Background and Objectives: Scar formation after burn trauma has a significant impact on the quality of life of burn patients. Hypertrophic scars or keloids can be very distressing to patients due to potential pain, functional limitations, or hyper- or hypopigmentation. In a previous study comparing Suprathel^® and the new and cheaper dressing epicite^hydro®, we were able to show that pain reduction, exudation, and time until wound-healing of partial-thickness burn wounds were similar, without any documented infections. No study exists that objectively measures and compares skin and scar quality after treatment with Suprathel^® and epicite^hydro® at present. Materials and Methods: In this study, the scar quality of 20 patients who had been treated with Suprathel^® and epicite^hydro® was objectively assessed using the Cutometer^®, Mexameter^®, and Tewameter^®, as well as subjectively with the Patient and Observer Scar Assessment Scale, 3, 6, and 12 months after burn injury. Results: In all performed measurements, no significant differences were detected in scar formation after treatment of partial-thickness burn wounds with the two dressings. Conclusions: Both the newer and less expensive wound-dressing epicite^hydro® and the well-known wound-dressing Suprathel^® resulted in stable wound closure and showed good cosmetic results in the follow-up examinations.

Necrotizing fasciitis (NF) is a rare and quickly progressing infection and leads to 100% mortality if untreated. Quick diagnosis and an early and radical surgical treatment are essential for stopping bacterial progression. Unfortunately, the absence of clear clinical signs makes the diagnosis often challenging. Therefore, we searched for easy determinable predictive laboratory markers for NF. This is the first study which includes lactate values in a new score. A retrospective analysis of patients with NF (n = 44) and patients with erysipelas (n = 150) was performed. Lactate values, patients' demographics, clinical presentations, site of infection, comorbidities, microbiological and laboratory findings, antibiotic therapies, and LRINEC and modified LRINEC scores were analyzed. Logistic regression analysis was used to derive adjusted weights, and final simple point score was assessed with a ROC curve analysis. Patients with NF had a mean age of 57 years and patients with erysipelas 65 years. The median hospital length of stay was 8 and 49 days in patients with erysipelas and NF, respectively. Although only one patient (0.7%) in the group of erysipelas died, the mortality rate of patients with NF was 9/44 (20.5%). The lactate values were statistically significant higher in the NF group, 4.1 vs 2.0 mmol/l (P < .001). The new created CologNe-FaDe-score shows the highest AUC-value with 0.907. With the help of lactate values, the CologNe-FaDe-score consists of easily practicable and highly available parameters, which could sensitize diagnosis.

There is an increased risk for burn injuries associated with home oxygen therapy of patients with chronic obstructive pulmonary disease (COPD) since 10% to 50% of these patients continue to smoke. Enzymatic eschar removal of facial burns is gaining popularity but intubation of this specific patient group often leads to prolonged weaning and can require tracheostomy. This study dealt with the question if enzymatic debridement in these patients can also be performed in analgosedation. A selective review of the literature regarding burn trauma associated with home oxygen use in patients with COPD was performed, as well as a retrospective analysis of all patients with burn injuries associated with home oxygen use and COPD that were admitted to the study clinic. In the literature, 1746 patients with burns associated with home oxygen use are described, but none of them received enzymatic debridement. In this study, 17 patients were included. All three patients in this study with facial full-thickness burn injuries received enzymatic debridement. The mortality rate in this cohort was 17.6% (3/17). Up to date, there is limited experience performing regional anesthesia debridement in patients with COPD. This is the first manuscript describing the use of enzymatic debridement in patients with COPD and home oxygen therapy. We could confirm other studies that intubation of these patients leads to prolonged ventilation hours and increases the probability for poor prognosis. Therefore, we described the treatment of enzymatic debridement in analgosedation without intubation.

Einleitung E-Zigaretten erfreuen sich immer größerer Beliebtheit. Neben abhängigkeitsrelevanten und pulmonalen Gesundheitsschäden häufen sich Berichte über Verbrennungsfolgen durch explodierende oder brennende E-Zigaretten. Zumeist entstehen diese Brände durch Fehler in der Lithium-Ionen-Batterie. Aufgrund der steigenden Zahlen der E-Zigaretten-Nutzer und der zunehmenden Verbrennungen durch diese Geräte möchten wir 3 Fälle unserer Klinik vorstellen und die Behandlungsstrategien erläutern. Patienten/Material und Methoden Die Fälle und retrospektiven Daten von 3 Patienten, die sich zwischen 2016 und 2019 mit Verbrennungen durch E-Zigaretten vorgestellt haben, werden dargestellt. Ergebnisse Alle 3 Patienten stellten sich in der Notaufnahme mit Verbrennungen vor, die aufgrund von in der Hosentasche explodierter E-Zigaretten aufgetreten sind. Zwei Patienten waren männlich und eine Patientin weiblich. Das Alter der Patienten betrug 24, 30 und 64 Jahre. Die verbrannten Körperoberflächen lagen zwischen 3 % und 12,5 % und benötigten Spalthauttransplantationen zwischen 1,5 % und 3,5 % der Körperoberflächen. Die Patienten konnten nach 5 bis 11 Tagen aus der stationären Krankenhausbehandlung entlassen werden. Schlussfolgerung In Zusammenschau der vorhandenen Literatur wird bei Verbrennungsverletzungen durch explodierte E-Zigaretten folgende Behandlungsstrategie empfohlen. Schwere Explosionstraumata bedürfen eines Schockraummanagements und besonders bei Explosionen während des Gebrauches sollte an ein Inhalationstrauma gedacht werden. Bei alkalischem pH-Wert der Verbrennung kann es aufgrund verbliebener metallischer Reste der E-Zigarette zu einer exothermen Reaktion in Verbindung mit Wasser kommen, sodass eine Wundspülung mit Mineralöl empfohlen wird. Introduction The popularity of E-Cigarettes is increasing. Besides addiction and pulmonary health damage, reports of burn injuries from e-cigarette explosions are also increasing. Mostly, explosions of e-cigarettes are attributed to its lithium-ion battery. Due to increasing cases and missing guidelines we want to present three cases of our hospital and publish recommendations for the management of burn injuries caused by e-cigarette explosions. Patients/Material and Methods Three cases of e-cigarette explosions which occurred between 2016 and 2019, are presented. Results All three e-cigarette explosions occurred in the trouser pockets. Two patients were male one patient was female. The age ranged from 24 to 64 years, the burned total body surface area (TBSA) from 3 % to 12.5 %. All three patients required skin grafting and the length of stay in hospital ranged from five to eleven days. Conclusion In the synopsis of recent literature, we recommend the following management of burns due to e-cigarette explosions. The guidelines of the Advanced Trauma Life Support should be followed, signs of an inhalation trauma should be checked and litmus test should be performed prior to irrigation with aqueous solutions to prevent exothermic reactions with remaining metals. If litmus test shows alkali pH wounds should be irrigated by mineral oil. Received: 05 June 2020 Accepted: 25 July 2020 Publication Date: 08 December 2020 (online) © 2020. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

There is an increased risk for burn injuries associated with home oxygen therapy of patients with chronic obstructive pulmonary disease (COPD) si |

Publication Date: 19 January 2021 (online) © 2021. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany