Efficiency of new treatment methods in burned patients

Daiva Gudavičienė, Rytis Rimdeika

Division of Plastic Surgery and Burns, Kaunas University of Medicine Hospital, Lithuania

Key words: burns, enteral nutrition, early escharectomy, mortality, hospital stay time.

Summary. The aim of study was to investigate if new treatment methods reduced mortality and diminished hospital stay time for survivors. Material and methods. We assessed patients, treated in Kaunas University of Medicine Hospital with 10–80% 2B–3o body surface area burned. Group A, which was assessed prospectively, included 89 patients, treated during 2001–2003. All patients in Group A received sufficient enteral nutrition, in 21 patient early escharectomy and skin-grafting were done. This group was compared with Group B, assessed retrospectively and included 89 patients, treated in 1997–1998. They did not receive enteral nutrition and were treated without early escharectomy and skin grafting. Results. Groups were homogeneous by age, extent of general and deep burn, and burn indexes. For 24% patients in Group A early escharectomy and skin-grafting was done, they were operated on the average at 3.6 day after admission (standard deviation – 1.32). In Group A mortality was 5.6%. Average hospital stay time for survivors was 35.7 days (standard deviation – 20.4) or 0.9 day/% body surface area burned, standard deviation – 0.6. In Group B no early escharectomies and skin grafting were done. Mortality in Group B was 23.6%, hospital stay time for survivors – 40.6 days (standard deviation – 23.6), or 1.9 day/% body surface area burned. These indicators were statistically significantly different compared to Group A (p<0.05). The significant influence of new treatment methods in major burns was established. Conclusion. New methods, early escharectomy and skin grafting and enteral nutrition, introduced in Kaunas University of Medicine Hospital in the last 5–7 years significantly reduced mortality and hospital stay time for survivors (p<0.05).

Correspondence to D. Gudavičienė, Division of Plastic Surgery and Burns, Kaunas University of Medicine Hospital, Eivenių 2, 50010 Kaunas, Lithuania. E-mail: daikle@centras.lt

Received 12 March 2004, accepted 30 March 2004