Kwesi Okumanin Nsaful1*, Edward Asumanu2, Yaa Konadu Asante-Mante1, Jeffery Eduku Mozu1, Jennifer Maame Efua Owusu1, Emmanuel Yaw Botchway1, Amma Gyamfuawaa Afriyie1, Stephen Mawuli Dei1, Edmund Tettey Nartey3, Richard Osei Boateng4

1 Plastics and Burn Centre, 37 Military Hospital, Accra, Ghana

2 General Surgery Unit, 37 Military Hospital, Accra, Ghana

3 Statistics and Data Analysis Department, Korle Bu Teaching Hospital, Accra, Ghana

4 Records and Data Collection Division, 37 Military Hospital, Accra, Ghana

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How to cite this paper: Nsaful, K.O., Asumanu, E., Asante-Mante, Y.K., Mozu, J.E., Owusu, J.M.E., Botchway, E.Y., Afriyie, A.G., Dei, S.M., Nartey, E.T. and Boateng, R.O. (2022) Burn Management at the 37 Military Hospital—A Tertiary Hospital in Accra, Ghana. Modern Plastic Surgery, 12, 1-12. https://doi.org/10.4236/mps.2022.121001

Received: November 28, 2021

Accepted: January 22, 2022

Published: January 25, 2022

Copyright © 2022 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).

http://creativecommons.org/licenses/by/4.0/

Abstract

      Burn injuries have been and remain a very significant source of mortality and morbidity in low- and middle-income countries. As a country in this category, Ghana, is not exempted. Ghana has a population of 31 Million with only 21 Plastic Reconstructive and Burn surgeons. Moreover, the country can boast of only 3 major Burn centres. This notwithstanding the country in particular and Africa, in general, carries an extraordinary burden of Burn injuries with devastating consequences. Burn data from the 37 Military Hospital were analyzed from March 2018 to September 2019—a period of 18 months. In all, 217 burn cases were seen representing about 2.1% of all trauma and surgical cases. Our burn data analyzed the peculiarities of epidemiology, types of burn, the pattern of injuries, and the outcome of burn care at the 37 Military Hospital. Flame is emerging as the predominant cause of burns, most frequently occurring from the use of Liquid Petroleum Gas. In the pediatric population, however, the most frequent cause of burns is hot water burns. The mortality rate among the burn population was 1.8% (4 mortalities). This paper aims to point out management methods adopted by our unit which helped to improve burn outcomes and to reduce mortality.

Keywords: Burns, Wound Healing, Wound Dressing, Burn Blisters, Antibiotics

ABSTRACT: Links between nutrition and pressure ulcer (PU) prevention and wound healing are well known and documented (Saghaleini et al, 2018). Less well documented is the link between hydration and pressure care. It was recognised that many patients admitted to acute hospitals are dehydrated (El-Sharkawy et al, 2015); this is particularly relevant to Gastroenterology patients based on the classifications of dehydration (Posthauer, 2016), although all patients are at risk. Dehydration status is not routinely assessed without painful and costly blood tests. Through the use of an adapted version of the GULP Dehydration risk screening tool (Food First Nutrition and Dietetics Team, 2012) and the implementation of a hydration-focussed care plan, it may be possible for a nurse-led assessment to identify dehydration risk and plan care accordingly. A pilot study showed that 50% of the sample group gained an improved level of hydration throughout their hospital admission and a decrease in their Waterlow score.

KEY WORDS Dehydration risk assessment GULP risk assessment Hydration Pressure ulcer prevention Nurse-led care

KAREN GREEN    Deputy Sister and Chief Nurse   Fellow, University Hospitals of Leicester NHS Trust, Leicester, UK

Objective: To examine the use of maggot debridement therapy (MDT) for individuals with diabetic foot ulcers (DFU) after a change in prescribing policy.

Method: A self completion survey/structured questionnaire to assess healthcare professionals' existing knowledge of MDT was given to those specialist services providing wound care treatments for DFUs.

Results: The results showed that those responding had a basic understanding of MDT and its use. However, further education is required for the type of wounds that maggots can be applied to, and what enzymes are produced. Enablers and barriers to MDT use also included policy and procedures, time constraints and the 'yuck factor'.

Conclusion: While there is good clinical evidence to support the use of MDT, there is a lack of evidence examining the factors that influence healthcare professionals’ decisions to recommend this treatment.

KEY WORDS  Maggot debridement therap  Lucillia sericata   Diabetic foot ulcer  Attitudes/knowledge  Service evaluation

CRAIG FAIREY Tissue Viability Podiatrist, Sound Primary Care Network, Oakside Surgery, Honicknowle Green Medical Centre, UK SAMANTHA HOLLOWAY Reader, Centre for Medical Education, School of Medicine, Cardiff University, Wales, UK

Background: Pressure damage in paraplegic patients is difficult to manage due to their limited mobility. Topical Negative Pressure Therapy (TNPT) has successfully been used for different types of wounds, including cavity wounds, leg ulceration and pressure ulcers (PU). The introduction of TNPT with instillation (TNPTi) has increased the categories of wounds that can be treated. Aim: To describe the wound management of an unstageable pressure damage with underlying osteomyelitis. Methods: Observation of the care provided to a patient presenting with an unstageable pressure damage on admission. On further investigation osteomyelitis was found. Results: Following 3 months of the application of TNPTi, the wound size had reduced significantly, making it suitable for flap surgery. The benefits of undertaking flap surgery after an overall short time thanks to this treatment includes also the psychological and social aspects of the patient’s life. This also reflected in a positive impact on the patient's wellbeing and reduced length of hospitalisation. Conclusions: The use of TNPTi positively affected the healing process of an unstageable PU presenting with osteomyelitis. Further studies are needed to validate the effectiveness this treatment regimen.

ALBERTO SPITILLI Specialist Nurse in Tissue Viability, Oxford University Hospital NHS Foundation TRUST

KEY WORDS Osteomyelitis Pressure ulcer Topical negative pressure therapy (TNPT) Paraplegic