Karki Bishal, Rai Shankar Man, Nakarmi Kiran Kishore, Basnet Surendra Jung, Magar Mangal Gharti, Nagarkoti Krishna Kumar, Thapa Sunil
From the Department of Burns, Plastic, and Reconstructive Surgery, Kirtipur Hospital, Public Health Concern Trust-Nepal, Kathmandu, Nepal.
Ann Plast Surg. 2018 Mar;80(3 Suppl 2):S95-S97. doi: 10.1097/SAP.0000000000001270.
Burn injury is a global health problem mainly occurring in developing countries. The Nepal Cleft and Burn Centre at Kirtipur Hospital, Kathmandu, has been providing the acute burn care since 2013 with 7 intensive care unit beds, 30 general beds, and 2 dedicated operating rooms. A similar descriptive study was performed in this center in 2014. These studies will be helpful for developing prevention strategies and monitoring the progress in the standard of care of acute burn patients.
This is a descriptive retrospective study of the clinical data of acute burn patients admitted from January 1, 2015 to December 31, 2016.
There were a total of 567 patients who came from 63 of 75 total districts of Nepal. Two hundred ninety-six (52.2%) patients were females and 271 (47.8%) were males. Two thirds of the patients were young adults. Most of the injuries occurred inside the house (72.1%). Flame burn was the most common mode of injury (66%) followed by scald (21.6%). Only 64 (11.3%) patients arrived on the same day of the injury. The longest time elapsed was 60 days with a median of 4.3 days. Range of total body surface area (TBSA) involved was 1% to 95%. The mean and median TBSAs were 25% and 15%, respectively. Range of hospital stay was 1 to 105 days with a median of 13.3 days.A total of 448 surgical procedures were performed in 384 patients (67.7%). A total of 110 (19.4%) patients died at the hospital. Only 13 patients (3%) survived deep burn injury involving 40% or more TBSA with either cadaveric skin allograft or with skin allograft from the live relatives.
The outcome of burn injuries in Nepal is very poor. Children and females are at high risk. There is a lack of knowledge about burn prevention, proper first aid, and skin donation among the Nepalese population. Delay in presentation and extensive burns are poor prognostic factors. Awareness programs about the proper first aid and the need of a skin bank has to be done to improve the burn scenario in Nepal. Availability of allograft can increase the chances of survivability of patients with extensive burns in Nepal.
烧伤是一个全球性的健康问题，主要发生在发展中国家。加德满都基尔蒂普尔医院的尼泊尔腭裂与烧伤中心自2013年以来一直提供急性烧伤护理，拥有7张重症监护病床、30张普通病床和2间专用手术室。2014年在该中心进行了一项类似的描述性研究。这些研究将有助于制定预防策略并监测急性烧伤患者护理标准的进展情况。
这是一项对2015年1月1日至2016年12月31日收治的急性烧伤患者临床数据的描述性回顾性研究。
共有567名患者来自尼泊尔75个区中的63个区。296名（52.2%）患者为女性，271名（47.8%）为男性。三分之二的患者为年轻人。大多数损伤发生在室内（72.1%）。火焰烧伤是最常见的损伤方式（66%），其次是烫伤（21.6%）。只有64名（11.3%）患者在受伤当天就诊。最长间隔时间为60天，中位数为4.3天。全身表面积（TBSA）受累范围为1%至95%。平均和中位数TBSA分别为25%和15%。住院时间范围为1至105天，中位数为13.3天。384名患者（67.7%）共进行了448次外科手术。共有110名（19.4%）患者在医院死亡。只有13名（3%）患者在TBSA累及40%或更多的深度烧伤后，通过尸体皮肤异体移植或活体亲属的皮肤异体移植存活下来。
尼泊尔烧伤损伤的预后非常差。儿童和女性风险较高。尼泊尔人群缺乏烧伤预防、正确急救和皮肤捐赠方面的知识。就诊延迟和大面积烧伤是不良预后因素。必须开展关于正确急救和皮肤库需求的宣传项目，以改善尼泊尔的烧伤情况。异体移植的可用性可以增加尼泊尔大面积烧伤患者的存活机会。
