Burn images segmentation based on Burn-GAN

Introduction Burn injuries are severe problems for human. Accurate segmentation for burn wounds in patient surface can improve the calculation precision of %TBSA (Total burn surface area), which is helpful in determining treatment plan. Recently, deep learning methods have been used to automatically segment wounds. However, owing to the difficulty of collecting relevant images as training data, those methods cannot often achieve fine segmentation. A burn image generating framework is proposed in this paper to generate burn image datasets with annotations automatically. Those datasets can be used to increase segmentation accuracy and save the time of annotating. Method This paper brings forward an advanced burn image generation framework called Burn-GAN. The framework consists of four parts: Generating burn wounds based on the mainstream Style-GAN network; Fusing wounds with human skins by Color Adjusted Seamless Cloning (CASC); Simulating real burn scene in three-dimensional space; Acquiring annotated dataset through three-dimensional and local burn coordinates transformation. Using this framework, a large variety of burn image datasets can be obtained. Finally, standard metrics like precision, Pixel Accuracy (PA) and Dice Coefficient (DC) were utilized to assess the framework. Results With non-saturating loss with R2 regularization (NSLR2) and CASC, the segmentation network gains the best results. The framework achieved precision at 90.75%, PA at 96.88% and improved the DC from 84.5% to 89.3%. Conclusions A burn data generating framework have been built to improve the segmentation network, which can automatically segment burn images with higher accuracy and less time than traditional methods.

Skin burns from monochloroacetic acid leak in a chemical plant: a case report

The patient, a 45-year-old male chemical factory worker, was burned by monochloroacetic acid discharged from a ruptured pipe. The patient was merely flushed with water and did not leave the workplace immediately. As a result, he suffered local burn symptoms, which gradually worsened. Two and a half hours after the accident, he developed symptoms of systemic poisoning, such as lethargy and dyspnoea. After a thorough debridement of the wound surface and subsequent skin grafting combined with early glucocorticoid therapy and haemofiltration, a satisfactory result was achieved, and the patient eventually recovered. With the widespread use of monochloroacetic acid in China, incidents of poisoning with this chemical are becoming increasingly common, with more than 100 cases reported in the past ten years in China alone.

548 The Economics of Burn Injuries Among Children Aged 0–4 Years

Introduction Children under the age of five years are particularly vulnerable to scalds and contact burns and have the highest rate of hospitalization and mortality from burns. Studies of costs associated with pediatric burns have included a limited number of patients and focused on inpatient and complication costs, limiting our understanding of the full economic burden of pediatric burns, including costs incurred through outpatient care and caregivers’ productivity loss. This study aimed to develop a societal costing model for burn injuries among children aged 0 to 4 years. Methods Children aged 0 to 4 years identified through the local Burn Registry with a burn injury between January 1, 2014 and March 15, 2018 were included in this study. Patients with inhalation injury, electrical, chemical and friction burns were excluded. An incidence-based cost-of-illness analysis with a human capital approach was used to quantify the cost of partial and full-thickness burns according to the percentage of total body surface area (%TBSA) involved. The cost of a burn injury was assessed from a societal perspective through the following cost categories: emergency department visits, inpatient, outpatient dressing changes, outpatient burnbaths, day surgeries, clinic visits and caregiver productivity losses. A list of resource items for each category were extracted from patient chart review, the local Burn Registry, and the local Hospital Finance Database, and assigned unit prices. Costs were discounted to a present value in 2017 dollars at 1.5% per annum. Results Burn injuries were observed for 342 children, of which 249 (73%) had their burn severity classified (%TBSA and partial/full thickness) and were included in this study. Burn severity categories (1–5%, 6–10%, 11–20%, and >20%) were developed based on the differential distribution of the costs allocated to each burn incident. The majority of children (60.8%) suffered from a 1–5% burn. A 1–5%, 6–10%, 11–20%, and >20% burn respectively cost an average of $2,229, $8,653, $13,663, and $98,634 to society. Costs incurred by the 1–5% burns were related mostly to emergency department visits and dressing changes, while costs incurred by the >20% were related mostly to inpatient and clinic visits (garments) costs. Conclusions This costing approach raises awareness about the important, yet preventable economic burden that pediatric burn injuries place on society. Applicability of Research to Practice This evidence may persuade policymakers and clinicians to invest in pediatric burns prevention programs in order to decrease pediatric burns costs allowing for the allocation of funds towards other clinical initiatives. This costing model may also facilitate cost-effectiveness analyses of burn prevention programs in the coming years.

Effects of montelukast on burn wound healing in a rat model

Purpose: Montelukast, a selective cysteinyl leukotriene D4-receptor antagonist, is used in the treatment of asthma. In a rat model, our aim was to investigate the effects of montelukast, alone or in combination with topical antibiotics, on local burn wound healing. Methods: Rats were randomly allocated to four groups after local burn development: Group 1; rats were left to secondary healing without treatment, Group 2; a dose of 10 mg/kg montelukast was given by gastric gavage once a day for 10 days, Group 3; rats were treated with topical pomade (bacitracin neomycin sulphate), and Group 4; rats were treat with a combination of topical antibiotic and montelukast (10 mg/kg were given by gastric gavage once a day for 10 days). Skin biopsies were taken on days 3, 10, 14, and 20 relative to burn induction. Results: Reepithelialization in the pomade and montelukast+pomade groups on the 10th day was significantly greater, in comparison with control and montelukast groups (p < 0.05). For the montelukast group, edema (on the 14th day) and angiogenesis, fibroblast proliferation, edema and macrophage infiltration (on the 20th day) were statistically improved in comparison with the control group (p < 0.05). For the montelukast+pomade group, angiogenesis, fibroblast proliferation and macrophage infiltration (on the 10th day), and angiogenesis, fibroblast proliferation, edema and macrophage infiltration (on the 14th and 20th days) were statistically improved in comparison with the control group (p < 0.05). Conclusion: In conclusion, montelukast was effective on burn wound healing. Moreover, the effect was amplified when combined with topical antibiotics applied in the early stage of burn wound healing.