TY - JOUR
T1 - The frequency and reason for amputations in electrically burned pediatric patients
AU - Tapking, Christian
AU - Hundeshagen, Gabriel
AU - Popp, Daniel
AU - Lee, Jong O.
AU - Herndon, David N.
AU - Zapata-Sirvent, Ramón
AU - Branski, Ludwik K.
N1 - Publisher Copyright:
© American Burn Association 2018. All rights reserved.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Electrical injuries induce substantial morbidity and mortality. Amputations are often necessary to enable survival and based on tissue nonviability, development of life-threatening infection, or expected nonfunctional outcome. They analyzed occurrence and type of amputations in their institution for electrical and nonelectrical pediatric burns and the number of reconstructive operations. Patients who underwent any amputation between 1999 and 2017 were identified. Patients with electrical burns (EB) were matched regarding age, sex, and percent total body surface area (%TBSA) burned to patients with nonelectrical burns (NEB). Both groups (n = 35 EB, n = 70 NEB) were comparable regarding age (EB, 11.6 ± 4.5 years; NEB, 11.1 ± 4.5 years, P =.550) and %TBSA (36.7 ± 15.4% and 37.7 ± 12.9%, P =.738). Major amputations (above wrist or ankle) were performed in 77% of EB vs 31% of NEB (P <.001). Amputations above knee or elbow were performed in 13 (37.1%) vs two patients (2.9%, P <.001). Eight (22.9%) vs six patients (8.6%) underwent combination of two or more major amputations (P =.042). In both groups, most amputations were performed for functional reasons. Length of stay was shorter in EB group (33 ± 27 vs 47 ± 38 days, P =.040). EB patients underwent 9.9 ± 7.1 total operations compared with 14.4 ± 5.1 operations (P <.001). Of these, 6.5 ± 3.6 and 7.9 ± 3.3 (P =.023) were performed during acute stay and 3.3 ± 4.8 and 6.5 ± 3.5 after acute stay (P <.001), respectively. Mortality was comparable. EB were associated with larger extent of limb loss and more major amputations than NEB with amputations. They furthermore required a smaller number of reconstructive procedures. EB require extra attention of caregivers, because of their extensive tissue damage.
AB - Electrical injuries induce substantial morbidity and mortality. Amputations are often necessary to enable survival and based on tissue nonviability, development of life-threatening infection, or expected nonfunctional outcome. They analyzed occurrence and type of amputations in their institution for electrical and nonelectrical pediatric burns and the number of reconstructive operations. Patients who underwent any amputation between 1999 and 2017 were identified. Patients with electrical burns (EB) were matched regarding age, sex, and percent total body surface area (%TBSA) burned to patients with nonelectrical burns (NEB). Both groups (n = 35 EB, n = 70 NEB) were comparable regarding age (EB, 11.6 ± 4.5 years; NEB, 11.1 ± 4.5 years, P =.550) and %TBSA (36.7 ± 15.4% and 37.7 ± 12.9%, P =.738). Major amputations (above wrist or ankle) were performed in 77% of EB vs 31% of NEB (P <.001). Amputations above knee or elbow were performed in 13 (37.1%) vs two patients (2.9%, P <.001). Eight (22.9%) vs six patients (8.6%) underwent combination of two or more major amputations (P =.042). In both groups, most amputations were performed for functional reasons. Length of stay was shorter in EB group (33 ± 27 vs 47 ± 38 days, P =.040). EB patients underwent 9.9 ± 7.1 total operations compared with 14.4 ± 5.1 operations (P <.001). Of these, 6.5 ± 3.6 and 7.9 ± 3.3 (P =.023) were performed during acute stay and 3.3 ± 4.8 and 6.5 ± 3.5 after acute stay (P <.001), respectively. Mortality was comparable. EB were associated with larger extent of limb loss and more major amputations than NEB with amputations. They furthermore required a smaller number of reconstructive procedures. EB require extra attention of caregivers, because of their extensive tissue damage.
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U2 - 10.1093/jbcr/iry056
DO - 10.1093/jbcr/iry056
M3 - Article
C2 - 30371857
AN - SCOPUS:85058917165
SN - 1559-047X
VL - 40
SP - 107
EP - 111
JO - Journal of Burn Care and Research
JF - Journal of Burn Care and Research
IS - 1
ER -