BACKGROUND: The Alfredo T. Ramirez (ATR) Burn Center of the University of the Philippines-Philippine General Hospital, being the first burn unit assembled in the Philippines, is currently at the forefront of burn care in the country. It remains the largest tertiary burn center locally with an 11-bed capacity and caters to every Filipino in need of treatment due to burns.

OBJECTIVE: To describe the c1inico-epidemiologic profile of pediatric patients admitted to the UP-PGH ATR Burn Center from January 2004 to December 2008 as to the following: Age, Gender, % total body surface area (%TBSA) involvement, Severity of injury based on % TBSA involvement, Etiology of burn, Place of injury, Incidence of inhalational injury, Length of time prior to consult, Number of operations, Morbidity, Mortality; to determine the factors predictive of mortality among pediatric burn patients.

METHODS: A retrospective study on pediatric patients admitted to the ATR Burn Center UP-PGH treated for burn injuries from January 2004 to December 2008 was conducted. The Integrated Surgical Information System (ISIS), a computerized registry of the patients of the Department of Surgery was searched to identify pediatric burn patients aged 0 to 18 years old.

RESULTS: Of the 361 patients, 234 patients were male (64.82%) while 127 patients were female (35.18%). The odds of mortality in patients with flame burns was 2.24 (OR 95% CI: 1.01 to 4.96) times that of those who were scalded. The odds of mortality in patients with inhalational injury was 11.98 (OR 95% 0: 5.07 to 27.88) times higher than those without. The odds of mortality in patients with late consultation (>8 hours post-injury) was 2.24 (1.05 to 4.77) times that of those who were treated early. There was a significant association between survival outcome and the aforementioned factors.

CONCLUSION: The presence of inhalational injury, flame burns, delayed time of consultation, increased number of operations and the presence of nosocomial pneumonia, burn wound infection, and/or graft loss, were the variables noted to be independent predictors of mortality. Age, gender, burn size, severity, place of injury and length of stay were not found to be statistically associated with mortality.

Human ; Male ; Female ; Adolescent ; Child ; Child Preschool ; Infant ; Infant Newborn ; Burn Units ; Incidence ; Hospitals, General ; Body Surface Area ; Length Of Stay ; Philippines ; Cross Infection ; Burns ; Morbidity ; Registries ; Pneumonia ; Wound Infection

OBJECTIVES: To compare the efficacy, safety and cost of locally-produced microcellulose dressing from Acetobacter xylinum in promoting healing of superficial partial thickness burn wounds to standard dressing using silver sulfadiazine (SSD) cream and gauze in terms of the following: time to healing, morbidity/infection rate, pain score, scarring and cost of dressing

METHODS: Comparative controlled trial. Each patient served as his own control, that is, one area was randomized to the treatment group dressed with microcellulose dressing, while another was assigned to the control group dressing with SSD. Both areas were inspected regularly for signs of infection, as well as reepithelialization. The patients were also asked for the pain score at rest, and during dressing using the visual analog scale. Once healed, the Vancouver scale was used to grade the resultant scars.

RESULTS: Ten patients were included from February to June 2008. All patients were males, with a mean age of 30.1 years (17-48 years, ± 12.05), and a mean total body surface involvement of 12.75% (4-22% TBSA,?± 7.0) superficial partial thickness burns. The time in days to complete reepithelialization was significantly lower in MCD dressings (p-value=0.05760). The mean times (in days) to complete reepithelialization for MCD and SSD were 11.4 (90 percent CI: 9.80-13.0) and 13.8 (90 percent CI: 12.33-15.27) days, respectively. Statistical analysis of differences of VAS scores during dressing changes were significantly lower in MCD dressing on days 2,6,9 and 12 post burn. Background VAS scores were also lower in those patients with MCD dressing on days 6, 9 and 12 post burn. None of the wounds in either treatment arm had signs of infection. Scarring of wounds dressed with MCD were better, based on the Vancouver scar score than those dressed with SSD (p = 0.0299). The means for the Vancouver score for MCD and SSD were 2.65 (90 percent CI: 2.25-3.05) and 4.05 (90 percent CI: 3.32-4.78), respectively.

CONCLUSION: Microcellulose dressing is significantly more effective than silver sulfadiazine in treatment of second degree burn wounds in terms of number of days to full reepithelialization and quality of scarring. Dressing with MCD was less painful on days 2, 6, 9 and 12 post burn. Background VAS scores were also lower on days 6, 9 and 12 post burn. None ofthe wounds in both treatment arms had signs of infection throughout the treatment period. Human ; Male ; Silver Sulfadiazine ; Cicatrix ; Gluconacetobacter Xylinus ; Burns ; Re-epithelialization ; Bandages ; Wound Healing ; Pain

This study aimed to share the authors’ preliminary experience with endoscopic nipple-sparing mastectomy in the Philippines. All medical records of patients who underwent endoscopic mastectomy done by the same surgeons in two institutions from March to October 2019 were collected and analyzed. Surgical margin, operating time, blood loss volume, and post-operative complications were noted. Three cases were recorded during the study period. The mean operative time was 341 minutes and the mean blood loss volume was < 20 mL. All cases had negative margins of resection on final histopathology. One patient developed ecchymosis on the axilla, while the other patients had unremarkable post-operative courses. Endoscopic nipplesparing mastectomy is a potentially safe and feasible alternative in breast cancer management. Further evaluation of the procedure is recommended.

Objective: To describe the use of autologous-fat grafting in postenucleation-socket syndrome. Methods: This is a case report. Results: There was marked improvement in the gross appearance of the treated orbit of the patient. There was relief in enophthalmos and superior-sulcus deformity. Bilateral orbital symmetry was achieved. Postoperatively, only minimal bruising and swelling both in the orbit and source site were observed, which resolved in 4 weeks. Conclusion The use of autologous-fat graft is a novel but highly effective technique and a good alternative in treating patients with postenucleation-socket syndrome.

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