuries(Başkent Üniversitesi, 2022-03) Burak Ozkan; Santiago J. Santelis; Abbas Albayati; Ayse Ebru Abali; Cagri A. Uysal; Mehmet HaberalABSTRACT Electric injuries have a wide variety of consequences ranging from disfigurements, extremity loss, and death. The limbs are the most affected sites because of the high resistance of muscles and tendons to electricity. The most common pathway of entry to exit point is upper limb to lower limb, so the thigh to foot pathway is exceptional. In this case report, we aimed to present the mechanisms in 2 construction workers who had high-voltage electric burns that followed this unusual pathwaItem 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 HaberalABSTRACT 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.Item 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 AydoganABSTRACT 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.Item Pediatric Burns During the COVID-19 Pandemic: A Single-Center Experience(Başkent Üniversitesi, 2021-06) Ayse Ebru Abali; Cem Aydogan; Nigar Turkmen; Mehmet HaberalOBJECTIVES: 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.