Stewart Barclay T, Trelles Miguel, Dominguez Lynette, Wong Evan, Fiozounam Hervé Tribunal, Hassani Ghulam Hiadar, Akemani Clemence, Naseer Aemer, Ntawukiruwabo Innocent Bagura, Kushner Adam L
From the *Department of Surgery, University of Washington, Seattle; †Surgery, Anaesthesia, Gynaecology, and Emergency Medicine (SAGE) Unit, Médecins sans Frontières-Operational Centre Brussels, Surgical Unit, Brussels, Belgium; ‡Centre for Global Surgery, McGill University Health Centre, Montreal, QC, Canada; §Surgeons Over Seas (SOS), New York, New York; ‖General Referral Hospital, Médecins sans Frontières, Batangafo, Central African Republic; ¶Boost General Hospital, Médecins sans Frontières, Lashkar-Gah, Afghanistan; #General Referral Hospital, Médecins sans Frontières, Lubutu, Democratic Republic of the Congo; **District Headquarters Hospital, Médecins sans Frontières, Dargai, Pakistan; ††General Referral Hospital, Médecins sans Frontières, Masisi, Democratic Republic of the Congo; and ‡‡Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
J Burn Care Res. 2016 Nov/Dec;37(6):e519-e524. doi: 10.1097/BCR.0000000000000305.
Humanitarian organizations care for burns during crisis and while supporting healthcare facilities in low-income and middle-income countries. This study aimed to define the epidemiology of burn-related procedures to aid humanitarian response. In addition, operational data collected from humanitarian organizations are useful for describing surgical need otherwise unmet by national health systems. Procedures performed in operating theatres run by Médecins Sans Frontières-Operations Centre Brussels (MSF-OCB) from July 2008 through June 2014 were reviewed. Surgical specialist missions were excluded. Burn procedures were quantified, related to demographics and reason for humanitarian response, and described. A total of 96,239 operations were performed at 27 MSF-OCB projects in 15 countries between 2008 and 2014. Of the 33,947 general surgical operations, 4,280 (11%) were for burns. This proportion steadily increased from 3% in 2008 to 24% in 2014. People receiving surgical care from conflict relief missions had nearly twice the odds of having a burn operation compared with people requiring surgery in communities affected by natural disaster (adjusted odds ratio, 1.94; 95% confidence interval, 1.46-2.58). Nearly 70% of burn procedures were planned serial visits to the theatre. A diverse skill set was required. Unmet humanitarian assistance needs increased US$400 million dollars in 2013 in the face of an increasing number of individuals affected by crisis and a growing surgical burden. Given the high volume of burn procedures performed at MSF-OCB projects and the resource intensive nature of burn management, requisite planning and reliable funding are necessary to ensure quality for burn care in humanitarian settings.
人道主义组织在危机期间以及为低收入和中等收入国家的医疗设施提供支持时，会照料烧伤患者。本研究旨在确定与烧伤相关手术的流行病学情况，以协助人道主义救援工作。此外，从人道主义组织收集的运营数据有助于描述国家卫生系统未能满足的手术需求。对2008年7月至2014年6月期间由无国界医生组织布鲁塞尔行动中心（MSF-OCB）运营的手术室中进行的手术进行了回顾。排除了外科专家任务。对烧伤手术进行了量化，分析了其与人口统计学和人道主义救援原因的关系，并进行了描述。2008年至2014年期间，在15个国家的27个MSF-OCB项目中总共进行了96,239例手术。在33,947例普通外科手术中，有4,280例（11%）是烧伤手术。这一比例从2008年的3%稳步上升至2014年的24%。与在受自然灾害影响社区中需要手术的人相比，从冲突救援任务中接受手术治疗的人进行烧伤手术的几率几乎高出一倍（调整后的优势比为1.94；95%置信区间为1.46 - 2.58）。近70%的烧伤手术是计划好的多次手术室就诊。这需要多种技能。面对受危机影响的人数不断增加以及手术负担日益加重的情况，2013年未得到满足的人道主义援助需求增加了4亿美元。鉴于MSF-OCB项目中进行的烧伤手术数量众多以及烧伤治疗资源密集的性质，必须进行必要的规划并提供可靠的资金，以确保人道主义环境下烧伤护理的质量。
