Concord Repatriation General Hospital, Burns Unit, Australia; Concord Clinical School, University of Sydney, Sydney, Australia; School of Medicine, University of Notre Dame, Sydney, Australia.
Concord Repatriation General Hospital, Burns Unit, Australia; Concord Clinical School, University of Sydney, Sydney, Australia.
Burns. 2021 May;47(3):705-713. doi: 10.1016/j.burns.2020.07.024. Epub 2020 Aug 5.
Foot burns represent a small part of the body with many challenges. The impact of diabetes on clinical outcomes adds further issues in management that clinicians must consider in their management. These factors have serious implications on morbidity and long term sequelae. Our aim is to analyse epidemiological trends of foot burns and examine the differences between diabetic and non-diabetics at Concord hospital from 2014 to 2019.
A retrospective audit from 2014-19 at Concord General Repatriation Hospital Burns Unit summarised patient demographics, burn injury, diabetic status, operations and length of stay. All foot burn injuries from 2014-19 of all ages and gender that attended Concord burns hospital were included in this study.
We treated 797 patients who presented with foot burns, of which 16.2% were diabetic. The average age was higher in diabetics (60.72 years) than non-diabetics (39.72 years) and more males suffered burns compared to females in both groups (p < 0.001). There was a larger portion of elderly patients (greater than 65 years old, 15.1% of total) who sustained foot burns in the diabetic group compared to the non-diabetic group (p < 0.001). The most affected season was summer (27.0%), but diabetic patients were 1.7 times more likely to sustain injury in winter than non-diabetics. Diabetics were 3.8 times more likely to have contact burns compared to non-diabetic patients (p < 0.001). In a multivariable linear regression analysis, factors that contributed to increased length of stay included elderly status, place of event, diabetic status, number of operations, ICU admission, wound infection, amputation, and admission [F (16, 757 = 41.149, p < 0.001, R = 0.465].
With the increase of diabetes, our multidisciplinary approach to diabetic foot care should include nursing, medical and surgical disciplines to identify patients at risk. The data highlights that a focus on prevention and education for diabetes is central to optimize glycaemic control and burn management, whilst providing a multidisciplinary network on discharge.
足部烧伤虽然仅占人体较小部分，但却极具挑战性。糖尿病对临床结果的影响给临床医生的管理带来了更多问题，这是他们在管理过程中必须考虑的因素。这些因素对发病率和长期后遗症有严重影响。我们的目的是分析足部烧伤的流行病学趋势，并检查 2014 年至 2019 年期间 Concord 医院糖尿病患者和非糖尿病患者之间的差异。
对 Concord 综合退伍军人医院烧伤科 2014-19 年的回顾性审计总结了患者的人口统计学、烧伤损伤、糖尿病状况、手术和住院时间。本研究纳入了所有年龄和性别的 2014-19 年在 Concord 烧伤医院就诊的足部烧伤患者。
我们治疗了 797 名足部烧伤患者，其中 16.2%为糖尿病患者。糖尿病患者的平均年龄（60.72 岁）高于非糖尿病患者（39.72 岁），且两组中男性烧伤比例均高于女性（p < 0.001）。老年患者（65 岁以上，占总数的 15.1%）在糖尿病组中比非糖尿病组更常见（p < 0.001）。最常见的季节是夏季（27.0%），但糖尿病患者在冬季受伤的可能性比非糖尿病患者高 1.7 倍。与非糖尿病患者相比，糖尿病患者接触烧伤的可能性高 3.8 倍（p < 0.001）。多变量线性回归分析显示，导致住院时间延长的因素包括年龄较大、事件发生地点、糖尿病状态、手术次数、入住 ICU、伤口感染、截肢和入院[F（16,757）=41.149，p < 0.001，R=0.465]。
随着糖尿病患者的增加，我们对糖尿病足护理的多学科方法应包括护理、医学和外科专业，以确定有风险的患者。这些数据表明，关注糖尿病的预防和教育对于优化血糖控制和烧伤管理至关重要，同时在出院时提供多学科网络。
