Rosadi Seswandhana M, Prawoto A N, Rachman I T, Wahdini S I, Vityadewi N, Ramli R N, Dachlan I
Plastic Reconstructive and Aesthetic Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada / Dr. Sardjito General Hospital, Yogyakarta, Indonesia.
Department of Obstetrics and Gynecology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada /Dr. Sardjito General Hospital, Yogyakarta, Indonesia.
Ann Burns Fire Disasters. 2023 Sep 30;36(3):229-233. eCollection 2023 Sep.
We report a case of severe burn injury in a 42-year-old pregnant patient referred to our hospital's burn unit after experiencing a scald burn injury that burned her neck, chest, trunk, abdomen and limbs. The patient had burn wounds distributed on her neck, all four extremities, the chest and abdomen, with a total burn area of 46.5%. The burn wounds were treated with surgical debridement and then covered with silver sulfadiazine and damp gauze. The patient's wounds were treated every three days. The patient delivered a healthy baby full-term through a spontaneous, vaginal delivery. After delivery, the amniotic membrane from the patient was used as an amniotic membrane graft and was planted on the patient's chest, right arm and right thigh. The amniotic membrane in this patient helped to accelerate the preparation of the wound bed for skin grafting. Split-thickness skin grafts were then used on the wounds and the patient was discharged from the hospital one week later. Patients that present with burn injuries during pregnancy require intense monitoring and careful management from a multidisciplinary team. A collaborative effort needs to be made in order to plan the best outcome for the mother and fetus. Precise and early resuscitation is the first step to treating such cases. The administration of fluids should be titered based on the patient's hemodynamic condition and urine output. Wound management can also be optimized using the amniotic membrane as a temporary dressing before skin grafting.
我们报告一例42岁的孕妇严重烧伤病例。该患者在经历烫伤后被转诊至我院烧伤科，烫伤部位包括颈部、胸部、躯干、腹部和四肢。患者的烧伤创面分布于颈部、四肢、胸部和腹部，烧伤总面积为46.5%。对烧伤创面进行手术清创处理，然后用磺胺嘧啶银和湿纱布覆盖。患者的创面每三天处理一次。患者通过自然阴道分娩，产下一名健康的足月婴儿。分娩后，将患者的羊膜用作羊膜移植片，移植到患者的胸部、右臂和右大腿。该患者的羊膜有助于加速创面床为植皮做准备。随后对创面进行了中厚皮片移植，患者一周后出院。孕期出现烧伤的患者需要多学科团队进行密切监测和精心管理。需要共同努力，为母亲和胎儿规划最佳结局。精确和早期复苏是治疗此类病例的第一步。应根据患者的血流动力学状况和尿量调整补液量。在植皮前，也可使用羊膜作为临时敷料来优化创面管理。
