15 year old with second & third degree burns treated with Activon Tube, Actilite and Eclypse dressings

15 year old with second & third degree burns treated with Activon Tube, Actilite and Eclypse dressings

Al-Kinidi Hospital Plastic Surgery & Burn Unit. Dr. Mohammad Ali ajam (M.D.F.R.C.S & The head of burn unit) Dr. Shervin Shalbaf (chief resident of Plastic surgery)

Background

The patient is female, 15 years old. She burnt herself while playing with fire on 6th November 2009. Came to hospital 4 days after incident and was admitted to hospital on 10th November 2009.

The burn was to the right breast and right lateral side of chest wall, right axillary area with anteromedial arm, the left breast was also burned.

The burns were second degree and third degree around 20% of her body surface. Because the patient delayed coming to hospital for treatment infection maybe likely.

Initial presentation

Initial presentation

The wound was cleaned by normal saline fluid. Hydrogel was applied with Eclypse as the secondary dressing.

 

Blood exam result

  • WBC: 16080 ul
  • Hg: 12.3 g/Dl
  • Plt: 191000 ul
  • BS: 67 mg/Dl
  • Ur: 17 mg/Dl
  • Cr: 0.39 mg/Dl
  • Alb: 3.7 g/dl
  • Na: 134.9 mmol/L
  • K: 3.66 mmol/L
  • Cl: 96.4 mmol/L
  • Blood group: +O

After 3 days

After 3 days

After 3 days

After 3 days

The dead tissue was removed and the wound cleaned with saline solution. Activon honey was applied with Actilite over the top. Eclypse was then applied as a secondary dressing.

 

After 5 days

After 5 days

After 8 days

After 8 days

Application of Activon Tube & Actilite

Application of Activon Tube & Actilite

Skin graft to lateral part of left breast

Skin graft to axillary area

Donor site

Donor site with Activon honey & Actilite

 

Blood exam results before being discharged

WBC: 5922 ul

Hg: 12.7 g/Dl

Plt: 231000 ul

BS: 72 mg/Dl

Ur: 17 mg/Dl

Cr: 0.39 mg/Dl

Alb: 4.2 g/dl

Na: 134.9 mmol/L

K: 3.66 mmol/L

Cl: 96.4 mmol/L

 

Blood sample analysis

3 days after skin graft

3 days after skin graft

First visit shown below as an outpatient, this is 20 days after initial presentation.

20 days after incident

20 days after incident

14 days after skin graft

14 days after skin graft

 

Conclusion

The majority of the burn area healed in no more than 14 days without needing a skin graft. A small percentage of the burn area needed a skin graft, this was at the third degree burn area that will need more attention.

During dressing she did not care for the smell of Actilite, however pain was reduced and no need for any sedation.

As blood analysis show during treatment her WBC decries and her Albumin rise to normal without need any Albumin injection. Hemoglobin is stable and came to normal.

Initial presentation

After 2 months

When skin graft taken

Donor site after 14 days