Ngim R C, Ghulam A K
Department of Plastic Surgery, Singapore General Hospital.
Singapore Med J. 1994 Jun;35(3):257-62.
To study logistic requirements in acute burn care in Singapore and to correlate statistics on fire, unnatural deaths and burns.
Fire data (from Singapore Fire Safety Bureau), mortality data (from Institute of Science & Forensic Medicine) and burn data (from Burns Centre, Singapore General Hospital) were studied.
Severe burn victims often require prolonged treatment. Useful data was obtained in a 1,500-bed restructured government hospital.
All reported and investigated fire incidents, coroner enquiries of unnatural deaths and admitted burn patients.
General burn data obtained retrospectively from 398 burn admissions in 1988 and logistic burn data from 41 patients requiring fluid replacement regime.
Fire data showed one burn admission in every 12 fires (398/4718), one burn death in every 314 fires (15/4174) or 55 unnatural deaths (15/828). Mortality data showed 15 burn deaths, two prior to admission, 7/13 admitted died of suicidal injuries and mortality rate was 3.3% (national annual average is 1.9%). General burn data showed adults 76% and children 24%, 3:1 male predominance; scalds (46%), fire (32%), explosions (11%) and others (11%). Seventy-eight patients (adults 58, children 20) required fluid resuscitation. Logistic burn data (average burn 35%, 28 partial thickness and 13 full thickness burns) were: ALOS 19.5 days, 2.4 major operations per patient (range 2-7), 56 minor procedures and 2.9 L blood transfusion per patient (those who were operated required 3.8 L and those not operated, 1 L per patient). Blood investigations increased with severity and pattern of injury, Acinetobacter species was commonest microorganisms, antibiotics were used in 66% of patients and commonest burn dressings were tullegra (T/G), followed by T/G with silverzine.
Data presented useful for correlation of fire, mortality and burn statistics, resource allocation and new burn facility establishment.
研究新加坡急性烧伤护理中的后勤需求，并关联火灾、非自然死亡和烧伤的统计数据。
研究了火灾数据（来自新加坡消防安全局）、死亡率数据（来自科学与法医学研究所）和烧伤数据（来自新加坡总医院烧伤中心）。
严重烧伤患者通常需要长期治疗。在一家拥有1500张床位的重组政府医院中获得了有用的数据。
所有报告并经过调查的火灾事故、死因裁判官对非自然死亡的调查以及收治的烧伤患者。
回顾性获取1988年398例烧伤入院患者的一般烧伤数据以及41例需要液体复苏方案的患者的烧伤后勤数据。
火灾数据显示，每12起火灾中有1例烧伤入院（398/4718），每314起火灾中有1例烧伤死亡（15/4174）或55例非自然死亡（15/828）。死亡率数据显示有15例烧伤死亡，2例在入院前死亡，13例入院患者中有7例死于自杀伤，死亡率为3.3%（全国年平均水平为1.9%）。一般烧伤数据显示，成人占76%，儿童占24%，男女比例为3:1；烫伤（46%）、火灾（32%）、爆炸（11%）和其他（11%）。78例患者（成人58例，儿童20例）需要液体复苏。烧伤后勤数据（平均烧伤面积35%，28例为部分厚度烧伤，13例为全厚度烧伤）为：平均住院时间19.5天，每位患者进行2.4次大手术（范围为2 - 7次），56次小手术，每位患者输血2.9升（接受手术的患者需要3.8升，未接受手术的患者每位需要1升）。血液检查随着损伤的严重程度和类型而增加，不动杆菌属是最常见的微生物，66%的患者使用了抗生素，最常用的烧伤敷料是tullegra（T/G），其次是含银锌的T/G。
所呈现的数据有助于关联火灾、死亡率和烧伤统计数据、资源分配以及新烧伤设施的建立。
