Başkent Üniversitesi Yayınları
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Item Simple Limbal Epithelial Transplant in a Patient With Limbal Stem Cell Deficiency Due to Chemical Burn(Başkent Üniversitesi, 2024-09) Leyla Asena; Mehmet Haberal; Sibel Oto; Dilek Dursun AltİnÖrsABSTRACT Limbal stem cell deficiency develops when corneal epithelial stem cells become dysfunctional or deficient. This deficiency leads to neovascularization of the corneal surface, persistent epithelial defects, scarring, and decreased vision. Simple limbal epithelial transplant is a relatively new technique to address limbal stem cell deficiency. Here, we describe a male patient with chemical ocular burn injury in his left eye that resulted in diagnosis of unilateral limbal stem cell deficiency. The patient was successfully treated with simple limbal epithelial transplant.Item A New Method for Determining the Volume Of Blood Loss During Necrectomy in Patients With Deep Burns(Başkent Üniversitesi, 2023-06) Evgenij V. Zinoviev; Denis O. Vagner; Alexander E. ChukharevABSTRACT OBJECTIVES: Most surgery manuals indicate that, for excisions of a burn scab on an area of 1 cm2 with skin plasty, blood loss, taking into account donor zones, is about 1 mL. This volume of alleged blood loss plays an essential role in planning surgical treatment of patients with burn injuries. To date, when volume of lost blood is calculated with the use of existing methods for determining intraoperative blood loss, it is not recommended to excise necrotic tissues on an area of more than 15% of the body surface. In this study, our aim was to develop a new formula for determining intraoperative blood loss during necrectomy in patients with deep burns. MATERIALS AND METHODS: We developed and proposed our own, original method for determining the volume of intraoperative blood loss, based on taking into account hemoglobin and hematocrit indicators, as well as differentiated calculation of the volume of circulating blood. This technique was tested on 109 patients with deep burns (per ICD-10), who were admitted to our department from January 2022 to December 2022 because of thermal lesions. We processed obtained data using Microsoft Office Excel and used generally accepted methods of nonparametric statistics. RESULTS: With the new formula, we determined blood loss of 0.52 mL per 1 cm2 of excised tissue, which is 2 times less than predicted by traditional methods. CONCLUSIONS: Our results showed that the expected intraoperative blood loss may not be 1 mL/1 cm2, as currently prescribed in clinical guidelines, but 0.5 mL/1 cm2 of the excised tissue. Our results allow for possible expansion of the removal of the burn eschar before the development of infectious complications.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 Treatment of Acute Gastroduodenal Bleeding in Patients With Severe Burn Injuries(Başkent Üniversitesi, 2021-12) Abdulaziz Fayazov; Adkham AkhmedovOBJECTIVES: Among causes of gastrointestinal bleeding, stress ulcers occupy the second place, second only to chronic ulcers of the stomach and duodenum; gastrointestinal bleeding accounts for 10% to 20% of all causes of hemorrhage. Bleeding relapses from acute stress ulcers (mortality rate range, 60%-90%) are particularly dangerous. Our aim was to compare treatment methods for patients with bleeding from acute gastroduodenal ulcers after severe burns. MATERIALS AND METHODS: Over the past 10 years at our burn department (Samarkand City Medical Association), 80 patients (average age of 51 ± 16 years; 46.4% older than 60 years) with severe burns and bleeding from acute gastroduodenal ulcers were treated. The total area of thermal damage to the skin indicated the significant severity of thermal injury (average of 36.7 ± 7.7% of body surface). Patients were divided into 2 groups: main group (n = 42; 7-day antiulcer therapy) and control group (n = 38; H2-receptor blockers and traditional treatment). RESULTS: In the main group, VEGF concentrations remained virtually unchanged for 3 days compared with that shown in the control group, with a predisposition for gastroduodenal complications but decreased to 18.5% on day 7 and to 24.2% on day 14. In patients without a tendency for gastroduodenal complications, there was a decrease of 10.9% on day 7 and 15.4% on day 14 compared with patients in the control group. Thus, the use of L-arginine-containing drug in the main group of patients on all sampling days resulted in a decrease of VEGF concentration compared with that shown in the control group. CONCLUSIONS: Stable hemostasis during bleeding from acute gastroduodenal ulcers in patients with severe burn injuries was achieved in 77.8% of the control group (who received antisecretory therapy with H2-receptor blockers) and in 88.1% of the main group (antisecretory treatment with addition of dopamine D2-receptor blockers).Item Prediction of Development of Acute Gastroduodenal Complications in Patients With Severe Burns(Başkent Üniversitesi, 2021-09) Abdulaziz Fayazov; Adkham Akhmedov; Akmal Mirzakulov; Abdukakhor NabievOBJECTIVES: Our aim was to find whether we could predict the likelihood of acute gastroduodenal complications developing in patients with severe burns. MATERIALS AND METHODS: From 2018 to 2020, there were 85 patients with extensive thermal injury and severe burns who were hospitalized at our burn department (Samarkand City Medical Association). Of these, 45 patients (53%) developed acute gastroduodenal complications in the first 7 days postinjury and 40 (47%) did not develop these complications in the first 2 weeks after admission. We analyzed the following 7 parameters: admission time and initiation of intensive care after 12 hours, total burn area of ≥40%, deep burn area ≥10%, lesion severity index (Frank index) of ≥130 units, development of thermal inhalational lesion in the respiratory tract, duration of mechanical ventilation of >48 hours, and history of peptic ulcer disease of >5 years. RESULTS: We found that 57.8% of patients who had postponed hospitalization in a specialized medical institution and started intensive therapy >12 hours later developed acute gastroduodenal complications versus 42.2% of patients without these factors. In those with total burn area <40% and ≥40%, 28.9% versus 71.1% developed acute gastroduodenal complications. At week 2 of burn disease, in patients with deep burn areas ≥10%, acute gastroduodenal complications developed 1.5 times more often. Among patients whose Frank index was ≥130 units, acute gastroduodenal complications developed 9 times more often than among those with Frank index ≤70 units. CONCLUSIONS: The 7 parameters that we used as prognostic criteria could assess patients with extensive thermal injury complicated by the development of burn disease. With these criteria, a scale was created to predict the development of acute gastroduodenal complications. This scale could allow better preparation to treat these complications and to take timely preventive measures.