OBJECTIVE: To present a complicated case of abdominal wall reconstruction after tumor extirpation using an anterolateral thigh free flap.

METHODS: This is a report of a case managed at the Philippine General Hospital last September 2016

RESULTS: A 25-year old male, diagnosed case of recurrent colon adenocarcinoma, underwent wide excision of recurrent abdominal wall tumor with fistula, resulting to 15cm x 30cm full thickness soft tissue abdominal wall defect with exposed bowels. A free anterolateral thigh fasciocutaneous flap was designed and elevated to cover the abdominal wall defect. Recipient vessels (contralateral deep inferior epigastric artery and veins) were anastomosed with donor vessels (descending branch of lateral circumflex femoral artery and veins). The donor site was closed with split thickness skin grafting.

CONCLUSION:The free anterolateral thigh flap allows for coverage of complicated recurrent abdominal wall malignancies, allowing for a single-stage surgery, with little donor site morbidity and shorter hospital stay.

Human ; Male ; Adult ; Free Tissue Flaps ; Thigh ; Abdominal Wall ; Skin Transplantation ; Epigastric Arteries ; Femoral Arter ; Abdominoplasty ; Veins ; Peritoneal Neoplasms ; Fistula ; Adenocarcinoma ; Colon

OBJECTIVE: Profiling of burn patients with inhalational injury will lead to better practices in the immediate and supportive management of their injuries. The goal of this study was to determine demographic and clinical factors associated with mortality in burn patients with inhalational injury admitted at Philippine General Hospital - Alfredo T. Ramirez (PGH - ATR) Burn Center from 2008 to 2013. METHODS: All patients who were admitted from 2008 to 2013 were included in the study. The patient database was searched for cases of burn patients with inhalation injury. Medical records were reviewed for further analysis. This study was exempted from review by the University of the Philippines Manila Research Ethics Board. RESULTS: Out of 1900 burn patients included in the study, 134 presented with concomitant inhalation injury with a prevalence rate of 7.0% and with a mortality rate of 38.06%. The study showed that the following variables: 1) percent total body surface area (%TBSA), 2) length of time from injury to resuscitation, 3) nebulization with N-acetylcysteine, 4) development of pneumonia, 5) administration of systemic antibiotics, and 6) performance of bronchoscopy correlated significantly with patient outcomes (p<0.05). Other variables did not show significant correlations with outcomes. The study also revealed that most of the patients were males with a mean age of 30.62, who sustained severe burns usually greater than 39% TBSA. CONCLUSION Poorer prognostic indicators include: 1) larger burnt body surface area, 2) delayed intubation, 3) delayed resuscitation, and 4) development of pneumonia.
Burns

OBJECTIVE: This study aimed to describe the demographic profile of patients admitted at the UP-PGH ATR Burn Center from August 2013 - July 2015, and correlate it with outcomes of burn injury.
METHODS:  A  retrospective  study  of  patients  admitted  at  the  UP- PGH  ATR  Burn  Center  from  August  2013  to  July  2015  was conducted,  using  the  data  in  the  Integrated  Surgical  Information System. Descriptive statistics was used to summarize the clinical characteristics of patients. Logistic regression analysis determined the significant predictors of mortality. STATA 12.0 was used for data analysis.
RESULTS:The age groups most commonly involved were: 1 operation). Ninety-one percent (91%) of the admitted burn patients improved; 9% of the patients died. The most common cause of death was multiple organ dysfunction syndrome (40%). Significant factors associated with mortality included: 1) percent total body surface area, 2) inhalational injury and 3) involvement of the head, lower extremities and perineum.
CONCLUSION:  Burns  continue  to  be  a  big  burden  to  developing countries. To confront the burden of burns especially in developing countries  like  the  Philippines,  key  primary  preventive  measures should be implemented and be a priority for public health advocates.

Human ; Male ; Female ; Multiple Organ Failure ; Perineum ; Cause Of Death ; Burns ; Hospitalization ; Head ; Lower Extremity

OBJECTIVE: This study determined the mean overall adherence to the clinical pathway formulated by the Section of Pulmonology together with the Division of Burns for adult burn patients at high risk for inhalation injury admitted at the UP-PGH ATR Burn Center in a two-year period METHODOLOGY: A retrospective cohort study regarding adherence to the clinical pathway of acutely burned adult patients at high risk for inhalation injury admitted at the UP-PGH ATR Burn Center between August 2016 to July 2018 was conducted. Medical records were reviewed and an adherence checklist was used to assess each item in the clinical pathway. For the adherence and patient profile, descriptive statistics were used. RESULTS: This pilot assessment study showed acceptable rates of adherence and implementation of the clinical pathway. Overall, 60% of the cases followed the clinical pathway completely. While 26.67% had acceptable rates of compliance (more than half of items adhered), while 13% of the cases scored adhered to less than half of the items. CONCLUSION The pathway has been shown to be a feasible clinical pathway that can be implemented in a tertiary hospital setting.
Burns