Objective: To analyze the literature published in Chinese Journal of Burns (now Chinese Journal of Burns and Wounds) in the last 22 years, and to explore the development trend of burn discipline. Methods: The relevant clinical and research literature published in Chinese Journal of Burns from January 1, 2000 to December 31, 2021 were retrieved through China National Knowledge Infrastructure database. Bibliometrics was used to classify and analyze the literature by research types, involved research fields, and reported causes of injury, and compare them every 3 years according to the year of publication (with literature published in 2021 being included in the last time period). Keywords of all the literature were retrieved, which were corrected and conversed later. CiteSpace 6.1.R2 software was used to visually cluster the included keywords, count high-frequency and high-centrality keywords, and divide the high-frequency keywords by time as before for segment comparison. Results: A total of 4 485 relevant papers were included, with an average of about 204 papers each year. The research types analysis of literature showed that clinical diagnosis and treatment literature had the highest proportion, reaching 65.3% (2 929/4 485), followed by cell experiment and animal experiment literature, accounting for 18.1% (812/4 485) and 13.2% (591/4 485), respectively. The proportion of various research types of the literature in each time period was basically stable. The analysis of the research fields involved in the literature showed that the literature in the field of systemic treatment of burns accounted for the highest proportion, reaching 60.2% (2 699/4 485), followed by the literature in the fields of acute wounds and plastic surgery, accounting for 20.2% (908/4 485) and 7.3% (326/4 485), respectively. The proportion of the literature in the field of systemic treatment of burns decreased from 84.0% (430/512) in 2000-2002 to 40.3% (373/926) in 2018-2021, with a decreasing proportion of 43.7%. While compared with that in 2000-2002, the proportions of literature in the fields of acute wounds, plastic surgery, chronic wounds, and burn rehabilitation were on the rise, with the proportions in 2018-2021 increased by 11.7%, 9.1%, 10.7%, and 5.5%, respectively. In the first 6 time periods, the number of literature in the field of discipline management was few and remained in single digits, but it increased to 49 in 2018-2021. Among the 1 099 literature in the field of systemic treatment of burns with a clear cause of injury, the literature on thermal burns was the most, accounting for 58.5% (643/1 099), followed by the literature on electrical burns and chemical burns, accounting for 19.8% (218/1 099) and 12.6% (138/1 099), respectively. The comparison by time period showed that the proportion of literature reporting thermal burns showed a significant downward trend, while the proportion of literature reporting other causes of injury did not change significantly. A total of 6 822 keywords from 2 236 literature were included for analysis. Visual cluster analysis showed that relevant studies focused on burns, surgical flaps, scars, and wound healing. The top 3 keywords in frequency were burns, wound healing, and surgical flaps, and the top 3 keywords in centrality were burns, scars, and skin transplantation. The comparison by time period showed that the only keyword with a stable frequency in the top 10 ranks was burns; with the passage of time, some keywords such as endotoxin/endotoxins and fibroblasts gradually dropped out of the top 10 ranks, while keywords such as wounds and injuries, surgical flaps, and negative-pressure wound therapy gradually entered the top 10 ranks. Conclusions: Among the literature published in Chinese Journal of Burns during the last 22 years, the literature on systemic treatment of burns and thermal burns has gradually decreased, while the literature on chronic wounds and burn rehabilitation has increased. Surgical flaps, wound healing, and scar prevention and treatment are the current research hot spots in burn discipline.
Bibliometrics ; Burns, Chemical ; Burns, Electric/therapy* ; China ; Cicatrix ; Humans

Tetanus is rare in Korea due to the introduction of vaccination programs and the advancement in public health. Its common signs are trismus, voice disturbance, neck stiffness, and difficulty in swallowing, etc. A 56 years old man was injured by grasping a high voltage electric cable. After the accident, he fell down on a steel plate and had a head trauma. When he visited Emergency Department, there was multiple electric burn wound on left arm and left facial area. He was hospitalized on a department of neurosurgery, because intra cranial hemorrhage was presumed. 12 days later, he was referred to department of OMFS with developed painful masseter spasms and trismus. That night he violently bit his tongue with his denture. Because masseter muscle and temporal muscle constriction was involuntary, tongue was lacerated and denture was distorted. At first we supposed that the symptom was related with neurologic disturbance following head trauma or electric shock. But it was revealed that trismus was caused by tetanus on an electrophysiological test. By using mechanical ventilation and administration of tetanus immunoglobulin, muscle-relaxant, and sedatives at ICU, symptoms had subsided (4-weeks). Because tetanus is rare disease, we rarely suppose tetanus infection to be a cause of a trismus. Especially it is more difficult to diagnose in patient who has head trauma, burn and neurologic problem as in this case.
Arm ; Burns* ; Burns, Electric ; Constriction ; Craniocerebral Trauma ; Deglutition ; Dentures ; Emergency Service, Hospital ; Hand Strength ; Hemorrhage ; Humans ; Hypnotics and Sedatives ; Immunoglobulins ; Korea ; Masseter Muscle ; Middle Aged ; Neck ; Neurosurgery ; Public Health ; Rare Diseases ; Respiration, Artificial ; Shock ; Steel ; Temporal Muscle ; Tetanus* ; Tongue ; Trismus* ; Vaccination ; Voice Disorders ; Wounds and Injuries

FeCl₂ is often used in stainless steel surface processing, wastewater treatment, or in laboratories. Effects of exposure to FeCl₂ include predominantly systemic side effects that can occur when inhalation or oral intake occurs. However, it is known that skin irritation or burning can be caused by exposure to skin, but there has never been reported a case of deep FeCl₂ burns. We will introduce a case of a patient treated with deep second degree burn due to FeCl₂ exposure. A 27-year-old healthy man came in contact with FeCl₂ on his right wrist. The patient didn't wear any protective clothing, and the clothes were contaminated with FeCl₂ about one hour ago, but the patient was not aware of the danger of exposure. After an hour, the patient felt tingling, so he took off his exposed clothes and washed exposed skin, then came to our hospital. Initially there were mild erosion, erythema, and tingling symptoms. Two days later, eschar began to develop and wound began to deepen. Surgical procedure was not performed and it took 5 weeks for the patient's wound to heal. As a rule, workers using FeCl₂ are required to wear protective clothing. In Korea, companies and laboratories using FeCl₂ are not strictly required the use of protective clothing. Workers handling FeCl₂ should be strictly encouraged to wear protective clothing, if exposed, should be instructed to visit the hospital after a quick washing away.
Adult ; Burns* ; Burns, Chemical ; Clothing ; Erythema ; Humans ; Inhalation ; Korea ; Protective Clothing ; Skin ; Stainless Steel ; Waste Water* ; Wounds and Injuries ; Wrist

PURPOSE: We evaluated the power of the Rapid Emergency Medicine Score (REMS) for predicting hospital mortality in trauma patients. Then, we compared the REMS with two other scoring systems, the Emergency Trauma Score (EMTRAS) and the Injury Severity Score (ISS) for predicting prognosis. METHODS: We examined data from a prospectively collected registry in a single trauma center from January 2010 to November 2011. Patients enrolled in the registry were trauma patients who were predicted to have an ISS>15 or who required urgent multiple surgical consultations as soon as possible. Pediatric patients (<18-years-old) who were referred after initial care or death on arrival, and those with injuries due to burns, asphyxia, or drowning were excluded. The study population was divided into two subgroups according to hospital mortality, and the differences in clinical characteristics and calculated scores were examined. The odds ratio (OR) of REMS for predicting In-hospital mortality was calculated and the prognostic power of the three scoring systems for predicting hospital mortality by drawing receiver operating characteristic (ROC) curves was compared. RESULTS: A total of 103 patients were included in the analysis. Of these, 44 died during hospitalization. All three prognostic scores were significantly higher in the hospital mortality subgroup. The OR of the REMS for predicting hospital mortality was 1.35 (p<0.001). The areas under the ROC curves of the REMS, EMTRAS, and ISS were 0.815 (95% confidence interval [CI], 0.727-0.884), 0.872 (95% CI, 0.793-0.930), and 0.693 (95% CI, 0.595-0.780), respectively. The area under the ROC curve of the REMS was not different from that of the EMTRAS or ISS. CONCLUSION: The REMS showed good prognostic power for predicting hospital mortality in severely injured patients. Consecutive prospective studies are warranted to determine the utility of this scoring system for trauma patients.
Asphyxia ; Burns ; Drowning ; Emergencies* ; Emergency Medicine* ; Hospital Mortality* ; Hospitalization ; Humans ; Injury Severity Score ; Mortality ; Odds Ratio ; Prognosis ; Prospective Studies ; Referral and Consultation ; ROC Curve ; Trauma Centers ; Trauma Severity Indices ; Triage ; Wounds and Injuries

Craniocerebral gunshot injuries (CGI) are increasingly encountered by neurosurgeons in civilian and urban settings. Unfortunately this is a prevalent condition in developing countries, with major armed conflicts which is not very likely to achieve a high rate of prevention. Management goals should focus on early aggressive, vigorous resuscitation and correction of coagulopathy; those with stable vital signs undergo brain computed tomography scan. Neuroimaging is vital for surgical purposes, especially for determine type surgery, size and location of the approach, route of extraction of the foreign body; however not always surgical management is indicated, there is also the not uncommon decision to choose non-surgical management. The treatment consist of immediate life salvage, through control of persistent bleeding and cerebral decompression; prevention of infection, through extensive debridement of all contaminated, macerated or ischemic tissues; preservation of nervous tissue, through preventing meningocerebral scars; and restoration of anatomic structures through the hermetic seal of dura and scalp. There have been few recent studies involving penetrating craniocerebral injuries, and most studies have been restricted to small numbers of patients; classic studies in military and civil environment have identified that this is a highly lethal or devastating violent condition, able to leave marked consequences for the affected individual, the family and the health system itself. Various measures have been aimed to lower the incidence of CGI, especially in civilians. It is necessarily urgent to promote research in a neurocritical topic such as CGI, looking impact positively the quality of life for those who survive.
Arm ; Brain ; Brain Injuries ; Cicatrix ; Craniocerebral Trauma ; Debridement ; Decompression ; Developing Countries ; Foreign Bodies ; Hemorrhage ; Humans ; Incidence ; Military Personnel ; Neuroimaging ; Neurons ; Quality of Life ; Resuscitation ; Scalp ; Vital Signs ; Wounds and Injuries

During the past 11 years period from April, 1961 to March, 1972 171 cases of electrical burn patients were treated at Orthopedic Department of Han-Il Hospital. The author reviewed and discussed our clinical experience of electrical thermal injuries. Clinical analysis of these 171 cases of electrical burn patients was carried out and summarized as follows; 1) The majority of the patients ranged two to three decades of life(68.4%); The youngest 1 year old and oldest 53 years of age. Male were involved significantly more than female, the incidence being 163 cases (95.3%) and 8 cases. 2) Seasonal distribution showed more than about two third with 114 cases for rainy summer times and Autumn from May to October. 3) Among 171 cases of electrical burn patients, 131 patients (54.2%) were under 5% of body surface and 15 patients (11.3%) were over 20% of body surface. 4) In the regional distribution of burn wound, the upper extremity were 157(92.3%), 73(42.9%) in lower extremity, and 49 (28.9%) in other region. 5) Occupational distribution; The electrical line man and electrician were seen 136 cases (80%) which is two third of 171 patients, labor 12 cases(7%), 10 cases (5.9%) in painters, 8 cases (4.6%) in company employee and industrialist, 5 cases (2.9%) in house-wife, and 4 cases (2.4%) in motor man. 6) The most frequently early complication at electric burn of 171 cases were gastrointestinal symptom 111 cases (65%), fracture 18 cases (10.5%), head injuries (intracranial bleeding and basal bone fracture of skull) 15 cases (6.4%), spinal cord injury and kidney rupture 1 cases (0.6%), hemorrhage 2 cases (1.2%), and other 8 cases (4%). 7) The predominating organisms cultured out of burn wounds of 26 cases were staphylococcus aureus 9 (34.7%), pseudomonas auerginosa 5 (19.2%), E. coli 3 (11.5%), staphylococcus albus 1(4%), β-hemolytic streptococcus 1 (4%), and no growth were 7 (26.9%). 8) The type of current and the voltage in 102 cases among the 171 cases of electric burn patients was clear. Injury of the 99 cases out of the 102 cases were by indirect current and the 3 was by direct current. In 99 cases by indirect current, electric burn in accordance with high tension current in voltage was 81 cases (79.4%), low tension current injuries 18 cases (17.6%). 9) At the admission, laboratory findings of the electric burn patients showed hemoconcentration and leukocytosis. 10) Early excision of the necrotic tissue and skin grafting was performed in 94 times. The results was excellent in 71 times. 11) Among 171 cases of electric burn patients, later complication were seen 47 cases (27.4%), which is 25 cases (14.3%) in amputation, 8 cases in cicatrical contraction, 4 cases in serum hepatitis, 4 cases in paralysis, 2 cases in osteomyelitis, 2 cases in ankylosis of knee joint, 2 cases in drop foot, 1 case in anal stricture, and 1 case in cataract. 12) The overall motality in this series was 8% (14cases) and the most frerent cause of the death was due to head injury (9 cases) at the time of electrical burn injuries.
Amputation ; Ankylosis ; Burns ; Burns, Electric ; Cataract ; Constriction, Pathologic ; Craniocerebral Trauma ; Female ; Foot ; Fractures, Bone ; Hemorrhage ; Hepatitis ; Humans ; Incidence ; Kidney ; Knee Joint ; Leukocytosis ; Lower Extremity ; Male ; Orthopedics ; Osteomyelitis ; Paralysis ; Pseudomonas ; Rupture ; Seasons ; Skin Transplantation ; Spinal Cord Injuries ; Staphylococcus ; Staphylococcus aureus ; Streptococcus ; Upper Extremity ; Wounds and Injuries

OBJECTIVETo analyze the epidemiological characteristics of hospitalized children with burn injuries in Fujian Medical University Union Hospital, so as to provide evidence to complete an adequate, timely, and effective prevention and treatment system of children with burn injuries.

METHODSMedical records of children with burn injuries, aged 14 and under, hospitalized in the Department of Burns from July 2012 to June 2015 were collected. Data of gender and age, location and cause of injury, time of injury, state of injury, admission time after injury, first aid, length of hospital stay, and treatment and so on were recorded. They were divided into 4 age brackets: less than or equal to 1 year old, more than 1 year old and less than or equal to 3 years old, more than 3 years old and less than or equal to 7 years old, more than 7 years old and less than or equal to 14 years old, then gender and cause of injury of children in the 4 age brackets were analyzed. Admission months of the children were divided into spring (March to May), summer (June to August), autumn (September to November) and winter (December to February of the following year), and then the cause of injury of children in each season was analyzed. Severities of male and female children, length of hospital stay of children with different causes of injury were analyzed. Data were processed with chi-square test, Wilcoxon rank-sum test.

RESULTSOut of 2 608 inpatients with burn injuries, 1 407 children with burn injuries, aged 14 and under, accounting for 53.9%, were admitted in the recent 3 years. The ratio of male to female was 1.6 ∶1.0. Children more than 1 year old and less than or equal to 3 years old ranked the largest number (68.3%, 961/1 407) in the 4 age brackets. There was statistically significant difference in constituent ratios of gender of children among the 4 age brackets (χ(2)=11.00, P=0.012). One thousand three hundred and seventy-two children were burned indoors (97.5%), while 35 children were burned outdoors (2.5%). Scalding with hot fluids was the most common cause of burn (95.0%, 1 337/1 407). There was statistically significant difference in constituent ratios of injury cause of children among the 4 age brackets (χ(2)=107.23, P<0.01). There was statistically significant difference in constituent ratios of injury cause of children more than 7 years old and less than or equal to 14 years old compared with those of the other 3 age brackets (with χ(2) values from 12.88 to 119.85, P values below 0.01). Most burn accidents occurred between 17: 00-20: 59 (33.5%, 472/1 407). Burns were more likely to happen in April to October. July (10.4%, 146/1 407) and August (10.5%, 148/1 407) were the crest-time. Most of the children were burned in summer (35.3%, 496/1 407). There was statistically significant difference in the injury cause of children among each season (χ(2)=14.61, P=0.024). The burn degrees of male and female children were mainly mild or moderate, and there was no statistically significant difference in the severity (Z=-0.39, P>0.05). The trunk was the most involved anatomic site (61.1%, 859/1 407). Most of children were admitted to hospital within 2 hours post burn (79.7%, 1 121/1 407). Majority of children were taken off clothes as first aid on spot or did not receive any treatment. Most of the children were discharged within 2 weeks after admission (80.0%, 1 126/1 407). There was statistically significant difference in length of hospital stay of children with causes of hot liquid scald, flame burn, electric burn, high temperature solid burn, chemical burn (χ(2) =17.33, P=0.002). Most of the children were treated with non-surgical methods, and the majority of the children got better condition or totally recovered and then discharged.

CONCLUSIONSThe majority of hospitalized children with burn injuries in our unit are young boys in preschool period, who were burnt by hot fluid at the time of dinner and bathing at home during summer. So we should make more effort on popularization of prevention about burn.

Adolescent ; Burns ; classification ; epidemiology ; Burns, Chemical ; Burns, Electric ; Child ; Child, Hospitalized ; statistics & numerical data ; Child, Preschool ; Female ; Hospitalization ; Humans ; Infant ; Inpatients ; Length of Stay ; Male

Animals ; Biological Warfare ; Burns ; pathology ; Burns, Chemical ; pathology ; Chemical Warfare ; China ; Humans ; Military Medicine ; Radiation Injuries ; pathology ; Wounds, Gunshot ; pathology

OBJECTIVE: Major burn injuries are strongly associated with both psychological trauma and severe pain, and opioids are the mainstay analgesics for the treatment of severe burn pain. The objectives of this study are to find the complex relationship between opioid dose, depression, and post-traumatic stress disorder (PTSD) symptoms during the acute management of pain in burn patients. METHODS: The symptoms of depression and PTSD were assessed in 43 burn patients immediately following wound stabilization and 2 weeks after the initial evaluation. RESULTS: Total opioid doses and Hamilton Depression Scale (HAMD) scores obtained during the second evaluation were positively but weakly correlated after controlling for age and total burn surface area (R=0.33, p=0.03). Moreover, pain management with opioids was significantly more common in burn patients with low Clinician Administered PTSD Scale scores (evaluation 1) and high HAMD scores (evaluation 2) (F=6.66, p=0.001). CONCLUSION: High opioid dose following acute burn trauma might have correlation with depressive symptoms. Monitoring of depressive symptoms may be important following acute burn trauma and consequent opioids pain management, particularly when PTSD symptoms appear minimal during the early stabilization of patients.
Analgesics ; Analgesics, Opioid* ; Burns* ; Depression* ; Humans ; Pain Management ; Psychological Trauma ; Stress Disorders, Post-Traumatic ; Wounds and Injuries

PURPOSE: This current study determined the type, incidence, characteristics of ocular complications from electrical burn and associated risk factors. METHODS: The authors retrospectively reviewed ocular complications from electrical injury on ninety-seven consecutive electrical burn patients. RESULTS: Of the ninety-seven patients with electrical burns, twelve patients (12%) had ocular complications (cataract, uveitis, macular hole, corneal opacity, and optic atrophy). The relationship between voltage and development of ocular complication was not statistically significant. The relationship between wound size and development of ocular complication was not significant. However, the relationship between entry site and development of ocular complication was statistically significant (P=0.00). CONCLUSIONS: The patient who had electrical injury at any voltage with any wound size, especially electrical head injury for at least 6 months should be evaluated carefully.
Burns* ; Corneal Opacity ; Craniocerebral Trauma ; Humans ; Incidence ; Retinal Perforations ; Retrospective Studies ; Risk Factors ; Uveitis ; Wounds and Injuries