Al-Kinidi Hospital Plastic Surgery & Burn Unit. Dr. Mohammad Ali ajam (M.D.F.R.C.S & The head of burn unit) Dr. Shervin Shalbaf (chief resident of Plastic surgery)
Background
The patient is female, 15 years old. She burnt herself while playing with fire on 6th November 2009. Came to hospital 4 days after incident and was admitted to hospital on 10th November 2009.
The burn was to the right breast and right lateral side of chest wall, right axillary area with anteromedial arm, the left breast was also burned.
The burns were second degree and third degree around 20% of her body surface. Because the patient delayed coming to hospital for treatment infection maybe likely.
Initial presentation
Initial presentation
The wound was cleaned by normal saline fluid. Hydrogel was applied with Eclypse as the secondary dressing.
Blood exam result
- WBC: 16080 ul
- Hg: 12.3 g/Dl
- Plt: 191000 ul
- BS: 67 mg/Dl
- Ur: 17 mg/Dl
- Cr: 0.39 mg/Dl
- Alb: 3.7 g/dl
- Na: 134.9 mmol/L
- K: 3.66 mmol/L
- Cl: 96.4 mmol/L
- Blood group: +O
After 3 days
After 3 days
After 3 days
After 3 days
The dead tissue was removed and the wound cleaned with saline solution. Activon honey was applied with Actilite over the top. Eclypse was then applied as a secondary dressing.
After 5 days
After 5 days
After 8 days
After 8 days
Application of Activon Tube & Actilite
Application of Activon Tube & Actilite
Skin graft to lateral part of left breast
Skin graft to axillary area
Donor site
Donor site with Activon honey & Actilite
Blood exam results before being discharged
WBC: 5922 ul
Hg: 12.7 g/Dl
Plt: 231000 ul
BS: 72 mg/Dl
Ur: 17 mg/Dl
Cr: 0.39 mg/Dl
Alb: 4.2 g/dl
Na: 134.9 mmol/L
K: 3.66 mmol/L
Cl: 96.4 mmol/L
Blood sample analysis
3 days after skin graft
3 days after skin graft
First visit shown below as an outpatient, this is 20 days after initial presentation.
20 days after incident
20 days after incident
14 days after skin graft
14 days after skin graft
Conclusion
The majority of the burn area healed in no more than 14 days without needing a skin graft. A small percentage of the burn area needed a skin graft, this was at the third degree burn area that will need more attention.
During dressing she did not care for the smell of Actilite, however pain was reduced and no need for any sedation.
As blood analysis show during treatment her WBC decries and her Albumin rise to normal without need any Albumin injection. Hemoglobin is stable and came to normal.
Initial presentation
After 2 months
When skin graft taken
Donor site after 14 days