This study attempts to know the current bacteriological profile and antimicrobial susceptibility pattern of the Gram negative organisms isolated in burn wounds with special reference to resistance pattern of Pseudomonas spp. at the Burn unit of B. J. Medical College and Civil Hospital, Ahmedabad. A total of 93 cases were studied from February 2006 to March 2007. The swab or pus culture was done to analyze the individual member of microbial flora and then the sensitivity to various antibiotics was studied. Culture was positive in 95.7% of cases. Gram negative isolates were encountered in 95.51% and were predominant compared to gram positive isolates (4.49%). Pseudomonas spp. were the predominant isolates (56.82%) followed by Klebsiella spp. (28.41%), Escherichia coli spp. (10.58%) and Citrobacter spp. (I. 17%). Results of antibiotic sensitivity of our study revealed that for Pseudomonas species, Carbapenum, combination of Piperacillin and Tazobactum, Monobactum and higher Quinolons were effective, whereas for Gram negative isolates other than Pseudomonas spp. (i . e. Klebsiel la species, Escherichia coli spp. and Citrobacter spp.), in addition to above antimicrobials, combinations of Ampicillin + Sulbactum and Cefoperazone + Sulbactam were also effective.

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Tourniquet [ Derived from the French word 'Tourner' meaning to turn ] is an essential component of a Surgeon's armory. The importance of tourniquet is stressed by Bunnell who said 'could a jeweller repair a watch immersed in ink ?'. One of the complications arising out of tourniquet Use is its contamination with blood, body fluids and therefore colonization with micro organisms resulting in transmission of infection and reduced longevity of the tourniquet. To avoid these complications, a simple technique is described in this article which may be a useful surgical tip.

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A series 403 patients of burns were analyzed to review the epidemiological and medicolegal aspect. The study revealed Female (53.1%) predominance with female-male ratio 1.13: 1. Most of the victims of burn were between 13 to 25 years (41.5%) with mean age 27.5year-s. Married (72.5%) outnumbered unmarried. Kerosene stove was the main causative agent with kerosene as the accelerant. The overall mortality was 26.0%. Extensive Total body surface area (TBSA) burnt had significant association with sex showing that female patients have higher risk for more extensive burns. There were 379 cases (94.0%) of accidental burns, 15 cases (3.8%) of homicidal burn and 9 cases (2.2%) of suicidal burn. Percentage of homicidallsuicidal burns underestimate the true incidence due to false dying declaration recorded by the victim and these burns may be classified as accidental due to lack of evidence.

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We present a series of 7 cases of post-burn contracture which were released by using Z- plasty. Use of Z-plasty prevents recurrence and gives a better cosmetic outcome.

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