Doctors in the UAE often perform plastic surgeries on burn victims, mostly children and women.
A passing mention of plastic surgery during conversations often triggers thoughts of using the procedure for beautification purposes for most people. However, plastic surgery is only a part of the armamentarium of a plastic surgeon.

Doctors in the UAE often perform plastic surgeries on burn victims, mostly children and women. Burn injuries globally account for an estimated 180,000 deaths annually.

Consultant plastic surgeon Dr Nadeem Akhtar from Al Zahra Hospital Sharjah, said he handles burn injuries of children, who get them due to "absent-mindedness" of parents and the latter not knowing what immediate first aid should be given in such a case.

Referring to one such case, Dr Akhtar said he recently handled a case where a small boy spilled hot tea on himself which caused a huge burn covering his scrotum area and legs. " In such critical cases, the first thing the doctor is required to do is stablise the child, assess the wound (which could take a couple of days) and see if it needed grafting or if it would heal on its own. It starts with blistering which can extend and at times the amount of fluid the child loses can be critical. Therefore, we need to ensure the patient is well hydrated because drying up fluid could deepen the wound."

Dr Akhtar, who treats about 10 patients a month, said burns change and evolve so it takes about two weeks to assess the wound and see if it needs grafting. "This happens in only second and third-degree burns," he said. "First thing for a doctor to do in such cases is to assess the depth of the burn and control the pain as it is the most important measure, especially when it is a child. At times, we admit the child in the ICU because of the amount of fluid he or she is losing which could be critical.

The quicker a burn heals, the fewer chances for scars.

"The most important thing in a burn case is first aid. Some people put toothpaste on burns while others say put egg yolk etc, but these are not the right measures. The first thing that one should put on a burn is cold water. The water ill numb the burn and then put a cling film around the skin, so there is no concern about infection. And then rush the child to the emergency department of the nearest hospital."

Narrating another burn case, where skin grafting was required, Dr Akhtar said: "A child burnt his hands while playing on a treadmill after his hand came into the roller mechanism of the treadmill. He had received deep friction burns. Since the child was not treated properly, his fingers were scarred up and curled into his palm, causing his hand to become dysfunctional. I operated on his hand for three hours wherein we removed the scars, straightened the fingers and grafted skin. The child is now doing well. It all depends on the severity of the burn and how quickly you can get first aid to it and show it to a doctor."

Dr Athar Khan, specialist in general surgery at Al Sharq Hospital Fujairah, said most of the cases they get are of children under five years of age. A matter of concern that needs to be addressed is the lack of 'burn management' in the community. "More than often people are not aware what kind of first aid is to be given in burn cases which complicates the case at times and worsens the condition of the victim," he said.

"A one-and-half-year-old child was brought to emergency with burns on both her legs and groin area. The child was found to have significant second and third-degree burns as her parents left her unattended and she pulled a hot cup of tea on her which burned her severely. Unfortunately, her family was unaware of what first aid was to be given. The child is being treated at our hospital and we are trying to minimise the scars caused."

In another case, Dr Khan said they came across a housewife who had severe burns when the pressure cooker she was using blasted, splashing the hot contents over her.

On inquiry, it was found the family didn't know what first aid should've been given to her. "She was brought to the emergency room 45 minutes after the incident, prolonging the damage to her body. We started the treatment immediately by hydrating her and putting her on IV fluids, cleaning and dressing the wounds and stabilising her," he said.

"We need to spread awareness of burn management in the community and people should know what first aid is to be given when a person gets burn injuries. Sometimes, the burn injury gets worse because the first aid was not proper and not started on time. Also, children are a vulnerable group and they should not be left unsupervised."

SOURCE : KHALEEJTIMES