BACKGROUND: We investigated the epidemiology and the knowledge of first aid regarding to burns in the rural area of Kulon Progo, located in Indonesia. Although 44% of Indonesia’s population resides in rural areas, data of burn in Indonesia are very limited to national referral centers located in Indonesia’s largest cities. We also surveyed the patients and families of these burn patients to try to understand their knowledge on the first aid of burns. AIM: We wanted to explore and discover what myths and misperceptions existed in rural communities. MATERIALS AND METHODS: A retrospective study analyzing the medical records of patients with burns admitted to two of Kulon Progo’s largest referral hospitals between January 2018 and December 2019. A survey was distributed to the patients and their families regarding their knowledge on the first aid of burns. We wanted to analyze if certain groups of the population were more at risk for specific types of burn etiologies, the correlation between burn etiology and length of stay, the correlation between total body surface area (TBSA) of burns and length of stay in the hospital, and the correlation between education level of survey participants’ and their knowledge of first aid of burns. RESULTS: A total of 115 patients were reviewed in this study. The highest proportion of total burn injuries occurred in the age group of 1–14 years old (38%). The major etiology of all burn cases were caused by scald (54%). Housewives and children were at a higher risk for scalds and laborers were at a higher risk for electrical and chemical burns (p = 0.001). There was no significant correlation between etiology and length of stay (p = 0.29). There was a statistically significant correlation between the TBSA and the length of hospital stay (p = 0.0001). The majority of survey respondents (66%) had poor knowledge on the first aid of burns. There was no significant correlation between education level and knowledge of first aid of burns (p = 0.07547). CONCLUSIONS: Children, laborers, and housewives have a significant risk of suffering from a burn injury. A majority of people still have poor knowledge on the first aid of burns. There was no correlation between education levels and knowledge of first aid burns.

Background Composite graft as a reconstructive therapy option has limitations in size so that it is easily necrotic. Deferoxamine administration has been associated with increased neo-vascularity in wounds. We aimed to compare the administration of deferoxamine and Platelet-Rich Plasma (PRP) injection in a composite graft in rabbits. Methods Thirty New Zealand rabbits were divided into three groups; the control group, the deferoxamine group, and the PRP group. The composite graft with a diameter of 2 cm was taken and replanted after rotating it 180°. The mean graft viability and the mean number of capillaries were evaluated on day 7 (POD 7) by macroscopic and histological evaluation using Hematoxylin-Eosin staining. Results While the mean number of capillaries was not significantly different in control, deferoxamine, and PRP groups ( p = 0.21), the mean survival rate in the control, deferoxamine, and PRP groups reached a significant level with p -value of 0.006 (66.6% vs. 63.8% vs. 99.6%, respectively). Conclusions Deferoxamine group had the highest number of capillaries, but had the lowest survival rate. In the PRP group, it had the lowest number of capillaries, but had the highest survival rate.

Background: Deep sternal wound infection (DSWI) or mediastinitis is a severe and life-threatening infection with high morbidity and mortality rates. Vacuum-assisted closure (VAC) provides good results and is very useful in wound closure. VAC therapy is a safe and affordable method for managing complex sternal and thoracic injuries. The use of VAC has been shown to increase parasternal blood flow by dilating arterioles, reducing bacterial load, and accelerating granulation tissue formation. It also helps with facilitating wound edge closure. Case and Operation Technique: A 6-month-old baby presented with an ulcer 2 cm deep in the thorax region. The wound had an exposed bone surrounded by slough and hyperemic edges. Bone destruction was seen to have reached the costochondral joint with a gross visible appearance of the pleura. Management of this patient included debridement, sternotomy, internal fixation of the sternum using the Robiscek technique, and application of the Water Shield Drainage (WSD) and VAC. The tobacco-sack technique was used to close the open wound. The Robiscek technique was used in this patient because of the bone destruction to the costochondral joints causing the sternum to become unstable. The VAC dressing was then connected to a suction with an intermittent negative pressure of 75mmHg. After a significant decrease in the wound surface area, a local rotational flap was used to close the wound. Conclusion: The use of modified VAC for deep sternal wound infection (DSWI) is effective, simple, and affordable with minimal complications.

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