Extravasation injury of balanced electrolyte solution simulates the clinical condition of necrotizing fasciitis: A case report

Extravasation injury (EI) is an iatrogenic condition that occurs preferentially in neonatal and pediatric patients when the injection of fluid substances by intravenous access is required and it accidentally leaks into the adjacent tissues or in spaces outside of vascular compartment. Different types and amount of substances once undergoing extravasation can affect the EI differently [1]. In some instances immediate measures such as saline washout, local antidotes, enzymatic debridement and surgical interventions can be required in order to prevent the occurrence of a growing injury avoiding the progression of the EI to a medical emergency [6]. Here we report an unusual case of a preterm 2-month-old male patient in which the extravasation of balanced electrolyte solution on the upper right arm resulted in the development of full-thickness skin necrosis appearing as the clinical condition of necrotizing fasciitis. The management of necrotic tissue was performed using escharectomy as well as autograft skin under conditions of general anesthesia

Economic Burden of Denatured Alcohol-Induced Burns: A 20-Year Retrospective Study

: Burn care has rapidly improved over the past decades, but health innovations are expensive. We present the first study focusing on the economic burden of exclusive denatured alcohol-induced burns. The goal of this study was to determine costs for the public health system due to inpatients' burn care because of these specific burns. Moreover, we aimed to observe the incidence of methylated spirit-related burns in the past 20 years. We performed an observational retrospective study in our burn unit including all patients with a denatured alcohol-related burn injury from 1 January 2001 to 31 December 2020. A total of 503 patients with a mean burn size of 24% were hospitalized; the mean annual total costs per patient was €43,879, varying from €31,518 to €63,274.00€; the total costs for denatured alcohol-related burns during the period 2001-2020 was €21,145,076. We noted an increasing incidence of denatured alcohol-related burns and related costs over the years, especially in the last decade. Our results highlight that burns by methylated spirits are still a real and expanding problem. Therefore, authorities should focus on sales rules, characteristics of the containers, and education of people who misuse denatured alcohol, based on historical habits of use. To reduce the socioeconomic costs of burns, future intervention strategies and studies from the dermatology community and burn specialists should focus on prevention programs and prompt wound healing to shorten the length of hospital stay, enable quick return to work, and improve the outcomes of patients with burns

Italian recommendations on enzymatic debridement in burn surgery.

Abstract Introduction Nexobrid®, a bromelain-based type of enzymatic debridement, has become more prevalent in recent years. We present the recommendations on enzymatic debridement (Nexobrid®)'s role based on the practice knowledge of expert Italian users. Methods The Italian recommendations, endorsed by SIUST (Italian Society of Burn Surgery), on using enzymatic debridement to remove eschars for burn treatment were defined. The definition followed a process to evaluate the level of agreement (a measure of consensus) among selected experts, representing Italian burn centers, concerning defined clinical aspects of enzymatic debridement. The consensus involved a multi-phase process based on the Delphi method. Results The consensus panel included experts from Italy with a combined experience of 1068 burn patients treated with enzymatic debridement. At the end of round 3 of the Delphi method, the panel reached 100% consensus on 26 out of 27 statements. The panel achieved full, strong consensus (all respondents strongly agreed on the statement) on 24 out of 27 statements. Discussion The statements provided by the Italian consensus panel represent a "ready to use" set of recommendations for enzymatic debridement in burn surgery that both draw from and complete the existing scientific literature on the topic. These recommendations are specific to the Italian experience and are neither static nor definitive. As such, they will be updated periodically as further quality evidence becomes available

Stem Cells

The main objective of this book is to present a thorough update on stem cell research and the potential therapeutic applications of stem cells. The text is structured following a path that starts from the molecular basics and the biological properties of pluripotent, embryonic or reprogrammed stem cells, and it compares the different degrees of stemness, while describing the adult stem populations residing in the various tissues and organs of the human body. Starting from basic research, the book discusses examples of regenerative medicine that translate the experimental findings into clinical applications of cell therapy. Finally, the book reviews how stem cells represent a model to understand not only the physiological mechanisms that control their fate, but also the pathological mechanisms involved in the aberrant biology of cancer stem cells. Each chapter has been conceived by distinguished researchers in the field who provide detailed and updated contributions that distill knowledge in a very readable text. Laura Bonsi is Associate Professor of Histology at the Department of Experimental, Diagnostic and Specialty Medicine of the University of Bologna. Francesco Alviano is Assistant Professor of Histology at the Department of Experimental, Diagnostic and Specialty Medicine of the University of Bologna. Prof. Bonsi and Dr. Alviano are authors of numerous scientific papers published in international journals. They coordinate the Biotechnology Laboratory of Human Stem Cells at the University of Bologna, that is focused on the study of stem cells isolated from different sources, above all from extraembryonic tissues such as the placenta, the umbilical cord, and the fetal membranes. They are longterm members of the International Placenta Stem Cell Society (IPLASS)