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  • Küçük Resim
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    Clinical infection in burn patients and its consequences
    (Turkish Association of Trauma and Emergency Surgery, 2017) Güldoğan, Cem Emir; Kendirci, Murat; Tikici, Deniz; Gündoğdu, Emre; Yastı, Ahmet Çınar
    BACKGROUND: Burn injuries facilitate invasive infections and sepsis not only by destroying the continuity of the protective skin barrier but also through systemic effects. The burn wound, blood, and urine samples are frequently cultured to determine the pathogen agent. The aim of this study was to analyze pathogen growth in patients’ cultures confirmed as “infection positive” by the hospital Infection Control Committee and to assess the clinical implications of these growths. METHODS: Hospitalized patients included in the study were those with a total burned body surface area of >10% and “presence of infection” confirmed by the Infection Control Committee. The patients were evaluated with respect to age, gender, burn etiology, the total body surface area burned (TBSA), the presence of inhalation injury, sepsis, positive cultures, the microorganisms cultured in wound-blood-urine samples, and septic focus. RESULTS: Of the total 36 (10.3%) “infection-positive” patients, 26 (72.2%) were male; the mean age of patients was 44±21 years. The mean burned TBSA of the whole group was 45.58%±23.1%. Acinetobacter baumannii was the most isolated organism in the wound cultures. In patients with confirmed infection, there was a correlation between the pathogen isolated in urine cultures and mortality rates (p=0.023). Sepsis was diagnosed in 23 (63.9%) patients, of whom 21 had inhalation injuries. There was a significant correlation between inhalation injury and sepsis (p=0.015), and both the presence of sepsis or inhalation injury increased mortality (p=0.027 and p=0.009, respectively). CONCLUSION: According to the study data, the TBSA burned demonstrated a greater significance for mortality, although the presence of sepsis and/or urinary tract infection should also be noted as a cause of mortality in burned patients. © 2017 TJTES.
  • Küçük Resim
    Öğe
    Dev retroperitoneal dedifferansiye liposarkom
    (Akdeniz Üniversitesi Tıp Fakültesi, 2017) Gülseren, Mehmet Onur; Saylam, Barış; Güldoğan, Cem Emir; Ünal, Devrim Tuba; Polat Düzgün, Arife; Coşkun, Faruk
    Retroperitoneal sarkomlar; bağ doku, yağ ve kas dokunun mesodermik kök hücrelerinden köken alır ve tüm malign tümörlerin %0,1-%0,2 sini, tüm sarkomların %15 ini oluşturur. Liposarkom en sık görülen tiptir ve bunu leiomyosarkom, malign fibröz histiyositom, fibrosarkom ve diğer undifferensiye sarkomlar takip eder. Kliniğimize sebat eden karın ağrısı ve abdominal distansiyon şikayetleriyle başvuran 53 yaşında erkek hastada yapılan tetkikler neticesinde retroperitoneal bölgede kitle tespit edilmiş ve hasta ameliyata alınmıştır. Ameliyatta, kitle sol böbrek ile beraber eksize edilmiş ve patoloji sonucu dedifferansiye liposarkom olarak raporlanmıştır. Yazıda nadir görülen bir retroperitoneal liposarkom olgusu sunuldu.
  • Küçük Resim
    Öğe
    Outpatient burn management and unnecessary referrals
    (Turkish Association of Trauma and Emergency Surgery, 2015) Sözen, İsa; Güldoğan, Cem Emir; Kısmet, Kemal; Sabuncuoğlu, Mehmet Zafer; Yastı, Ahmet Çınar
    BACKGROUND: This study aimed to determine the profile of burn patients presented in our polyclinic and evaluate the current status in comparison to the treatment methods of past series. METHODS: Burn patients presented in the polyclinic in a one-year period were included into this prospective study. The records of all patients were examined in respect of gender, age, burn percentage, burn location, cause of burn, degree of burn, dressing material, number of dressings, type of treatment, place of trauma, and month of trauma. RESULTS: From a total of one thousand seven hundred and ninety-five patients presented, management was completed in the polyclinic for one thousand five hundred and eleven cases with a mean age of 27.9 years, with a female: male ratio of 0.88. While most patients were in the 18-64 age group, hot liquid burn was the leading cause in all age groups (p<0.05, p<0.001). Of the total patients, 89.6% were injured at home (p<0.001). The extremities were determined as the body area most often burned (p<0.001). While a single dressing was applied to 446 patients (29.5%), in 64.9% of cases polyclinic follow-up was terminated after the frst 3 dressings. The mean number of dressings was greater in patients with deep dermal burns (mean 14.5, median 14, p<0.001). CONCLUSION: A higher incidence of burns was found due to increasing urban populations compared to previous years. Currently, the majority of patients are referred to a healthcare facilty near their residences for follow-up after a few dressings. Unnecessary presentation at specialist centers increases the workload of these centers and creates a burden of wasted time and transport expense for the patients. The application of current burn treatment principles in primary and secondary health facilities will reduce the workload of reference centers. © 2015 TJTES