It has become the fashion to have a gas cooking facility in the kitchen of even the middle class personnal like teachers, and office going people (middle income group) in Chennai.

Electrical injuries in children are gruesome injuries that result in disabilities and death in developing countries. In this article we present a series of 6 children who were treated for electrical burns. Reconstructive surgery followed by prolonged rehabilitation is required.

Full thickness burns in children often leads to eschar formation which requires escharotomy. Escarotomies in children pose various challenges depending on the site involved, age of the child, mechanism of injury etc. In this article we discuss a series of children under special circumstances who required escharotomies. We are describing the methodology used and precautions to be taken before and after surgical procedure to improve the outcome in these children.

Introduction: Exfoliative skin diseases in children can mimic burns in many ways and require early diagnosis and management. Here we enumerate the different skin conditions with four case based examples and their management. Clinical Presentation: Varying degrees of skin involvement may be seen with severe involvement in DRESS syndrome and milder involvement in Stevens-Johnson syndrome. Management: The management of this exfoliative lesion is the application of collagen membrane to the wound as we treat burns. Although systemic symptoms can produce mortality (e.g., dress), collagen dressing heals the wound well with good epithelialization. Early and appropriate antibiotic therapy is mandatory. Conclusion: Careful attention to correct diagnosis, early intervention and use of collagen dressing have improved outcome in these children.

Material and Methods: This is a retrospective review of children with burns admitted to the Kanchi Kamakoti Childs Trust Hospital, a 220-bed tertiary-care children's hospital in Chennai, India. Results: Four hundred and twenty-nine children with burns were admitted and treated between 2007 and 2014. Among these, 40 patients with over 20% deep and deep partial thickness burns were transferred to the Pediatric Intensive Care Unit (PICU) for various acute complications. In the presence of invasive sepsis or complication at the time of admission or later, the children are transferred to the PICU. Of the 40 cases transferred, 13 died and 27 survived. Details of the management of these complications and the causes of death were analyzed. It was realized that the survival of 27 burnt children was possible due to the combined team approach of treatment by the burn and plastic surgeons and the intensivists of the PICU. Conclusion: Continued approach is necessary for better survival in pediatric burns.

Introduction: Normal wound repair of human skin involves several well-orchestrated phases, which are overlapping, yet distinct in their own way. This presentation aims to define, identify, and classify scars, irrespective of the etiology, describe the methods available to differentiate the various types of scar, and describe the current management strategies available to prevent scar formation. From our studies we conclude that for a good scar outcome early intervention during the evolution of wound healing is required. Meticulous surgery is also essential. Various interventions could be with drugs, chemicals, growth factors, or ionizing radiation. Future holds for continued research in cellular signals.

This article tells the story of the making of collagen sheets as dressing material in India. The thought process behind the science and the methods of usage of collagen sheets have been deliberated upon. Versatility of collagen based dressings is approved by most of the surgeons and plastic surgeons for burn injuries. There have been no adverse reactions by way of allergy, or anaphylaxis. Collagen dressings are very cost-effective, less labor intensive, but the person who uses must understand the nuances thoroughly, before starting to use. It is better to learn all about the membrane prior to using it.

Chemical burns are not uncommon in India. Both accidental and non-accidental chemical burns are encountered in our setting. In the paediatric age group, chemical burns are mainly accidental. Analysis of chemical burn admissions to the Burn Units of a medical college hospital, and to an exclusively tertiary care children's hospital in Chennai, India, from 2001 to 2010 is described. A total number of 75 adults and 38 children are included in the study. Detailed analysis of age, sex, percentage of burn total body surface area (TBSA %), causative agents, aetiology (accidental or non-accidental), treatment instituted, mortality, and outcome are reported.

A group of 273 paediatric patients admitted to Kanchi Kamakoti Childs Trust Hospital Burn Unit, Chennai, India between the years 2004 to 2010 were analysed retrospectively. Of these, 89 were suffering from sepsis and septic shock and 15 died. Strict adherence to antibiotic administration and to the Paediatric Intensive Care Unit (PICU) and management protocol improved the outcome, especially in 2009 and 2010.

We report a rare case of absence of the flexor pollicis longus in a hypoplastic right thumb, without hypoplasia of the thenar muscles in an 11-year-old girl, who was treated by transfer of flexor digitorum superficialis of the ring finger to the thumb to achieve active flexion at the interphalangeal joint of the thumb.

Acute and chronic burns leave behind a full-thickness defect that always requires a flap cover. Such defects are common in electrical burn injuries of the limbs. This paper deals with 35 patients with full-thickness defects following burns in whom deepithelialized turnover dermis flaps and deepithelialized turnover flaps with deep fascia have been used. This flap is an extension of Hynes's reversed dermis graft and Smahel's deepithelialized turnover flap where there is a larger area of blood supply on the deeper aspect of the dermis. If a good hinge is provided for safe blood supply, such a flap settles well in the defect, and cumbersome multistaged procedures can be avoided. If there is less fatty tissue in the area of flap used, then reversed dermis flaps are ideal because split-skin graft take is good. When there is a lot of fatty tissue on the undersurface of dermis, the fascia is also included to make it a reversed fasciocutaneous flap to augment the blood supply and for better split-skin graft survival. Advantages of the procedure and complications are elaborated.

The incidence of velopharyngeal incompetence (VPI) following cleft palate surgery is fairly high in our country. We have attempted to analyse the aetiology and then selected 50 cases of VPI from our group of operated cleft palates. These patients were then evaluated using cephalometry, speech rating, pressure studies and nasendoscopy. We identified 13 patients in whom there was incompetence due to failure of movement of the walls responsible for proper closure of the velopharyngeal port. In these patients we performed circumferential sling pharyngoplasty using denervated palmaris longus; since this procedure narrowed the port circumferentially. We re-evaluated these patients and the results have been gratifying. Speech rating improved and E.M.G. tracings after 6 months showed evidence of reinnervation of the Palmaris Longus.

Infection is the most important problem in the treatment of burns in a developing country. A burn compromises a major body protective mechanism, namely the skin. Hence, the susceptibility to local infection increases at these sites. The incidence of burn wound sepsis is very high in south India as the socio-economic conditions and the standard of personal hygiene are poor and the hot moist climatic conditions encourage bacterial growth. These three factors are rarely present in the temperate zone countries of Europe and North America. This study was undertaken to identify more clearly the factors that are responsible for the higher incidence of burn wound infection and to formulate methods of treatment which are appropriate for our patient population living in a tropical country.