Journal of Disaster Medicine and Burn Injuries

Evaluation of ambulance readiness in Vietnamese military hospitals

2025-11-17T01:53:17+00:00

Aims: To assess the current status of ambulances in Vietnamese Military Hospitals. Subject and methods: A cross-sectional descriptive study was conducted on 30 ambulances from the Military Hospitals. Data were collected through direct observation, interviews, verification of technical inspection records, and analysis based on the criteria set forth in Circular No. 27/2017/TT-BYT and Decision No. 3385/QĐ-BYT issued by the Ministry of Health. Results: A total of 83.3% of ambulances were in good operational condition; however, none fully met all the standards required. Some items had low compliance rates, such as emergency hammers (50%), anti-slip floor mats (60%), and medical staff seats (66.7%). The basic sets of medicines and medical equipment were generally adequate but lacked standardization among units. Conclusions and recommendations: The ambulance system in Military Hospitals generally meets the operational requirements for patient transport and prehospital emergency care. Nevertheless, there is a need to standardize equipment, strengthen periodic inspection, and enhance training for prehospital emergency teams to improve effectiveness, safety, and readiness in disaster response.

Characteristics of organ dysfunction according to the SOFA score in severe burns patients

2025-10-20T12:58:06+00:00

Objective: Assessment of Organ Dysfunction Characteristics According to the SOFA Score in Severe Burns Patients. Patients and method: A prospective descriptive study was conducted on 119 patients with severe burns, aged 18 years and older, who were admitted to the Intensive Care Unit for treatment from June 1, 2024, to June 30, 2025. All patients were admitted within 48 hours after the burn injury, with no underlying diseases or associated trauma. Data were collected at three time points: upon admission (N0), three days after the burn injury (N3), and seven days after the burn injury (N7). Results: The prevalence of organ dysfunction according to the SOFA score was high at all time points: upon admission (77.31%), three days after the burn injury (87.39%), and seven days after the burn injury (68.07%). Upon admission and on day 7 after the burn injury, the respiratory system showed the highest rate of dysfunction according to the SOFA score (39.50% and 47.06%, respectively). On day 3 after the burn injury, the hematologic system had the highest rate of dysfunction (56.30%). The SOFA scores at admission and on day 7 post-burn showed a fairly strong positive correlation with burn extent (p < 0.001). There was also a fairly strong positive correlation between the extent of full-thickness burns, inhalation injury, and SOFA scores at admission, on day 3, and on day 7 post-burn (p < 0.001). Conclusion: The incidence of organ dysfunction according to the SOFA score in patients with severe burns was high. SOFA scores at admission and on day 7 post-burn showed a fairly strong positive correlation with burn severity.

Describe the antimicrobial resistance patterns of bacteria and fungi isolated of severe burn patients treated at the Intensive Care Unit (ICU) of the National Burn Hospital Le Huu Trac

2025-10-06T15:16:45+00:00

Objective: This study aimed to describe the antimicrobial resistance patterns of bacteria and fungi isolated from clinical specimens of severe burn patients treated at the Intensive Care Unit (ICU) of the National Burn Hospital Le Huu Trac in 2024. Subjects and methods: A cross-sectional descriptive study was conducted from January to December 2024. All microbial isolates from blood, sputum, urine, and pus samples of severe burn patients admitted to the ICU were included. Microorganisms were identified and tested for antimicrobial susceptibility using the Vitek 2 Compact system, and results were interpreted according to CLSI M100 (2023) guidelines. Data were analyzed using STATA 17.0. Results: A total of 131 microbial isolates were identified, comprising Gram-negative bacteria (68.7%), Gram-positive bacteria (17.6%), and fungi (13.7%). • Acinetobacter baumannii (26.7%) and Klebsiella pneumoniae (15.3%) were the most common Gram-negative organisms. A. baumannii exhibited complete resistance to meropenem and ceftazidime (100%), while K. pneumoniae showed high resistance to meropenem (92.3%) and ceftazidime (84.6%). • Pseudomonas aeruginosa (10.7%) showed 85.7% resistance to ceftazidime and 71.4% to ciprofloxacin, but remained relatively susceptible to colistin. • Staphylococcus aureus was the most common Gram-positive bacterium, with a methicillin-resistant rate (MRSA) of 73.91%; most isolates remained susceptible to vancomycin and linezolid. • Candida tropicalis accounted for 12.2% of isolates and exhibited a fluconazole resistance rate of 51.9%. Conclusion: The study reveals alarmingly high levels of antimicrobial resistance among bacterial and fungal pathogens isolated from severe burn patients, particularly Gram-negative organisms and MRSA. These findings highlight the urgent need for regular antimicrobial surveillance, rational antibiotic use, and strict infection control measures in burn ICUs.

Association between nutritional status, burn injury deverity, and length of hospital stay in burn patients

2025-10-28T11:23:25+00:00

Objective: This study aimed to determine the association between nutritional status, burn injury extent, and length of hospital stay (LOS) in burn patients treated at the National Burn Hospital, and to identify independent prognostic factors influencing LOS. Methods: A prospective cross-sectional study was conducted on 57 burn patients admitted during the 2021 Nutrition Day week periods. Demographic information, burn characteristics, and nutritional status were collected. Nutritional screening tools included the Malnutrition Screening Tool (MST) and the Nutritional Risk Screening 2002 (NRS-2002). Data were analyzed using SPSS version 26.0 with descriptive statistics, Pearson correlation, and multivariate linear regression. Results: The mean age of patients was 40.35 ± 17.74 years; males accounted for 73.7%. The most common causes of burns were electricity and dry heat (each 40.4%). The mean total burn surface area (TBSA) was 15.26 ± 14.50% of body surface, with deep burns area averaging 11.25%. According to MST, 38.6% of patients were at risk of malnutrition, while 78.9% were at nutritional risk by NRS-2002. The mean LOS was 35.67 ± 20.50 days. LOS was significantly correlated with TBSA (r = 0.575; p < 0.001), deep burns (r = 0.543; p < 0.001), MST (r = 0.541; p < 0.001), and NRS-2002 (r = 0.318; p = 0.016). Multivariate regression showed TBSA (B = 0.668; p < 0.001) and MST (B = 7.158; p < 0.001) as independent predictors of LOS. Conclusion: Total burn surface area and nutritional risk assessed by MST are key prognostic factors for hospital stay duration in burn patients. Routine nutritional screening at admission, combined with accurate assessment of burn extent, plays a crucial role in prognosis and in optimizing treatment strategies.

Evaluation of the topical therapeutic effect of Berberine nanogel on experimental

2025-11-17T02:45:14+00:00

Objective: To evaluate the topical therapeutic effect of nano Berberine gel on an experimental burn model. Materials and methods: 45 rabbits (90 III-degree burn zones: Superficial burn) were randomized into 3 groups: (1) 0.9% NaCl; (2) 1% silver sulfadiazine (SSD); (3) Berberine nanogel. Burns were followed for 28 days. Outcomes included systemic course, wound morphology, wound area and re-epithelialization rate, time to complete healing, and bacterial culture positivity and load. Results: The Berberine nanogel accelerated wound area reduction compared with both controls, with a significant between-group difference emerging at week 3 (T3: 1.41 ± 1.66 cm² vs 2.98 ± 1.06 cm² with SSD; p < 0.001). Mean time to healing was markedly shorter with the nanogel (22.40 ± 3.56 days) than with SSD (27.23 ± 3.70 days) and NaCl (27.63 ± 3.92 days) (p < 0.001). On day 14, the positive culture rate was lower in the nanogel group (26.67%) than in the SSD (86.67%) and NaCl (60.0%) groups (p < 0.05). Conclusion: In this experimental burn model, the berberine nanogel demonstrated clear topical benefits-shortening healing time, enhancing re-epithelialization, and reducing bacterial contamination-compared with SSD and NaCl, with significant differences evident from third week.

Evaluation of the topical therapeutic effect of 5% Mafenide acetate solution on deep burn wounds

2025-08-04T10:12:35+00:00

Objective: To evaluate the efficacy and safety of a 5% mafenide acetate solution in the topical treatment of deep burn wounds, compared with 1% silver sulfadiazine (SSD). The study aimed to compare local wound healing and infection control between these two standard burn treatments. Subjects and methods: We conducted a prospective, controlled, before-and-after intervention trial on 40 patients with deep burns admitted to the Adult Burn Department of Le Huu Trac National Burn Hospital between June 2024 and June 2025. Patients were allocated into two groups of 20 each: The study group received a topical 5% mafenide acetate solution, while the control group received 1% silver Sulfadiazine. After five days of topical treatment, all patients underwent complete excision of full-thickness necrotic tissue and autologous meshed split-thickness skin grafting (expansion ratio 1:1.5). Postoperatively, the study group continued with 5% Mafenide acetate for an additional five days; thereafter, both groups had their dressings changed daily with 0.1% Berberine solution until graft take. Outcome measures included local wound clinical course (inflammation and exudation), graft take rate, time to complete wound epithelialization, and microbiological results (culture positivity rate and bacterial colony counts). Results: The two groups were comparable in age, sex distribution, burn size, and burn etiology. The group treated with 5% mafenide acetate showed a significantly faster reduction in local inflammation and wound exudate compared to the 1% SSD group. Mean bacterial colony counts decreased significantly in the Mafenide group (from 162.6 ± 62.61 to 111.0 ± 35.0 CFU) compared to the SSD group (from 159.89 ± 62.41 to 154.89 ± 58.97 CFU). The most commonly isolated organisms were Staphylococcus aureus (40.04%) and Pseudomonas aeruginosa (33.33%), with the SSD group tending to have a higher proportion of P. aeruginosa isolates. Graft take rates were similar between groups (70% in the Mafenide group vs. 65% in the SSD group on postoperative day 5), and the time to complete wound epithelialization did not differ significantly. Conclusion: A 5% mafenide acetate solution is an effective option for local management of deep burn wounds. It provides improved infection control compared to 1% silver sulfadiazine and is safe for use in conjunction with autologous meshed skin grafts, without delaying wound epithelialization.

A survey on patients’ knowledge regarding the role of rehabilitation in burn treatment at Le Huu Trac National Burn Hospital

2025-10-20T15:24:30+00:00

Objective: To evaluate the effectiveness of rehabilitation counseling on burn patients’ knowledge regarding functional rehabilitation after burns. Subjects and methods: A quasi-experimental study with intervention was conducted on 154 inpatients treated at the National Burn Hospital Le Huu Trac from April 2024 to June 2025. The intervention materials were adapted from the internationally peer-reviewed study by Gete BC, Mitiku TD, Wudineh BA, and Endeshaw AS (2022), Knowledge, Attitude and Practice towards Burn First Aid and its Associated Factors among Caregivers attending burn units in Addis Ababa, Ethiopia, Annals of Medicine and Surgery, 81, 104402. Data were analyzed using SPSS 26.0. Results: After the intervention, patients’ knowledge regarding burn rehabilitation significantly improved. The mean knowledge score increased from 3.9 ± 1.4 before intervention to 7.6 ± 1.2 after intervention (p < 0.001). Before counseling, the correct response rate ranged from 33.3% to 46.7%, indicating limited understanding among most participants. Following the intervention, the rate of correct answers increased markedly to 70.3% - 82.2%, demonstrating the clear effectiveness of the health education program. Conclusion: Before counseling, burn patients’ knowledge about rehabilitation was limited; however, significant improvement was observed after the educational intervention.

Evaluation of surgical outcomes of impacted mandibular third molar extraction combined with low-level diode laser therapy

2025-10-20T08:56:44+00:00

Objective: Evaluation of overall results after surgical removal of impacted lower wisdom teeth combined with low-level laser therapy (LLLT). Materials and Methods: This is a controlled, descriptive clinical intervention study conducted on 90 patients, divided equally into two groups: 45 patients received postoperative LLLT (laser group) and 45 patients were not treated with laser (control group). Data collected included surgical technique, intensity and duration of pain, intraoperative and postoperative complications, and overall surgical outcomes assessed at one week postoperatively. Results: The mean pain intensity in the laser group was significantly lower (p < 0.001) than in the control group at all evaluated time points (2 hours, 4 hours, 6 hours, Day 1, Day 2, and Day 7). Complete pain resolution was observed in the laser group by Day 2. Pain classification analysis also demonstrated a marked improvement in the laser group (p < 0.001), with 66.7% of patients reporting no pain on Day 1, compared to 0% in the control group. At one week postoperatively, 100% of patients in the laser group achieved good surgical outcomes, significantly higher than the control group (68.9% good outcomes, p < 0.001). Conclusion: The use of LLLT following surgical extraction of impacted mandibular third molars significantly enhances postoperative pain control and improves overall surgical outcomes.

Efficacy of non-cultured autologous cell suspension in the treatment of donor sites for split-thickness skin grafting

2025-10-07T14:23:07+00:00

Objectives: To evaluate the efficacy of non-cultured autologous skin cell suspension in accelerating re-epithelialization and improving scar quality at split-thickness skin graft donor sites. Subjects and methods: A prospective, randomized, intra-patient controlled clinical trial was conducted on 30 burn patients aged 18-60. On the thigh donor site, half of the area was randomly treated with non-cultured autologous skin cell suspension (Area A), while the other half received Vaseline gauze dressing (Area B). The primary endpoint was the time to re-epithelialization. Secondary endpoints included pain levels, scar quality at 6 months (VSS, POSAS scales), and complication rates. Results: The mean time to re-epithelialization was significantly shorter in Area A (10,8 ± 1,4 days) compared to Area B (14,1 ± 2,7 days) (p < 0,001). Pain levels were significantly lower in Area A during the first two weeks. - After 3 and 6 months, the rate of normal pigmented skin in the grafted area in the Recell group was significantly higher than in the control group (66.7% vs 26.7% at 3 months; 83.3% vs 40% at 6 months; p < 0.001). The infection rate was lower in Area A (3.3%) than in Area B (16.7%); however, the difference was not statistically significant (p=0.098). Conclusion: The application of non-cultured autologous skin cell suspension significantly shortens healing time, reduces postoperative pain, and improves scar quality at 6 months. It is a safe and effective method for treating split-thickness skin graft donor sites in burn patients.

Amputation and relation factors in diabetic foot ulcer patients treated at Nghe An General Friendship Hospital

2025-10-07T17:07:00+00:00

Aims: To determine the risk factors for limb amputation in patients with diabetic foot ulcers at Nghe An Friendship General Hospital. Patients and methods: This retrospective study enrolled 115 adult patients with diabetic foot ulcers admitted to Nghe An Friendship General Hospital between January 1, 2024, and June 30, 2025. A purulent discharge specimen was collected from the ulcer before wound cleansing for bacterial culture. The primary outcome was the limb amputation rate. Cox regression analysis was utilized to estimate hazard ratios, and the time from study initiation to healing was evaluated as a censored time-to-event outcome using the Kaplan-Meier curve. Results: A total of 115 patients with diabetic foot ulcers treated at Nghe An Friendship General Hospital were included, comprising 64 males (55.65%), with a mean age of 44.4 ± 14.7 years. In total, 34 (29.57%) diabetic foot ulcer patients were overweight, and 16 (13.91%) were obese, with a mean body mass index (BMI) of 24.94 ± 3.69 kg/m². A total of 56 (48.69%) diabetic foot ulcer patients presented with diabetic complications. Among the diabetic foot ulcer patients, 35 (30.43%) underwent lower-extremity amputation (LEA). In total, 18 (46.15%) patients treated with inappropriate antibiotics achieved healing, while 21 (53.85%) patients did not heal (p = 0.017). Additionally, a higher Wagner grade was associated with poorer healing outcomes. A total of 19 (21.84%) patients with a Wagner grade of < 4 and 16 (57.14%) patients with a grade of ≥ 4 did not achieve healing (p = 0.005). Conclusion: The rate of limb amputation among patients with diabetic foot ulcers was higher in those who received inappropriate antibiotic therapy and in those with severe-grade ulcers.

Evaluation of the biodegradation and in vitro biocompatibility of Glutaraldehyde-crosslinked decellularized human umbilical artery scaffolds

2025-10-27T15:53:35+00:00

Objectives: This study aimed to evaluate the biomechanical durability and cytocompatibility of decellularized umbilical artery (DUA) scaffolds treated with 0.1% glutaraldehyde (GA). Methods: The 0.1% GA-treated decellularized umbilical artery scaffolds (G - DUA) were incubated in PBS (pH 7.4) at 37°C for 2, 4, and 8 weeks. Changes in tensile strength and remaining mass were compared with the untreated group (DUA). Biocompatibility was assessed using an indirect cytotoxicity test (MTT assay), a cell migration test (scratch wound healing assay), and by evaluating the direct adhesion of fibroblasts onto the G - DUA scaffold surface via H&E staining. Results: Glutaraldehyde treatment demonstrated a pronounced effect on enhancing the durability of the scaffold. Regarding mass change, at week 4, the DUA group lost approximately 25% of its mass (75.2 ± 2.41% remaining), whereas the G - DUA group showed almost no change (101.94 ± 0.77%). This degradation continued to week 8, where the remaining mass of the DUA group was only 55.38 ± 2.18%, in contrast to 99.46 ± 1.361% for the G-DUA group (p < 0.0001). Similarly, in terms of mechanical strength, the tensile strength of the DUA group decreased by nearly half after 4 weeks (2.886 ± 0.67 N) and continued to decline sharply by week 8 (1 ± 0.31 N). Conversely, the G-DUA group maintained significantly better durability, with tensile strengths of 5.526 ± 0.67 N at week 4 and 4.4 ± 0.58 N at week 8, respectively (p < 0.0001). Regarding biocompatibility, the results indicated that the extract from G-DUA was not cytotoxic; cell viability rates exceeded 99% at all time points, comparable to the PTFE negative control group (p > 0.05). The G - DUA scaffold also did not adversely affect migration and adhesion of fibroblasts on its surface. Conclusion: Glutaraldehyde treatment significantly enhances the mechanical strength and biodegradation resistance of decellularized human umbilical artery scaffolds without inducing in vitro cytotoxicity in fibroblasts.

Application of superficial radiation therapy combined with thin split-thickness skin grafting in treatment of extensive keloids on extremities post-burn

2025-05-12T09:52:48+00:00

Introduction: Current treatment methods for extensive post-burn keloids exhibit high recurrence rates approaching 100%, along with the formation of keloids at donor sites, posing significant physical and psychological burdens on patients. At present, globally and in Vietnam, there remains no widely accepted and effective solution to manage extensive keloids on extremities post-burn, leaving patients with high risks of functional impairment. Patients and methods: The research investigates the application of superficial radiation therapy (SRT-100) in combination with thin split-thickness skin grafting for patients with extensive keloids located on the extremities post-burn. The surgical procedures involved complete excision of keloid tissue followed by thin split-thickness skin grafting, coupled with subsequent superficial radiation to inhibit keloid recurrence, minimize surface tension, and prevent new keloid formation at donor sites or adjacent skin areas. Results: Patients presented with extensive keloids averaging dimensions of approximately 15 x 8 cm, characterized by thick, stiff, and poorly mobile scar tissue associated with limited joint motion and chronic itching. Outcomes assessed over six months post-operatively revealed significant improvement in both functional recovery and cosmetic appearance: All patients (6/6 cases) exhibited restoration of normal limb function, and the cosmetic outcomes were assessed as good, showing 75% improvement compared to pre-treatment conditions. Conclusion: The combined method of superficial radiation therapy and thin split-thickness skin grafting represents a viable and effective approach for overcoming current therapeutic challenges associated with extensive keloids on extremities.

Evaluating the effectiveness of analgesia after cesarean section by using ultrasound-guided quadratus lumborum block procedure at Viet Tiep Friendship Hospital

2025-08-04T13:45:58+00:00

Background: Pain relief after cesarean section by using ultrasound-guided quadratus lumborum block procedure is a new technique, effective pain and safe for post-cesarean women. Purpose: To evaluate the effectiveness of analgesia after cesarean section using a single dose of ultrasound-guided quadratus lumborum block. Research on the side effects of ultrasound-guided quadratus lumborum block. Methods: Research on progress, clinical trial, randomized distribution of over 30 patients aged 20 years old, ASA I, II, undergoing cesarean section, are under spinal block at Việt Tiệp Hospital. They received QLB with 1 mg/kg - Levobupivacain 0.25% for a side when the VAS score (pain upon activity) > 3, Diclofenac 100 mg rectally after QLB, Paracetamol 1 g I.V every 6 hours. Results: 1. In terms of analgesia: The average onset time was 12.45 ± 2.44 minutes. The average duration of analgesic effect was 20.85 ± 1.23 hours. The VAS score postoperatively: The VAS score (pain at rest) < 2, the VAS score (pain upon activity) < 4. The rate of very satisfied was 70% and of satisfied was 30%. 2. About side effects: No serious adverse event was reported. The rate of nausea and vomiting was 3.33%, cold and shivering was 6.67%. Conclusions: Anesthesia of the lumbar squamous muscle to relieve pain after cesarean section is effective and safe for post-cesarean women.

Epidemiological characteristics of burn injuries of students at Nguyen Binh Khiem Secondary School, Dau Tieng District

2024-10-26T08:23:06+00:00

Objective: To describe the epidemiological characteristics of burn injuries among students at Nguyen Binh Khiem Lower Secondary School, Dau Tieng District. Subjects and methods: A cross-sectional descriptive study with analytical elements was conducted using self-administered questionnaires completed by 352 students who voluntarily participated in the study. Results: A total of 33% of students had experienced burn injuries, with a higher proportion among females (34.9%) than males (31.1%). Among these cases, 40.5% had suffered burns two times or more; 81% of burns occurred on the way to or from school, and 15.5% occurred within the school premises. Regarding anatomical location, 46.6% were limb injuries, and 25% affected the head, face, and neck region. Self-treatment was reported in 81% of cases. Students aged 14 years or older had a 2.34 times higher risk of burn injuries than younger students, with statistical significance (95% CI: 1.22-4.50; p = 0.01). Conclusion: The prevalence of burn injuries among students at Nguyen Binh Khiem Lower Secondary School was 33%, considerably higher than in many other localities. Notable differences warranting further research include the higher prevalence among females compared to males and the predominance of burns occurring on the way to school.

Evaluation of the quality of non-cultured autologous skin cell suspension after cryopreservation

2025-10-07T16:04:57+00:00

Autologous non-cultured skin cell therapy has gradually become a potential approach for the treatment of wounds and extensive deep burns [1, 2]. The use of non-cultured skin cell suspensions has been proven to positively influence the wound healing process. Standardizing the cryopreservation procedure for these suspensions holds significant scientific and clinical value. Objective: To evaluate cell quality after 4 weeks of cryopreservation at different DMSO concentrations using blue Trypan staining and cell culture methods. Materials and methods: Ten thin split-thickness skin samples (0.25 mm) were collected from donor sites during autologous skin graft surgery. The isolated cell suspensions were cryopreserved at -800C using different DMSO concentrations (9%, 10%, 11%). After thawing, cell viability was assessed using blue Trypan staining, and cultured to evaluate their ability of the cells to attach and proliferate. Results: The mean post-isolation cell viability was above 80%, with the highest reaching 92.1%. A DMSO concentration of 10% (C2) was identified as optimal for cryopreservation. After 4 weeks of storage, cell viability slightly decreased, but the cells remained viable, adherent, and capable of proliferation in culture. Conclusion: The study demonstrated that non-cultured autologous skin cell suspensions maintained high viability after 4 weeks of cryopreservation. Cells thawed and cultured in defined media remained viable after 6 days, with 10% DMSO identified as the optimal cryoprotectant concentration.

Clinical and subclinical characteristics of patients with acute kidney injury following cardiac surgery in the Intensive Care Unit at Military Hospital 175

2025-10-06T15:43:06+00:00

Objective: To describe the clinical and paraclinical characteristics and the impact of acute kidney injury (AKI) following cardiac surgery in the Intensive Care Unit of Military Hospital 175. Subjects and Methods: A cross-sectional, longitudinal, controlled comparative study was conducted on 52 patients diagnosed with AKI and 50 patients without AKI after cardiac surgery from January 2023 to December 2024. Results: The AKI group had a significantly higher prevalence of NYHA class III - IV heart failure (32.7% vs. 16%, p = 0.04), lower SpO₂ (92% vs. 96%, p < 0.001), higher heart rate (85 vs. 78 bpm, p = 0.03), higher incidence of oliguria (23.1% vs. 0%, p < 0.001), pre-existing chronic kidney disease (15.4% vs. 4%, p = 0.04), and pulmonary hypertension (63.5% vs. 36%, p < 0.01). Postoperatively, the AKI group exhibited significant renal impairment (peak creatinine: 210.6 vs. 90.2 µmol/L; lowest eGFR: 32.4 vs. 85.1 mL/min/1.73m²; both p < 0.001), along with elevated lactate and CRP levels, electrolyte imbalances, and metabolic acidosis. Most patients were classified as KDIGO stage I (73.1%), with 7.7% requiring renal replacement therapy. Independent risk factors for AKI included oliguria (OR = 6.8; p < 0.001), preoperative chronic kidney disease (OR = 4.1; p = 0.036), elevated serum lactate (OR = 1.9; p < 0.001), NYHA class III–IV heart failure (OR =2.8; p = 0.041), pulmonary hypertension (OR = 2.95; p = 0.01), low SpO₂ (OR = 0.81; p = 0.001), tachycardia (OR = 1.05; p = 0.042), and lower systolic blood pressure (OR = 0.96; p = 0.049). Conclusion: Postoperative AKI is associated with multiple preoperative clinical and hemodynamic abnormalities, particularly impaired oxygenation, cardiorenal dysfunction, and reduced tissue perfusion.

Survey on the level of stress and related factors among family members of patients at the Intensive Care and Anti-Poisoning Department, Vietnam - Cuba Friendship Hospital, Dong Hoi, 2024

2025-08-05T14:50:26+00:00

Background: Intensive Care Units (ICUs) admit and treat critically ill patients with life-threatening conditions. Having a relative hospitalized in the ICU is a stressful experience that may lead to stress. Although many studies worldwide have addressed this issue, research in Vietnam on stress among family members of ICU patients remains limited. The aim of this study was to determine the stress levels and related factors among family members of patients in the Intensive Care - Toxicology Department. Objectives and methods: The objective of this study is to determine the level of stress and the factors associated with stress among family members of patients in the ICU - Poison Control Department. This is a cross-sectional descriptive study conducted with 384 participants from May to October 2024. The data collection tool used was the DASS-21 scale and a structured questionnaire. Data were analyzed using SPSS software. Results: The results showed that 41.7% of family members experienced stress, of which 63.8% had mild stress, 25.6% moderate, 8.7% severe, and 1.9% extremely severe. Factors influencing stress levels included age, gender, occupation, educational level, relationship with the patient, ability to pay hospital fees, family economic condition, waiting room conditions, and the amount of time spent communicating with healthcare staff winh a p-value <0.05 Conclusion: Stress among family members of ICU patients is a serious issue that requires timely intervention. Many related factors are modifiable. Therefore, psychological support measures should be implemented to minimize the negative impact of stress on patients’ families.

Đánh giá ảnh hưởng của nồng độ Trypsin - Edta đến hiệu quả tách tế bào và bảo toàn cấu trúc da trong chế tạo tấm trung bì da đồng loại không tế bào

2025-10-28T10:09:25+00:00

Human acellular dermal matrix (hADM) is a biological scaffold derived from human skin in which the epidermis and cellular components of the dermis are completely removed, while preserving the collagen structure of the dermis. Objective: This study aimed to evaluate the effect of different Trypsin-EDTA concentrations on cell removal efficiency and structural preservation of the dermis, in order to determine the optimal concentration for the preparation of hADM. Subjects and methods: Thirty donated human skin samples were randomly assigned into three groups (n = 10 each) and treated with different Trypsin-EDTA concentrations: 0.5X (0,125%), 1X (0.25%) and 1.5X (0.375%). All samples underwent repeated freeze-thaw cycles, followed by a two-step enzymatic decellularization process: immersion at 40C for 24 hours, then incubation at 370C for 3 hours. Epidermal separation efficiency and cellular removal were evaluated using epidermal detachment rates and histological analysis. Results: Increasing Trypsin - EDTA concentrations showed a strong correlation with higher epidermal separation rates after enzymatic treatment at 40C for 24 hours (p < 0.05), with mean 15.24 ± 8.94%, 36.84 ± 7.44%, and 45.99 ± 7.10% for the 0.5X, 1X and 1.5X groups, respectively. After the second enzymatic treatment at 370C for 3 hours, the separation rates continued to rise, reaching 28.25 ± 10.33%, 93.98 ± 13.08%, and 95.47 ± 11.99%, respectively. However, the difference between the 1X and 1.5X groups was not statistically significant (p > 0.05). Histological evaluation confirmed complete cell removal in all groups. However, the 1.5X group exhibited more pronounced disruption of collagen structure, with lower fiber density and looser organization. Conclusion: Trypsin - EDTA proved to be an effective agent for both epidermal separation and dermal decellularization in hADM preparation. A concentration of 0.25% (1X) was identified as optimal, providing high cell removal efficiency while better preserving collagen structure.

Describe the clinical, paraclinical characteristics and analyze factors related to periodontitis in patients with type 2 diabetes mellitus (T2DM)

2025-10-07T15:44:26+00:00

Objective: To describe the clinical, paraclinical characteristics and analyze factors related to periodontitis in patients with type 2 diabetes mellitus (T2DM). Subjects and methods: A cross-sectional descriptive study was conducted on 50 T2DM patients at Military Hospital 103. Periodontal indices (GI, OHI-S, PD, CAL, tooth mobility) and glycemic control (HbA1c) were assessed. Results: The mean age was 64.94 ± 8.41 years. 92% of patients were diagnosed with periodontitis (68% severe, 24% moderate), while 8% had gingivitis. The mean HbA1c was 7.75 ± 0.62%, with 98% of patients exhibiting poor glycemic control. Periodontal indices were high: GI (1.54 ± 0.53), OHI-S (2.89 ± 0.97), PD (5.84 ± 0.81 mm), and CAL (2.97 ± 1.38 mm). Periodontitis severity was significantly associated with high HbA1c levels (≥7.5%), longer disease duration (≥5 years), and older age (≥60). Patients with HbA1c ≥ 7.5% had a 4.36-fold increased risk of severe periodontitis (p<0.05). Conclusion: Patients with T2DM exhibit a high prevalence and severity of periodontitis. Poor glycemic control, longer disease duration, and older age are significant associated factors.

Evaluation of antibiotic use in the treatment of chronic wounds in patients with spinal cord injury at the Wound Healing Center, Le Huu Trac National Burn Hospital

2025-06-05T10:47:57+00:00

Objective: To evaluate the actual situation and appropriateness of antibiotic use at Wound Healing Center, International Hospital of Burn Subjects and methods: A retrospective study of 173 patients (over 16 years old) with chronic wounds treated at Wound Healing Center from January 1st, 2019, to December 31st, 2019. Result: Four classes of antibiotics were prescribed: β-lactams, quinolones, aminoglycosidé, and macrolides. The highest number of prescriptions was for ampicillin/ sulbactam (139), followed by moxifloxacin (131) and cefepim (81). The rate of monotherapy (61,89%) was higher than combination therapy. A total of 187 prescribing errors were identified, mainly related to dosage regimens. Conclusion: It is necessary to develop guidelines for the initial selection of antibiotics in the treatment of chronic wound infections, based on epidemiological characteristics, and to provide specific recommendations for the use of each antibiotic in different patient populations.

Sepsis-associated acute kidney injury

2025-10-10T15:47:09+00:00

Sepsis-associated acute kidney injury (SA-AKI) is common among critically ill patients and represents a major contributor to both disease severity and mortality. The pathophysiology is multifactorial, involving systemic and microcirculatory hemodynamic disturbances, mitochondrial dysfunction, and cellular metabolic reprogramming. Recovery following AKI depends on the balance between adaptive repair mechanisms (endothelial repair, tubular epithelial regeneration) and maladaptive repair, which predisposes patients to chronic kidney disease progression. Current therapeutic strategies focus on early recognition and timely management of sepsis, including appropriate antimicrobial therapy, fluid resuscitation, and vasopressor support when indicated. In addition, organ support plays a pivotal role, particularly renal replacement therapy (RRT) in severe AKI, although the optimal timing and dosing of RRT remain controversial.

The antimicrobial resistance crisis: Key challenges and strategic approaches for mitigation

2025-06-05T10:55:18+00:00

Antimicrobial resistance (AMR) has emerged as one of the most pressing challenges of modern medicine, particularly in countries with a high burden of infectious diseases like Vietnam. The rapid increase of multidrug-resistant and pan-resistant pathogens has made the treatment of common infections more difficult or even impossible. This review summarizes the historical context, resistance mechanisms, and key ESKAPE pathogens, with a focus on the current AMR situation in Vietnam. Practical directions are proposed from the perspective of clinical pharmacy and antimicrobial stewardship to tackle this global and national crisis.

Successful treatment of a case of pyoderma gangrenosum (PG)

2025-10-10T16:05:35+00:00

Pyoderma gangrenosum (PG) is a rare, ulcerative neutrophilic dermatosis often associated with autoimmune and neoplastic diseases. Its clinical presentation is a rapidly progressive, painful skin ulcer with ill-defined borders and surrounding erythema. The exact pathogenesis of PG remains unclear but is thought to involve immune dysregulation and neutrophil dysfunction. PG frequently occurs in patients with systemic disorders, particularly inflammatory bowel disease (IBD) and arthritis. Although several diagnostic tools and validated criteria have been proposed, no universally accepted standard currently exists. There are also no standardized treatment guidelines for PG. Therapeutic strategies depend on disease severity and progression, with systemic corticosteroids, immunosuppressive agents, and biologic therapies serving as the mainstays of treatment. Appropriate wound care and management of underlying conditions are essential to optimize outcomes.

Ứng dụng phẫu thuật nội soi đa khoang trong xử trí biến chứng sau tiêm chất làm đầy nâng ngực

2025-10-06T16:42:34+00:00

Objective: To report our experience with endoscopic multilevel surgery for managing complications after breast augmentation with injectable fillers, highlighting its advantages of minimal invasiveness, precision, improved aesthetics, and reduced recurrence. Patients and Methods: A retrospective case series of patients who developed complications after breast filler injection and were treated with endoscopic surgery through different approaches (periareolar, inframammary, and transaxillary), following a “multilevel endoscopic” strategy. The distribution of filler was mapped preoperatively using clinical examination, ultrasound, and magnetic resonance imaging (MRI). Outcomes were assessed in both the short and long term, with a minimum follow-up of 6 to 24 months. Results: Four female patients, aged 18–33 years, had previously undergone unlicensed breast filler injections with various products (polyacrylamide hydrogel [PAAG], copolyamide/Aquafilling, unidentified filler, and hyaluronic acid [HA]). Endoscopic surgery provided magnified visualization, enabling near-complete removal of filler material while minimizing tissue trauma. Postoperatively, all patients experienced rapid recovery, significant pain relief, small and concealed scars, and good cosmetic outcomes. No recurrence was observed during follow-up (6–18 months). The patient injected with HA was successfully managed with ultrasound-guided hyaluronidase injection without the need for surgery. Conclusion: Multilevel endoscopic surgery is a safe, effective, and aesthetic approach for treating complications of breast filler injections. Preoperative imaging (US/MRI) combined with an individualized choice of surgical access is crucial for optimal outcomes. Based on current literature review, this may represent the first clinical report describing the application of multilevel endoscopy in managing breast filler–related complications.

Preliminary application of dynamic infrared thermography in reduction mammoplasty for macromastia

2025-11-19T02:11:44+00:00

Objective: To evaluate the effectiveness of Dynamic Infrared Thermography (DIRT) in identifying arterial branches supplying the nipple-areola complex (NAC) prior to reduction mammoplasty, and to investigate its role in assessing NAC perfusion intraoperatively and postoperatively. Methods: A prospective cross-sectional descriptive study was conducted on 20 female patients with severe or gigantomastia undergoing breast reduction surgery. Preoperative assessments included DIRT, color Doppler ultrasound, and contrast-enhanced computed tomography (CT) angiography. DIRT was also performed intraoperatively and postoperatively. Results: An average of 2.25 arterial branches per breast were identified using DIRT, consistent with Doppler and higher than CT angiography (1.80). The highest anatomical concordance between DIRT and Doppler reached 78.26%. The detected arterial branches had diameters ≥ 0.8 mm and depths ≤ 64.40 mm. Simple linear regression analysis of Level 1 concordant branches between DIRT and Doppler demonstrated a statistically significant positive correlation between blood flow velocity and thermal recovery rate. One case of partial NAC hypoperfusion was recorded; no complete NAC necrosis was observed. Conclusion: DIRT is a safe, non-invasive technique with promising potential for evaluating NAC perfusion before, during, and after reduction mammoplasty. Further studies with larger sample sizes are needed to determine its clinical accuracy and detection thresholds.

Hiệu quả của gel Prontosan trong điều trị bỏng Trẻ em: Phân tích loạt bệnh

2025-10-28T08:41:05+00:00

Pediatric burns are a serious medical concern, particularly in developing countries where mortality and complication rates remain high. This study analyzes five clinical cases treated with Prontosan Wound Gel X to evaluate its effectiveness in infection control, tissue regeneration, and aesthetic outcomes. The results indicate that Prontosan promotes faster wound healing and reduces scarring compared to Povidone-Iodine 10%, while also lowering the risk of infection, even in severe burn cases requiring skin grafting. The combination of Prontosan with Anson, Therasob, and BluMembrane dressings helps maintain moisture, alleviate pain, and prevent dehydration, thus shortening the treatment duration. Additionally, Prontosan demonstrated high safety, with no severe complications recorded during the study. Although the study has limitations in terms of sample size and retrospective nature, the findings suggest that Prontosan is an effective, safe, and promising treatment option for pediatric burns, with potential for broader clinical application.

Điều trị thành công bệnh nhân cao tuổi bỏng sâu diện rộng: Báo cáo ca lâm sàng

2025-05-09T08:00:12+00:00

A 73-year-old female patient suffered from 23% TBSA (21% full-thickness) due to flame burns. She underwent intensive treatment, including surgical debridement, autologous skin grafting, and antibiotic therapy adjusted according to clinical progression. Despite advanced age and complex wound infections (Pseudomonas aeruginosa and Candida tropicalis detected in urine), the patient recovered after 64 days through multidisciplinary collaboration, rigorous infection control, and optimized nutrition. Key lessons emphasize the critical role of appropriate timing and methods for surgical intervention, judicious antibiotic use, and holistic care underpinned by effective teamwork.

Clinical and subclinical characteristics of breast cancer with I - II stages

2025-10-28T09:13:55+00:00

Objectives: To describe some clinical and subclinical characteristics of patients with stage I-II breast cancer. Subjects and methods: A prospective, cross-sectional descriptive study without a control group was conducted on 103 patients with stage I–II breast cancer who were diagnosed and treated at Military Hospital 175 from February 2018 to June 2022. Results: The youngest patient age was 21 years old, the oldest age was 76 years old, the median age was 44 years old. The most common age group was from 40 - 59 years old, accounting for 65%. The position of the upper and outer quadrant was the most common, accounting for 56.3%. There were 63 patients with left breast cancer, accounting for 61.2%. The most common Invasive ductal breast cancer accounted for 74.8%. The highest proportion of patients was in the Luminal A group with 39.8%, followed by the Luminal B/HER2 group negative with 32%, the basal group with 16.5%, the HER2 (+) group with 8, 7% and the lowest group was Luminal B/HER2 (+) with 2.9%. The majority of patients in the study were in stage I at 51.4%, followed by stage IIA with 37.9%. Conclusion: The most common age for breast cancer was 40-59 years old, usually in the upper-outer quarter position. Invasive ductal breast cancer was the most common. The highest percentage of patients was in the Luminal A group.

Research on clinical and radiographic characteristics of class II

2025-10-20T16:03:48+00:00

bjectives: To describe some clinical characteristics and study some craniofacial indices on Cephalometric radiographs and plaster models of Class II malocclusion patients. Materials and Methods: A descriptive cross-sectional study was conducted on 69 patients with skeletal Class II at Dental department, 103 Military Hospital. Results: 78.26% females and 21.74% males, and an average age of 24.5 (range 14-53). Extraoral clinical features showed 100% of patients had a convex facial profile, 78.3% had lip incompetence at rest, and 46.7% had bad habits. A tendency towards vertical growth pattern (decreased lower facial height in 43.2% of patients) was observed. The oval arch form was the most prevalent (70.3%). The mean pre-treatment PAR index was 34.45±10.95, with 69.6% classified as severe malocclusion (PAR>30). Skeletal characteristics included a mean ANB of 6.61±1.71°, SNA of 83.91±9.89°, and SNB of 78.37±3.62°. The mean GoGn-SN angle was 34.86±5.78°. Dental measurements indicated maxillary incisor proclination with U1-SN at 112.77±8.88°, and an interincisal angle (U1-L1) of 111.54±9.17°. Soft tissue analysis showed a nasolabial angle of 90.41±13.49°, and both upper and lower lips were protruded relative to the E-line (Ls-E 2.11±1.86mm, Li-E 4.18±2.15mm). Conclusion: Patients with Class II malocclusion at the Dental Department, 103 Military Hospital exhibited complex clinical and radiographic characteristics, including a high rate of severe malocclusion, convex facial profiles, bimaxillary incisor proclination, and significant anteroposterior and vertical skeletal discrepancies.