Objective: This study aimed to analyze the factors associated with mortality in burn patients in order to develop a nomogram for predicting mortality that can be used as a guideline to treat major burn patients.Material and Methods: This was a retrospective study done in Songhklanagarind Hospital, Hat Yai, Songkhla, Thailand. The study included major burn patients who were admitted to the burn unit or the intensive care unit between the years 2011 and 2018, and analyzed demographic data and significant factors associated with mortality.Results: A total of 127 major burn patients were treated during the study years, with a mean age of 33 years with an average total burn surface area (TBSA) of 43.5%. The most common cause of the burns was flame injury, and the most significant factors associated with mortality were TBSA >55.0%, blood creatinine >1.2 milligrams per deciliter (mg/dL) and face involvement.Conclusion: The 3 significant burn-related factors of TBSA >55.0%, blood creatinine >1.2 mg/dL and face involvement can be used to predict mortality using the nomogram created in this study.

Introduction: This study is to examine the reduction in wound size between the LTAPP and the control group and also investigate the wound healing effect factor. Methods: A randomized controlled trial was conducted at five study centers. Participated patients were between 18–80 years old who had pressure ulcer wound(s) and excluded patients with high risk or receiving other treatment such as previous radiation therapy in the affected area, pregnancy, sepsis, and immunocompromised host. The study divided participant into LTAPP group and standard of care (SOC) group, the LTAPP group would received a dressing of non-Ag materials and administer LTAPP for 1 min per 1 cm ² (maximum of 20 min). The SOC group would received standard dressing wound protocol. Both groups would be followed until the end of study (ninth visit) or until the wound healed. Results: When considering patients who attended follow-up ≥4 visits, only 45 ulcers were eligible, of which consisted of 21 ulcers in the LTAPP group and 24 ulcers in the SOC group. The results showed significant healing rate of the LTAPP group, whether to be the wound size: wound area and wound volume, wound healing: exudate reduction, granulation and lesser necrotic tissue or Pressure Ulcer Scale for Healing (PUSH) score. The LTAPP group had better bacterial load reduction without the use of tropical antibiotic, this also signified the quality in bacterial eradication of LTAPP. Conclusion: LTAPP showed outstanding performance in treating pressure ulcer wounds. The LTAPP gave greater outcome in wound size, wound healing indicators, microbiological analyses and cost-effective comparison. Although, the absence of statistical significance, it did not affect the outcome trends. This study suggested further investigation of the potential role of LTAPP therapy in different wound types in near future.

Lymphedema can cause by a congenital anomaly, an infectious disease, chronic inflammation, connective tissue disease, and cancer. The most common presenting symptoms are swelling of the affected limb, difficulty wearing clothes, and disturbances to daily life activities. Most of the time, patients have a high chance of developing a soft tissue infection that will jeopardize the quality of their life and socioeconomic status. As to management of the disease, it necessary to make a precise diagnosis and clinico-pathological staging in order to guide the treatment plan and yield optimum results. Currently, surgical management for lymphedema is based on the use of 1) physiological treatment, and 2) reductive or ablative procedures. Conservative treatment (especially for complete decongestive therapy) is still the mainstay for the management of lymphedema.

Objective: Controlling infection and promoting healing should be the aims of hard-to-heal diabetic ulcer treatment, along with improving a patient's general condition and their blood sugar control. Many hard-to-heal diabetic ulcers present with cavities, tracks or a combination of these. There is a new biocellulose (with a nanosilver dressing) which has the ability to contour around and conform to the irregular surface of a wound bed. The purpose of this study was to evaluate its efficacy compared with a silver sulfadiazine cream, for hard-to-heal diabetic ulcer treatment. Methods: In this randomised control trial, patients with hard-to-heal diabetic ulcers were divided into two equal-sized groups: treatment with the biocellulose with blue nanosilver (experimental group), and treatment with silver sulfadiazine cream group (control group). Cotton gauze was used as the secondary dressing for both groups. Demographic data, wound size, wound classification, wound photography and bacterial cultures were recorded at the beginning of the study. Wounds were debrided as necessary. Dressings were changed twice daily in the control group, and every three days in the experimental group. Results: A total of 20 patients took part in the study (10 patients in each group). The highest mean wound healing rates were 91.4% in the experimental group and 83.9% in the control group. No wound infections or adverse effects from the dressings were detected in either group. Conclusion: In this study, biocellulose with blue nanosilver adapted well to the wound bed. Wound reduction was greater in the experimental group than the control group. Biocellulose with blue nanosilver could therefore be a good choice for hard-to-heal diabetic ulcer treatment, due to its good healing rates and minimal care requirements.

Sternal clefts are rare congenital chest-wall deformities, which can be complete or incomplete; therefore, reconstruction with autologous tissue is essential to protect the heart and prevent respiratory infection. In this report, we present the case of a 16-month-old baby girl from a preterm, twin pregnancy with a partial superior sternal cleft. A moist dressing for promoting wound healing was used until cutaneous layer complete epithelialization at which time we performed reconstruction with autologous tissue. After surgery the patient recovered with close-to-natural chest wall contour and adequate heart and lung function.

Background: Maxillofacial injury was usually found in low to middle countries moreover it commonly associated with brain injury, the major etiological factors are traffic collision, violence, and fall from hight. The incidence and etiology was important to developed treatment moreover to improve patient care in the future. The aim of this study was to analyze the incidence of the pattern of maxillofacial fracture in a patient with a traumatic head injury and to measure the incidence of the cause of injury, age, and gender distribution Methods: This is a retrospective study in Songhklanagarind hospital. We evaluate all patients who presented with a concomitant maxillofacial and traumatic head injury in Songklanagarind hospital between 2007 and 2016. Results: 859 patients consisting of 73.3% male and 22.7% female. The mean age was 39.5 years.The severity of the traumatic head injury was mild traumatic head injury 70.15%. Moreover the alcohol consumption was significantly related to a mild and severe traumatic head injury (P < 0.05). The most frequent was maxilla bone. 33.9% of patients were undergone the operation. Conclusion: In this retrospective study, the maxilla bone fracture was the most frequent site involved. The patients with mild traumatic head injury are related to the coronoid process of mandible, Le Fort fracture type II and type III, moderate traumatic head injury is only related to the coronoid process of mandible and severe traumatic head injury are related to Le Fort fracture type II and III. Keyword: traumatic head injury, maxillofacial fracture