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Copyright (c) 2019 Diego Fernando Alarcón Ariza, Genny Liliana Meléndez Flórez, Héctor Julio Meléndez Flórez
This work is licensed under a Creative Commons Attribution 4.0 International License.
Epidemiology of hand burns in a referral center in Colombia: Retrospective cohort
Corresponding Author(s) : Diego Fernando Alarcón Ariza
Ciencia e Innovación en Salud,
2019
Abstract
Background: Hands are involved in more than 80% of all severe burns. The majority occur in lower resource locations, where prevention programs are exceptional.
Methods: analytic retrospective study of hand burns patients admitted to the burn unit from January 2013 to December 2017. Univariate, bivariate and multivariate analyses were perform for each outcome variable.
Results: 349 patients with hand burns were included, 60% men and 40% women, most of the inpatients aged from 0- 9 years. Scalds (40%), fire (27%) and contact (15,5%) were the major causes of hand burns. The mean total body surface area (TBSA) compromised was 3.9%, with a range of 0.5- 33% TBSA. Hand burns happened more commonly at home (58,7%). 71 patients (20%) required hand surgery. The mean length of stay was 14,2 days, and the range from 1 day to 108 days. In the multivariate analyses male gender, rural residence, burn extension and depth, were the most significant factors impacted on surgery.
Conclusion: the results of this study contribute to characterize the behavior of hand burns in Colombia. Children are a high risk group, burn prevention education would help to reduce the incidence of hand burns on northeast area of Colombia.
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- Anzarut A, Chen M, Shankowsky H, et al. Quality-of life and outcome predictors following massive burn injury. Plast Reconstr Surg. 2005; 116(3):791–797.
- Arifi H, Ahmeti H, Zatriqi V, Buja S, Rexhaj Z, Arifi N. Epidemiology of burn injuries in Kosovo: a 10-year review. Ann Burns Fire Disasters. 2017; 30(3):163–166.
- Belliappa P, McCabe S. The burned hand. Hand Clin. 1993;9:313–24.
- Bhansali CA, Gandhi G, Sahastrabudhe P, Panse N. Epidemiological study of burn injuries and its mortality risk factors in a tertiary care hospital. Indian J Burns. 2017; 25:62-66.
- Brown M, Coffee T, Adenuga P, Yowler C. Outcomes of outpatient management of pediatric burns. J Burn Care Res. 2014; 35: pp. 388-394.
- Choi M, Armstrong M, Panthaki Z. Pediatric hand burn: thermal, electrical, and chemical. J Craniofac Surge. 2009; 20(4):1045–1048.
- Danielson J, Capelli M, Lee R. Upper extremity electrical injury. Hand Clin. 2000; 16:225–234.
- Duke J, Wood F, Semmens J, Edgar D, Spilsbury K, Rea S. An assessment of burn injury hospitalisations of adolescents and young adults in Western Australia. Burns J Int Soc Burn Inj. 2012; 38:128–35. DOI 10.1016/j.burns.2011.02.008
- Edstrom L, Robson M, Macchiaverna J, Scala A. Prospective randomized treatments for burned hands: nonoperative vs. operative. Preliminary report. Scand J Plast Reconstr Surg. 1979; 13:131.
- Engrav L, Dutcher K, Nakamura D. Rating burn impairment. Clin Plast Surg. 1992; 19:569–598.
- Engrav L, Heimbach D, Reus J, et al. Early excision and grafting vs. nonoperative treatment of burns of indeterminant depth: a randomized prospective study. J Trauma. 1983; 23:1001.
- Erdmann T. Tap water burn prevention: the effect of legislation. Pediatrics. 1991; 88:572–577
- Forjuoh S. Burns in low- and middle-income countries: a review of available literature on descriptive epidemiology, risk factors, treatment, and prevention. Burns. 2006; 32:529.
- Goodwin C, Maguire M, McManus W, Pruitt B Jr. Prospective study of burn wound excision of the hands. J Trauma. 1983; 23:510.
- Hwee J, Song C, Tan K, Tan B, Chong S. The trends of burns epidemiology in a tropical regional burns centre. Burns: Journal of the International Society for Burn Injuries. 2016; 42(3):682–686. DOI 10.1016/j.burns.2015.10.019
- Kreymerman P, Andres L, Lucas H, et al. Reconstruction of the burned hand. Plast Reconstr Surg 2011; 127(2):752–759.
- Macarthur C. Evaluation of Safe Kids Week 2001: prevention of scald and burn injuries in young children. Injury Prevention. 2003; 9:112–116.
- Miller S, Jeng J, Bessey P, et al. National Burn Repository. Chicago, Ill: American Burn Association. 2005:1–51.
- Ministerio de Salud Registro especial de prestadores de servicios de salud. Ministerio de salud, República de Colombia; 2015. http://201.234.78.38/habilitacion/
- Mohammadi A, Bakhshaeekia A, Marzban S, et al. Early excision and skin grafting versus delayed skin grafting in deep hand burns (a randomised clinical controlled trial). Burns. 2011; 37:36
- Ng D, Anastakis D, Douglas L, Peters W. Work related burns: A 6-year retrospective study. Burns. 1991; 17:151–154.
- Ogada E, Gebreab A, Potokar T. Review of the epidemiology of burn injuries in Ethiopia; implications for study design and prevention. Burns. 2019. DOI 10.1016/j.burnso.2019.05.002
- Palmieri T. Initial Management of Acute Pediatric Hand Burns. Hand Clin. 2009; 25(4):461–467. DOI 10.1016/j.hcl.2009.06.006
- Peck M, Kruger G, van der Merwe A, et al. Burns and fires from non-electric domestic appliances in low and middle income countries Part I. The scope of the problem. Burns. 2008; 34:303.
- Peck M. Epidemiology of Burns throughout the World. Part I Distribution and Risk Factors. Burns. 2011; 37, 1087-1100
- Pegg S. Burn epidemiology in the Brisbane and Queensland area. Burns J Int Soc Burn Inj. 2005; 31(Suppl 1):S27–31. DOI 10.1016/j.burns.2004.10.004
- Pegg S. Escharotomy in burns. Ann Acad Med Singapore. 1992; 21:682–684.
- Piccolo N, Piccolo M, Piccolo P, et al: Escharotomies, fasciotomies and carpal tunnel release in burn patients: review of the literature and presentation of an algorithm for surgical decision making. Handchir Mikrochir Plast Chir. 2007; 39:161–167.
- Pruitt B Jr, Dowling J, Moncrief J. Escharotomy in early burn care. Arch Surg. 1968; 96:502–507.
- Ramirez C, et al. Infection in burn patients in a referral center in Colombia. Burns. 2017. DOI 10.1016/j.burns.2016.07.008
- Richards, Winston T., et al. Acute Surgical Management of Hand Burns. Journal of Hand Surgery. 2014; 39(10): 2075-2085.
- Rybarczyk M, Schafer J, Elm C, Sarvepalli S. A systematic review of burn injuries in low- and middle-income countries: Epidemiology in the WHO-defined African Region. Afr J Emerg Med. 2017; 7(1):30–37.
- Schneider J, Holavanahalli R, Helm P, et al. Contractures in burn injury part II: investigating joints of the hand. J Burn Care Res. 2008; 29(4):606–13.
- Sheridan RL, Hurley J, Smith MA, et al. The acutely burned hand: Management and outcome based on a ten-year experience with 1047 acute hand burns. J Trauma.1995; 38:406–411.
- Shupp J, Pavlovich A, Jeng J, Pezzullo J, Oetgen W, Jaskille A, et al. Epidemiology of bloodstream infections in burn-injured patients: a review of the national burn repository. J Burn Care Res. 2010; 31:521–528.
- Sinha S, Nuñez Martinez C, Hartley RL, Quintana Alvarez RJ, Yoon G, Biernaskie J, Nickerson D, Gabri Epidemiological analysis of pediatric burns in the Dominican Republic reveals a demographic profile at significant risk for electrical burns. Burns. 2018; 45(2), 471-478. DOI 10.1016/j.burns.2018.03.014
- Smolle C, Cambiaso-Daniel J, Forbes A, et al. Recent trends in burn epidemiology worldwide: A systematic review. Burns. 2017; 43(2):249–257. DOI 10.1016/j.burns.2016.08.013
- Tambuscio A, Governa M, Caputo G, Barisoni D. Deep burn of the hands: Early surgical treatment avoids the need for late revisions? Burns. 2006; 32:1000.
- Van Zuijlen P, Kreis R, Vloemans A, et al. The prognostic factors regarding long-term functional outcome of full-thickness hand burns. Burns. 1999; 25:709.
- Wang K, Sun Y, Wu G, Wang Y, Xia Z. Epidemiology and outcome analysis of hand burns: a 5-year retrospective review of 378 cases in a burn center in Eastern China. Burns. 2015; 41:1550–1555.
- Wong E, Groen R, Kamara T, Stewart K. Burns in Sierra Leone: a population-based assessment. Burns. 2014; 40(8):1748–1753.
- Ytterstad B, Sogaard A. The Harstad Injury Prevention Study: prevention of burns in small children by a community-based intervention. Burns. 1995, 21:259–266.
- Zikaj G, Belba G, Xhepa G. Epidemiology of hand burn in Albania 2011-2016. Open access Maced.
References
Anzarut A, Chen M, Shankowsky H, et al. Quality-of life and outcome predictors following massive burn injury. Plast Reconstr Surg. 2005; 116(3):791–797.
Arifi H, Ahmeti H, Zatriqi V, Buja S, Rexhaj Z, Arifi N. Epidemiology of burn injuries in Kosovo: a 10-year review. Ann Burns Fire Disasters. 2017; 30(3):163–166.
Belliappa P, McCabe S. The burned hand. Hand Clin. 1993;9:313–24.
Bhansali CA, Gandhi G, Sahastrabudhe P, Panse N. Epidemiological study of burn injuries and its mortality risk factors in a tertiary care hospital. Indian J Burns. 2017; 25:62-66.
Brown M, Coffee T, Adenuga P, Yowler C. Outcomes of outpatient management of pediatric burns. J Burn Care Res. 2014; 35: pp. 388-394.
Choi M, Armstrong M, Panthaki Z. Pediatric hand burn: thermal, electrical, and chemical. J Craniofac Surge. 2009; 20(4):1045–1048.
Danielson J, Capelli M, Lee R. Upper extremity electrical injury. Hand Clin. 2000; 16:225–234.
Duke J, Wood F, Semmens J, Edgar D, Spilsbury K, Rea S. An assessment of burn injury hospitalisations of adolescents and young adults in Western Australia. Burns J Int Soc Burn Inj. 2012; 38:128–35. DOI 10.1016/j.burns.2011.02.008
Edstrom L, Robson M, Macchiaverna J, Scala A. Prospective randomized treatments for burned hands: nonoperative vs. operative. Preliminary report. Scand J Plast Reconstr Surg. 1979; 13:131.
Engrav L, Dutcher K, Nakamura D. Rating burn impairment. Clin Plast Surg. 1992; 19:569–598.
Engrav L, Heimbach D, Reus J, et al. Early excision and grafting vs. nonoperative treatment of burns of indeterminant depth: a randomized prospective study. J Trauma. 1983; 23:1001.
Erdmann T. Tap water burn prevention: the effect of legislation. Pediatrics. 1991; 88:572–577
Forjuoh S. Burns in low- and middle-income countries: a review of available literature on descriptive epidemiology, risk factors, treatment, and prevention. Burns. 2006; 32:529.
Goodwin C, Maguire M, McManus W, Pruitt B Jr. Prospective study of burn wound excision of the hands. J Trauma. 1983; 23:510.
Hwee J, Song C, Tan K, Tan B, Chong S. The trends of burns epidemiology in a tropical regional burns centre. Burns: Journal of the International Society for Burn Injuries. 2016; 42(3):682–686. DOI 10.1016/j.burns.2015.10.019
Kreymerman P, Andres L, Lucas H, et al. Reconstruction of the burned hand. Plast Reconstr Surg 2011; 127(2):752–759.
Macarthur C. Evaluation of Safe Kids Week 2001: prevention of scald and burn injuries in young children. Injury Prevention. 2003; 9:112–116.
Miller S, Jeng J, Bessey P, et al. National Burn Repository. Chicago, Ill: American Burn Association. 2005:1–51.
Ministerio de Salud Registro especial de prestadores de servicios de salud. Ministerio de salud, República de Colombia; 2015. http://201.234.78.38/habilitacion/
Mohammadi A, Bakhshaeekia A, Marzban S, et al. Early excision and skin grafting versus delayed skin grafting in deep hand burns (a randomised clinical controlled trial). Burns. 2011; 37:36
Ng D, Anastakis D, Douglas L, Peters W. Work related burns: A 6-year retrospective study. Burns. 1991; 17:151–154.
Ogada E, Gebreab A, Potokar T. Review of the epidemiology of burn injuries in Ethiopia; implications for study design and prevention. Burns. 2019. DOI 10.1016/j.burnso.2019.05.002
Palmieri T. Initial Management of Acute Pediatric Hand Burns. Hand Clin. 2009; 25(4):461–467. DOI 10.1016/j.hcl.2009.06.006
Peck M, Kruger G, van der Merwe A, et al. Burns and fires from non-electric domestic appliances in low and middle income countries Part I. The scope of the problem. Burns. 2008; 34:303.
Peck M. Epidemiology of Burns throughout the World. Part I Distribution and Risk Factors. Burns. 2011; 37, 1087-1100
Pegg S. Burn epidemiology in the Brisbane and Queensland area. Burns J Int Soc Burn Inj. 2005; 31(Suppl 1):S27–31. DOI 10.1016/j.burns.2004.10.004
Pegg S. Escharotomy in burns. Ann Acad Med Singapore. 1992; 21:682–684.
Piccolo N, Piccolo M, Piccolo P, et al: Escharotomies, fasciotomies and carpal tunnel release in burn patients: review of the literature and presentation of an algorithm for surgical decision making. Handchir Mikrochir Plast Chir. 2007; 39:161–167.
Pruitt B Jr, Dowling J, Moncrief J. Escharotomy in early burn care. Arch Surg. 1968; 96:502–507.
Ramirez C, et al. Infection in burn patients in a referral center in Colombia. Burns. 2017. DOI 10.1016/j.burns.2016.07.008
Richards, Winston T., et al. Acute Surgical Management of Hand Burns. Journal of Hand Surgery. 2014; 39(10): 2075-2085.
Rybarczyk M, Schafer J, Elm C, Sarvepalli S. A systematic review of burn injuries in low- and middle-income countries: Epidemiology in the WHO-defined African Region. Afr J Emerg Med. 2017; 7(1):30–37.
Schneider J, Holavanahalli R, Helm P, et al. Contractures in burn injury part II: investigating joints of the hand. J Burn Care Res. 2008; 29(4):606–13.
Sheridan RL, Hurley J, Smith MA, et al. The acutely burned hand: Management and outcome based on a ten-year experience with 1047 acute hand burns. J Trauma.1995; 38:406–411.
Shupp J, Pavlovich A, Jeng J, Pezzullo J, Oetgen W, Jaskille A, et al. Epidemiology of bloodstream infections in burn-injured patients: a review of the national burn repository. J Burn Care Res. 2010; 31:521–528.
Sinha S, Nuñez Martinez C, Hartley RL, Quintana Alvarez RJ, Yoon G, Biernaskie J, Nickerson D, Gabri Epidemiological analysis of pediatric burns in the Dominican Republic reveals a demographic profile at significant risk for electrical burns. Burns. 2018; 45(2), 471-478. DOI 10.1016/j.burns.2018.03.014
Smolle C, Cambiaso-Daniel J, Forbes A, et al. Recent trends in burn epidemiology worldwide: A systematic review. Burns. 2017; 43(2):249–257. DOI 10.1016/j.burns.2016.08.013
Tambuscio A, Governa M, Caputo G, Barisoni D. Deep burn of the hands: Early surgical treatment avoids the need for late revisions? Burns. 2006; 32:1000.
Van Zuijlen P, Kreis R, Vloemans A, et al. The prognostic factors regarding long-term functional outcome of full-thickness hand burns. Burns. 1999; 25:709.
Wang K, Sun Y, Wu G, Wang Y, Xia Z. Epidemiology and outcome analysis of hand burns: a 5-year retrospective review of 378 cases in a burn center in Eastern China. Burns. 2015; 41:1550–1555.
Wong E, Groen R, Kamara T, Stewart K. Burns in Sierra Leone: a population-based assessment. Burns. 2014; 40(8):1748–1753.
Ytterstad B, Sogaard A. The Harstad Injury Prevention Study: prevention of burns in small children by a community-based intervention. Burns. 1995, 21:259–266.
Zikaj G, Belba G, Xhepa G. Epidemiology of hand burn in Albania 2011-2016. Open access Maced.