عبدالخالق کشاورزی

COVID-19 induces a systemic inflammation in the body and predisposes thromboembolic events in the patients. Consequently, skin autografting in burn patients might be affected by this disease.

In this cross-sectional study, 41 burn patients with COVID-19 were evaluated regarding the rejection of the graft, and the size of the wound and the graft, as well as COVID-19 symptoms and past medical history. The association of autograft rejection with these parameters was evaluated.

The study included 41 patients, with 24.4% being female and 75.6% male. The patients had a mean age of 36.63±15.951 years. One patient experienced autograft rejection, which was not higher than expected in non-COVID-19 patients. Autograft rejection was not associated with age, COVID-19 severity, burn wound size, or graft size. Unfortunately, 14 patients passed away. Mortality was associated with COVID-19 symptoms and burn rate (P = 0.004 and P < 0.001, respectively).

In COVID patients who received skin grafts for burns, the severity of COVID symptoms, gender, burn mechanism, degree of burn, and amount of grafted skin were not linked to graft rejection. The only factor directly related to patient mortality before and after surgery was the extent of the burn. COVID-19 symptoms were found to be associated with mortality in COVID-19 burn patients, but this association may be overestimated. The results also indicated that COVID-19 was not associated with autograft rejection in these patients.

The use of antibiotic prophylaxis in the treatment of burns is a controversial issue. Many specialists start antibiotic treatment after the patient is admitted to prevent infection, while in most cases, antibiotic use is not necessary. The aim of the present study was to determine the relationship between the use of antibiotic prophylaxis on mortality, infection and drug resistance in burn patients without sepsis symptoms admitted to Amir al-Momenin Burn Injury Hospital.

The present analytical-cross-sectional study was conducted in 2020-2021 at Amir al-Momenin Burn Injury Hospital, Shiraz, Iran. 2982 patients were included in the study. Patients' information, results of bacterial culture and antibiotic resistance of isolated isolates were extracted from burn patients' registry system and health information system. Descriptive statistics and the collected data were presented in tabular form. Quantitative data were summarized as mean and standard deviation and qualitative data as frequency and percentage graphs. Statistical analysis was analyzed for the association of results using paired t-test and chi-square. The level of statistical significance in all tests was considered P≤0.05.

Antibiotic resistance in hospitalized patients with prophylaxis treatment was 54.30%. The rate of mortality and re-hospitalization of patients in patients with no antibiotic prophylaxis was zero; In addition, the blood, liver and kidney factors of the patients were within the normal range. There was no significant difference between platelet levels, alkaline phosphatase serum level, alanine aminotransferase, blood urea nitrogen level and its ratio to creatinine (P≥0.05) on the first day of hospitalization and at the time of discharge. On the other hand, there was a significant difference between the levels of white blood cells, neutrophils and albumin (P<0.001) in the first three days of hospitalization and the time of discharge.

The use of prophylactic antibiotics had no effect in the treatment of burn diseases without infection, and in order to reduce microbial resistance, it is better to avoid unnecessary use of antibiotics in burn areas.

Burns is one of the most severe forms of trauma that cause damage to the skin and subcutaneous tissues in different ways with different severity and extent. Effective reduction of itching symptoms after burns is a major problem in rehabilitating all burn patients. However, although there are many potential treatments for pruritus, there is still no consensus on the best treatment. This study was conducted to investigate and compare the effects of cetirizine, gabapentin, and coconut oil in reducing skin itching after burn wound healing.

The present research population was selected from among the patients of Amir-Al-Momenin burn hospital affiliated with Shiraz University of Medical Sciences who suffered from mild to severe burns that are resistant to treatment and sometimes have bleeding. In this study, after the approval of the ethical committee of the University Research Council and the consent of the patients, 150 people were selected by random sampling. To collect data from the studied sample, the questionnaire of Khars Yusipovich et al. (2001) was used. The obtained data were statistically analyzed using t-correlated and covariance analysis and with the help of SPSS.

The average and standard deviation of the itchiness of the burn site before the cetirizine drug is 4.32 and 0.74. Also, the average and standard deviation of the itchiness of the burn site after the cetirizine drug is equal to 3.04 and 1.57. The mean and standard deviation of the itchiness of the burn site before the gabapentin drug are equal to 4.98 and 0.82. Also, the average and standard deviation of the itchiness of the burn site after the gabapentin drug is equal to 1.66 and 0.47. The average and standard deviation of the itchiness of the burn site before coconut oil is equal to 4.40 and 1.76. Also, the mean and standard deviation of the itchiness of the burn site after coconut oil is equal to 1.60 and 0.49. The intensity of itching was measured before and after the administration of cetirizine, gabapentin, and coconut oil, and there was a significant difference between all three groups.

This study showed that all three drugs, cetirizine, gabapentin, and coconut oil, reduce itching after burns and coconut oil showed the greatest effect, followed by gabapentin and finally cetirizine. The long-term follow-up of patients after discharge from the hospital showed that after transplant surgery, itching was less and that patients who lived in cold areas experienced less itching after burns.