Giurgiu Rares-Adrian, Bordeanu-Diaconescu Eliza-Maria, Grosu-Bularda Andreea, Frunza Adrian, Grama Sabina, Costache Raducu-Andrei, Cristescu Carina-Ioana, Neagu Tiberiu-Paul, Lascar Ioan, Hariga Cristian-Sorin
Department 11, Discipline Plastic and Reconstructive Surgery, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania.
Burn Centre, Emergency Clinical Hospital of Bucharest, 014461 Bucharest, Romania.
Eur Burn J. 2025 May 22;6(2):27. doi: 10.3390/ebj6020027.
Face and neck burns present significant clinical challenges due to their proximity to the airway, predisposing patients to inhalation injuries and subsequent respiratory complications. In our cohort of 206 patients, facial and neck burns were associated with a markedly higher incidence of inhalation injury (34.8% vs. 2.8%), necessitating more frequent endotracheal intubation (51.9% vs. 14.1%). Furthermore, respiratory infections were significantly more common in patients with facial and neck burns (26.7% vs. 7%, < 0.001), with respiratory secretion cultures revealing a predominance of Pseudomonas aeruginosa (39.58%), Acinetobacter baumanii (18.75%), and Klebsiella pneumoniae (6.25%). In contrast, patients without facial and neck burns primarily exhibited Pseudomonas aeruginosa (50%) in their cultures. These complications translated into a significantly increased mortality rate in patients with facial and neck burns (31.1% vs. 12.7%), with a reduced mean survival period (66.7 days vs. 84.3 days) and a 2.8-fold increase in the hazard of mortality. Additionally, older age emerged as a significant determinant for the development of respiratory infections. Multivariable model regression analysis revealed that only TBSA remained a consistent and independent predictor for adverse respiratory outcomes and increased mortality, while face and neck burns are more causally associated with TBSA.
面部和颈部烧伤因其靠近气道而带来重大临床挑战，使患者易发生吸入性损伤及随后的呼吸并发症。在我们的206例患者队列中，面部和颈部烧伤与吸入性损伤的发生率显著更高相关（34.8%对2.8%），需要更频繁地进行气管插管（51.9%对14.1%）。此外，面部和颈部烧伤患者的呼吸道感染明显更常见（26.7%对7%，<0.001），呼吸道分泌物培养显示铜绿假单胞菌占主导（39.58%）、鲍曼不动杆菌（18.75%）和肺炎克雷伯菌（6.25%）。相比之下，无面部和颈部烧伤的患者培养物中主要为铜绿假单胞菌（50%）。这些并发症导致面部和颈部烧伤患者的死亡率显著增加（31.1%对12.7%），平均生存期缩短（66.7天对84.3天），死亡风险增加2.8倍。此外，年龄较大是呼吸道感染发生的一个重要决定因素。多变量模型回归分析显示，只有烧伤总面积仍然是不良呼吸结局和死亡率增加的一致且独立的预测因素，而面部和颈部烧伤与烧伤总面积的因果关系更强。
