Objective: To study and analyze the cases of post burn breast contracture over a period of three years based on age, etiology, duration, side, severity, surgical procedures, complications, results and patient compliance. To study the relationship between specific treatment variables and functional outcome among patients undergoing post burn breast reconstruction as measured by symmetry of breast, location of infra mammary line, breast projection and scarring. To measure, the effect of duration of contracture and patient age on the above outcome and the types of surgery. Methods: A Prospective study of all cases of post burn contracture of one or both the breasts managed by various methods in our department. Depending up on the extent of damage, the contractures were classified as mild, moderate and severe. The treatment options adopted were contracture release followed by split skin grafting, Z plasty, Y-V plasty, V-Y plasty, 5 flap plasty, sliding abdominal flap, Parascapular flap and reduction Mammoplasty Results: 40 patients were studied. 37 had thermal burns, 2 had acid burns and 1 had scald burn. The mean age of admission at treatment was 15 years. The average duration of deformity was 5 years. Majority of the contractures were of moderate type, where the breast tissue was present but was covered by scar. Out of the total patients studied, 14 had bilateral breast involvement, 15 had right breast contracture and 11 had left breast contracture. Nipple areola reconstruction was done in 13 patients. Resurfacing of the raw area after contracture release with local flaps gave good results in terms of color match, contour of breast and infra mammary crease projection but was not always possible especially when extensive areas were involved where skin grafting was the option.

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Burn patients are usually resistant to the neuromuscular effects of nondepolarising muscle relaxants mostly because of receptor changes. The magnitude of the resistance is related to burn size and time after burn. Rocuronium 0.9mg/kg & 1.2mg/kg was used as the neuromuscular blocking drugs in burn as well as in non burn patients. Eighty patients were divided in to four groups. Forty burned patients ASA grade II & III aged 18 to 50 years, weighted 40 to 66 Kg burn area, was > 25% and < 40% with > 25 and < 60 days after burn injury were divided in to BO (0.9mg/kg Rocuronium) and B1 (1.2mg/kg Rocuronium). Another 40 non burn patients were divided in to NO (0.9mg/kg Rocuronium) and N1 (1.2mg/kg Rocuronium), as controlled group. After premedication with Inj. Glycopyrrolate 0.004mg/kg, inj. Midazolam 0.01mg/kg and inj. Fentanyl 1ug/kg intravenously. Anaesthesia was induced with inj. Propofol 2mg/kg IV. Rocuronium was given according to dosage. Neuromuscular block was monitored by using train of four stimulation. Onset time was prolonged in burn patients, 123 ± 9.97 seconds (0.9mg/kg) and, 85.2 ± 15.08 seconds (1.2mg/kg ), in compare with 82.3 ± 16.3 (0.9mg/kg) and 54.25 ± 9.79 seconds (1.2mg/kg) in non burn patients. Time to intubations was also prolonged in burn patients, 152.85 ± 25.27 seconds (0.9mg/kg) and 108.7 ± 13.01 seconds (1.2 mg/kg). Intubating conditions were graded on a three point scale as excellent, good, or poor. Recovery was observed as a time to reappearance of T1, 10%, 25%and 75% duration, Recovery index and TOF > 0.8 ratio and it was significantly shorter in burn patients as compared to non burn patients. This study shows that a 1.2mg/kg dose of Rocuronium provides good intubating conditions, faster onset time and recovery in compared with a dose of 0.9mg/kg.

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Objective: To study the etiology, incidence, socioeconomic factors in superficial burns of the adults and to study the efficacy of glycerol preserved amnion dressing in superficial burns in terms of pain relief, wound healing, ease of availability, preparation and storage. Methods: A prospective study of superficial burn wounds with less than 25% of TBSA [Total Body Surface Area] with varying etiology and managed with glycerol preserved amnion dressing. Conclusion: 50 patients with superficial burns with less than 25% of TBSA were selected out of total 107 admissions. The male: female ratio was 1.73: 1, the common age group being 20 to 29 years and majority had TBSA of 10% or less, the common cause being flame burns and the average duration of hospital stay was 7 to 12 days. Glycerol preserved amnion gave excellent pain relief, wound cover, extremely cost effective and the process of procurement, preparation and storage were simple.

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The meshing of skin grafts is done for expansion of the surface area of the skin graft and for drainage of secretions from the wound surface. Meshing of skin grafts are done using meshers or manually with surgical blades. There are numerous methods described in the literature about manual meshing of skin graft but there is only a single report suggesting how to do it in a planned way. We describe a technique to do it more effectively using the instrument box which has appropriate fenestrations on the surface.

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Non invasive blood pressure monitoring is associated with multiple dangers in the back drop of old and fragile skin, anti coagulant medicines and critical care units. We share our experience which states that the dangers of the blood pressure cuff can happen even without the above mentioned factors.

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In present pilot study, a three layer Artificial Neural Network (ANN) is used to predict the survival of burn patients. Retrospective data of 226 patients is used with age, sex, delay in admission and size of burn for eight different parts of the body as input features for ANN, output being survival or death. Out of these 226 patients 113 are used for training of ANN & 113 are used for testing. Results are compared with statistical method of regression analysis. Sensitivity up to 96.30%, specificity up to 84.37% and misclassification rate up to 7.07% is achieved using ANN proving it's efficacy.

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