A Focused Look On The State Of Burn Injury: Case Study of a Tertiary Institution in Nigeria.

摘要

CONTEXT AND AIM: Burn injury is common. Measures that reduce morbidity and mortality have been the gold standard of treatment. There is a need for a regular review to assess the impact of such measures and their availability.METHODS: We retrospectively analyzed 138 consecutive patients that presented to the burn unit of our hospital with acute burns over a five-year period.RESULTS: Ninety-two patients (66.7%) were males and 46 (33.3%) females with an age range of 2 months to 86 years. Flame was the most common cause of the injury. Fifty-five percent of the burn injuries occurred indoor. Late presentation was a usual occurrence. Artisans, students and traders constitute the majority of patients. The mortality rate was 45.8%. CONCLUSION: Burn remained a serious issue with high mortality in our environment. There is need for critical appraisal of the preventive measures and management principles currently being practised. Introduction Burn injury is common. It is the most devastating injury anyone can sustain and still remain alive. No group of the society is exempt from the onslaught. Mortality from burn injury has remained critically high in our environment.1,2 This is quite different from what obtains in the developed world where mortality in burns has reduced significantly to a unit value.3,4,5 This improvement has been largely attributed to the introduction of early excision and skin grafting, in addition to the earlier reduction resulting from management of patients within burns units. In most parts of our country, burn units are not available; treatments are offered mainly by non burn specialists who do not have assess to the facilities for early excision and skin grafting. Prevention therefore is the most important step in controlling the menace of burn in our environment. That the knowledge of the epidemiology and outcome of the burns in various communities is necessary in instituting appropriate preventive measure and planning management has been well alluded to.1 Studies of the pattern of burn have been performed in various parts of the country6,7,8,9,10. These studies should have positive impact on the prevention and outcome of burns in our environment. To what extent this has been so needs to be reviewed continually. We hereby present the state of burn care in a tertiary institution located in Lagos Nigeria, reflecting on what has been gained and lessons that could be learnt. Method And Patients A retrospective analysis was conducted based on the case reports of 138 consecutive patients that presented to the burn unit with acute burns over a period of five years (1st January 2001 to 30th December 2005). The case files were retrieved from the record department. Where case files were not available or the data insufficient, the admission and discharge records kept by the nurses on the ward were examined. The sex, age, occupation, cause and place of burn were extracted. The injury-arrival time, month and year of burn, percentage of burnt surface area (BSA) and depth, length of hospital stay, and disposition were also determined for each patient. Though the hospital now has a standard burn unit, there was no one during the years under review. Adult patients reviewed in the emergency were admitted into two 4-bed lobbies in the plastic surgery wards while children were admitted to the children ward. The percentages of burnt surface were calculated using the Wallace rule of nines. The data were entered into a database created with the Microsoft Access Software. Descriptive analyses of the data were invoked and the results presented in tables and charts. Results Records of 138 patients who had acute burns were retrieved. Ninety-two patients (66.7%) were males and 46 (33.3%) females giving a male to female ratio of 2:1. The age ranged from 2 months to 86 years, with a mean age of 27.8 years (SD = 14.9 years). The female population tended to be younger than their male counterpart (mean (SD) ages for males and females: 29.8 (15.