Mushin Oren P, Bogue Jarrod T, Pencek Megan E, Bell Derek E
From the Department of Plastic Surgery, University of Rochester Medical Center, New York.
J Burn Care Res. 2017 Sep/Oct;38(5):e814-e817. doi: 10.1097/BCR.0000000000000492.
Ring-associated burns are infrequent, comprising only a small fraction of burn consults and admissions. However, because of the location of these burns and the propensity for circumferential wounds, small burn size may belie the severity of resultant injuries. Herein, the authors present their experience with this potentially severe type of burn. Records from a regional burn center were retrospectively analyzed during a 36-month period. All patients who sustained ring burns were included. Data points included demographics, burn location, need for surgical intervention, grafted area, hospital days (length of stay), percent graft take, complications, and time to re-epithelialization. Nine patients sustained ring-associated burns during the study period, accounting for 1.4% of all patients with burns seen during the same period. Average age was 41 years (range: 29-52 years). Seven (77%) ring-associated burns involved contact with a battery. All injuries were circumferential. Average burn TBSA was 0.07%. Two patients (22%) had third-degree injuries, both of which received split-thickness skin grafts. Grafted area was 4 and 5 cm, respectively. Average length of stay was 2.8 days. Mean graft take was 99.5 ± 1.5%. Average time to complete re-epithelialization was 12 days. One patient suffered temporary disability. No patients suffered from compartment syndrome. Ring-associated burns are an uncommon source of injury in the burn population. Despite small burn TBSA, these patients are more likely to require split-thickness skin grafts and suffer dysfunction compared with similarly-sized burns in other body regions. Expedient treatment and coordination with occupational therapy should be undertaken to achieve optimal outcomes.
环形烧伤并不常见，仅占烧伤会诊和住院病例的一小部分。然而，由于这些烧伤的部位以及环形伤口的倾向，较小的烧伤面积可能掩盖了由此导致的损伤的严重程度。在此，作者介绍了他们处理这种潜在严重类型烧伤的经验。对一个地区烧伤中心36个月期间的记录进行了回顾性分析。纳入了所有遭受环形烧伤的患者。数据点包括人口统计学信息、烧伤部位、手术干预需求、植皮面积、住院天数（住院时长）、植皮成活率、并发症以及上皮化时间。在研究期间，有9名患者遭受了环形相关烧伤，占同期所有烧伤患者的1.4%。平均年龄为41岁（范围：29 - 52岁）。7例（77%）环形相关烧伤涉及与电池接触。所有损伤均为环形。平均烧伤总面积为0.07%。两名患者（22%）为三度损伤，均接受了中厚皮片移植。植皮面积分别为4平方厘米和5平方厘米。平均住院时长为2.8天。平均植皮成活率为99.5±1.5%。完全上皮化的平均时间为12天。一名患者出现了暂时性功能障碍。没有患者发生骨筋膜室综合征。环形相关烧伤在烧伤人群中是一种不常见的损伤来源。尽管烧伤总面积较小，但与身体其他部位同等大小的烧伤相比，这些患者更有可能需要中厚皮片移植且出现功能障碍。应进行及时治疗并与职业治疗协作以实现最佳治疗效果。
