Burn Unit, Plastic Surgery, Padua University Hospital, Via Giustiniani 2, Padua, Italy.
1st Surgical Ward, Padua University Hospital, Via Giustiniani 2, Padua, Italy.
Burns. 2021 Feb;47(1):52-57. doi: 10.1016/j.burns.2020.09.004. Epub 2020 Oct 3.
The actual epidemic outbreak is the third time in the last two decades in which a coronavirus results in a major global spread with serious consequences in terms of vastity of affected patients, life losses, health system organization efforts and socio-economic implications. Lacking effective therapies and vaccinations, during viral outbreak the major and most incisive mean for viral spread control is spread prevention, especially for the fragile burn-injured patients we are called to care for in Burn Units.
We developed an admission and inpatient management protocol to preserve burn patients from SARS-CoV-2 contagion, in order to avoid additional morbidity and mortality in patients with already compromised health conditions. Data from burn-injured patients admitted to our Unit following this new protocol were retrospectively analyzed in order to verify its effectiveness in prevention of viral spread.
From the 8th of March to the 8th of June, we admitted 18 patients in the Burn Unit ICU and semi-ICU and 17 patients in the Burn Ward. Two of them resulted positive to COVID-19 nasopharyngeal swab and bronchoalveolar lavage collected immediately on admission, for both the extension of burns and their general clinical conditions implied ICU admission. Moreover, a caregiver of an admitted child resulted positive to the nasopharyngeal swab. No other cases of SARS-CoV-2 positivity have been reported neither between hospitalized patients nor between healthcare workers.
The evidence of high ICU admission rate and high mortality in patients affected by SARS-CoV-2 combined with the fragile clinical conditions of burn patients required the development of an admission and hospitalization management protocol.
这是过去二十年来冠状病毒第三次引起重大全球传播，对受影响患者的数量、生命损失、卫生系统组织努力和社会经济影响都产生了严重后果。由于缺乏有效的治疗方法和疫苗，在病毒爆发期间，控制病毒传播的主要和最有力的手段是传播预防，特别是对于我们在烧伤病房中需要护理的脆弱烧伤患者。
我们制定了一项入院和住院管理方案，以防止烧伤患者感染 SARS-CoV-2，避免因健康状况已经受损的患者而导致更多的发病率和死亡率。我们回顾性分析了按照这一新方案入院的烧伤患者的数据，以验证其在预防病毒传播方面的效果。
从 3 月 8 日至 6 月 8 日，我们在烧伤病房 ICU 和半 ICU 收治了 18 名患者，在烧伤病房收治了 17 名患者。其中 2 名患者因烧伤范围广泛且一般临床情况需要 ICU 入院而立即对鼻咽拭子和支气管肺泡灌洗液进行 COVID-19 检测，结果呈阳性。此外，一名住院患儿的护理人员鼻咽拭子检测结果呈阳性。在住院患者或医护人员中均未报告其他 SARS-CoV-2 阳性病例。
SARS-CoV-2 感染患者 ICU 入院率和死亡率高，再加上烧伤患者的脆弱临床状况，这就需要制定入院和住院管理方案。
