Batac Joseph N, Simpson Roger L, Sinnott Catherine J, Catanzaro Michael P, Glickman Laurence T
From the Nassau University Medical Center Burn Center, East Meadow, NY.
Ann Plast Surg. 2018 Apr;80(4 Suppl 4):S140-S143. doi: 10.1097/SAP.0000000000001361.
Patients with burn wounds of the lower extremities are at increased risk of developing cellulitis. The probability of developing burn-associated cellulitis is presumed to be correlated with a medical history of diabetes, the etiology of the burn, delay in hospitalization of the patient during their initial presentation, and depth of the burn itself. This study aims to identify factors that place patients at increased risk for developing lower extremity burn wound cellulitis.
A retrospective chart review was performed of all Nassau University Medical Center Burn Center admissions from January 2010 to January 2016. All patients admitted with burns of any etiology isolated to the lower extremity were included in this study. Patients who were evaluated and followed as an outpatient were not included in this study. Pediatric patients less than or equal to 12 years of age were excluded from this study.
Of the 218 admissions for lower extremity burns during the 6-year study period, 34% of patients developed cellulitis. Risk factors for developing lower extremity burn wound cellulitis included being male, greater depth of burn, and burn-to-admission delay. This was true in both univariate and multivariate analysis. total body surface area was a risk factor on univariate analysis but was not found to be an independent risk factor on multivariate analysis. No difference was observed in the development of cellulitis in patients discharged on oral antibiotics compared with those not given antibiotics.
Burn wound cellulitis is the second most common complication observed in burns. Identification of patients at risk for developing cellulitis is important. Admitting these patients at increased risk and excising and grafting the burned area is a reasonable solution in preventing this costly complication.
下肢烧伤患者发生蜂窝织炎的风险增加。烧伤相关蜂窝织炎的发生概率被认为与糖尿病病史、烧伤病因、患者初次就诊时住院延迟以及烧伤本身的深度相关。本研究旨在确定使患者发生下肢烧伤创面蜂窝织炎风险增加的因素。
对2010年1月至2016年1月期间所有入住拿骚大学医学中心烧伤中心的患者进行回顾性病历审查。本研究纳入所有因任何病因导致下肢孤立性烧伤而入院的患者。作为门诊患者接受评估和随访的患者不纳入本研究。12岁及以下的儿科患者被排除在本研究之外。
在为期6年的研究期间，218例下肢烧伤患者中，34%发生了蜂窝织炎。发生下肢烧伤创面蜂窝织炎的危险因素包括男性、烧伤深度更深以及烧伤至入院的延迟时间。单因素和多因素分析均如此。总体表面积在单因素分析中是一个危险因素，但在多因素分析中未被发现是独立危险因素。与未接受抗生素治疗的患者相比，口服抗生素出院的患者发生蜂窝织炎的情况没有差异。
烧伤创面蜂窝织炎是烧伤中观察到的第二常见并发症。识别有发生蜂窝织炎风险的患者很重要。收治这些风险增加的患者并对烧伤区域进行切除和植皮是预防这种代价高昂的并发症的合理解决方案。
