Başkent Üniversitesi Yayınları
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Item Use of Running Tap Water as an Initial Treatment in Patients With Scald Burns(Başkent Üniversitesi, 2024-12) Cem Aydogan; Murathan Erkent; Ebru Abali; Afig Gojayev; Abbas Albayat; Mehmet HaberalOBJECTIVES: First aid methods can be better understood by clinical events than by experimental studies. We retrospectively investigated how clinical outcomes were influenced by type of first aid method. MATERIAL AND METHODS: We reviewed patient medical records from January 2024 through January 2025 in the Baskent University burn center. We included only outpatients with scald burns (N = 340) in our study. All patients were examined and managed by the same 2 staff burn surgeons. We compared data from patients who were admitted on day 1 of injury and later and compared patients treated with and without cold running water. All patients had standard burn wound management. RESULTS: Wound healing time was reduced in patients who received appropriate first aid (cold running water) versus incorrect or no first aid (P < .05), including in all age groups examined (pediatric, adult, and geriatric groups) (P < .05). In patients who received appropriate first aid, numerical pain scores recorded during day 1 follow-up examinations were found to be lower (P < .05). Among patients who presented to the burn center on the first or second day postinjury, healing times were shorter than for those who presented later (P < .05). Patients who received appropriate first aid (vs incorrect or no first aid) had fewer debridement and graft surgery procedures (P < .05). CONCLUSIONS: Despite its retrospective design, our study emphasized that first aid methods affected clinical outcomes and showed that inappropriate burn wound management in the first 24 hours could negatively affect healing time. Education for prevention of burns and first aid for burns are crucial steps in these accidents. Cooling of wounds reduces further damage, morbidity, and mortality. Effective first aid methods in burns must be easy and fast for practicability.Item 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 HaberalABSTRACT 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.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 Necrotizing Fasciitis Due To Mosquito Bite(Başkent Üniversitesi, 2022-09) Burak Ozkan; Abdullah Kizmaz; Orkhan Sahpazov; Cem Aydogan; Cagri A. Uysal; Mehmet HaberalABSTRACT 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.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 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 HaberalABSTRACT 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.Item 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 HaberalABSTRACT 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.Item 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 HaberalABSTRACT 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.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.