Many strains of enterobacteriaceae and frequent gram positive as well as gram-negative microbes, that are responsible for infection of burn wound, have started producing ESBL (extended-spectrum beta lactamases). Surgically acquired infections due to ESBL producing organisms, are yet another difficult situation in burn management. The organisms responsible for different infective foci in a Burn patient, are showing change in their resistance pattern mainly due to the production of ESBL. New combinations of Beta Lactam antimicrobial with Beta Lactamase inhibitors are aimed at targeting the ESBL enzyme, so that the antimicrobial can reach the cell wall of the microbe without being hydrolyzed.

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Major work of the Reconstructive Surgeons in post burn contracture of neck will start only after the surgical release and free skin grafting. Splintage is required for long period. We have been using thermoplastic material with gratifying results in patients of neck contractures. It provides splintage as well as pressure over the graft and has various other advantages.

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Management of facial burns remains a challenge to the treating surgeon. . The external ear being situated prominently on the side of face is vulnerable to thermal injury involving face. We present a case study of 16 cases ranging from skin loss to complete ear loss, each of which was reconstructed using different methods depending on the amount of tissue available.

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Burns and Plastic Surgery Department, B. J. Medical College and Civil Hospital, Ahmedabad conducted a study of short term recombinant growth hormone (rhGH) [LG Eutropin] therapy in 25-50% Total Body Surface Area, 2nd degree & 3rd degree burns patients of 15-35 yrs age group, given for duration of 2 weeks. Study included 7 patient in rhGH (study) group & 7 in control group. All patients of both the groups were treated as per the standard protocol for burns management in the form of intravenous fluids, antibiotics, daily closed dressings and adequate nutritional supplementation. The outcome was based on results of both clinical & biochemical parameters. Observations showed that rhGH definitely restricted the hyper catabohc state with better and faster healing of burns wound &also reduced the hdspital stay.

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Mini External Fixators have been used in severe injuries of hand and its role has been well established in case of post burn contractures. Long standing post burn contractures involving the upper and lower extremity are mostly associated with, incomplete release and patients have to be put to the trauma of repeated releases and grafting. In long run, the patients are lost in follow up due to poor compliance. Hence, we have started applying external distraction frame for incomplete releases and the distraction carried for 6 or more weeks. We have achieved encouraging results with early 10 patients included in the study.

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A prospective study of microbial flora of burn wounds was carried out from November- 2002 to November- 2005, at the Burns unit of B. J. Medical College & Civil Hospital, Ahmedabad. During this period of the study, out of many hundreds of patients being treated, 203 were selected for our study. Wound swab cultures were assessed at weekly intervals for four weeks. 354 sampling procedures (surface swabs) were performed from the burn wounds. The study revealed that bacterial colonization was observed in 80% of patients, within the first week of admission. Although the gram negative organisms, were more prevalent overall, staphylococcus aureus (28.4%) was the most prevalent organism in the first week. It was however, surpassed by Pseudomonas aeruginosa from third week onwards. For staphylococcus aureus & pseudomonas aeruginosa, Amoxicillin-Clavulinic acid and Ceftazidime were found to be most effective drugs, respectively. Isolates showed high level of resistance to other antimicrobial agents. Fungi were rarely found to colonize the burn wound in our burn patients.

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Presentation of burn victims involve trauma in suspicious situation. There is inherent responsibility of all citizens, to report incidences of unexplainable nature to the police. Responsibility of a doctor is an extension of the general duty of a citizen. There are some norms, followed by doctor fraternity and the police, which actually are the guiding factors to maintain channel of information between the law enforcing agencies and the doctor. Alternate procedures of informing police are also enlisted.

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Burns is one of the major causes of morbidity and mortality in India. An epidemiological study of a disease, gives us the data for studying the disease in terms of magnitude, distribution and etiology. It also provides data for formulation of policies for prevention and control I of the disease. Burn centre, Civil Hospital, Ahmedabad has a large input of patients from three states, with an average admission of 600 patients every year. Our study is a I retrospective, descriptive type of epidemiological study, where in we studied data from our past record books, dating from January 1, 2003 to December 31, 2005. The available data from these three years was distributed on the basis of type and mode of burns and also place, age and sex of th'e patient. From the above data, mortality rate was calculated. Thb following dere the results of this study. Most of our patients were accidental thermal burns, 75% of which were above 40% Total Body surface Area (TBSA). Most of the electrical burns (70%) were below 40% Total Body Surface Area. More than 50% were in the age group of 20-40 years. 70% of dur patients were females. Our overall mortality rate is SO%, but the mortality rate in 40-60% Total Body Surface Area of thermal burns has been reduced by 13%. Now our focus is on the 60-80% Total Body Surface Area category.

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This is a retrospective study of different types of industrial burns. The study also compares them with other burns, in terms of incidence, etiology, patients healing pattern, treatment and outcome. We take a step forward by suggesting, preventive and safety measures to decrease such accidents. In this study, the incidence of industrial burns is 5.9% of the total burn cases. Accidents are the common mode of burns in chemical, engineering and fabrication industries. They have occurred mainly in the age group of 21 to 30 years. Burns less than 30% TBSA constitute 74.24%, while the mean burn surface area constituted 26.4%. These indicate that industrial burns are mainly due to lack of safety regulations.

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