Privé S, Benyamina M, Mimoun M, Chaouat M
Centre de Traitement des Brûlés, Hôpital Édouard Herriot, Lyon, France.
Centre de Traitement des Brûlés, Hôpital Saint Louis, Paris, France.
Ann Burns Fire Disasters. 2022 Sep 30;35(3):199-208.
We checked the files of 30 inpatients with diabetes and deep burns to the lower limbs. We looked for a diabetes-related neuropathy (60% had one), the context of the accident, the topography of burns, any delays before the first and possible subsequent surgeries, the length of stay, and return to walking, if achieved. Burns mostly involved distal parts of the lower limbs, were thermal in 90% with an intentional action in 43%, and frequently occurred in a bathing room (48%) during a footbath (54%). Mean time to the first surgery was day 3,35 and, when needed, the second one was performed 6,54 days later. Mean LOS was 14,6 days, eleven patients were walking again by this time. We found a significant (p<0.001) association between the time to the 1st surgery and time elapsed between the burn and hospitalization. The existence of a diabetes-related neuropathy is a risk factor of lower limb burns, provided it suppresses the alarm of pain. Early surgery seems to reduce the LOS.
我们检查了30例患有糖尿病且下肢深度烧伤的住院患者的病历。我们查找了与糖尿病相关的神经病变（60%的患者有神经病变）、事故背景、烧伤部位、首次及可能的后续手术前的任何延误、住院时间以及是否恢复行走（若已恢复）。烧伤大多累及下肢远端，90%为热烧伤，其中43%为故意行为，且经常发生在浴室（48%）的足浴过程中（54%）。首次手术的平均时间为第3.35天，如有需要，第二次手术在6.54天后进行。平均住院时间为14.6天，此时有11名患者再次能够行走。我们发现首次手术时间与烧伤至住院之间的时间间隔存在显著关联（p<0.001）。存在与糖尿病相关的神经病变是下肢烧伤的一个危险因素，前提是它抑制了疼痛警报。早期手术似乎能缩短住院时间。
