Differences in burn wound size estimation between points of referral and the burn unit: experience at a major burn center in southwestern Nigeria.

BACKGROUND: Accurate burn wound size estimation is important for resuscitation and subsequent management. It is also important for the development of referral guidelines in Nigeria. OBJECTIVE: To establish whether a significant discrepancy exists in burn size estimation between referral centers and burn units. METHODS: A retrospective review of burn patients managed at the burn unit of a premier tertiary hospital in Ibadan, southwestern Nigeria, between January 1, 2016, and October 31, 2019 was conducted. Patients' demographic and other characteristics, inclusive of TBSA estimation from point of referral and the burn unit, were retrieved and analyzed. RESULTS: A total of 96 burn injury records were found for the study period, with a male-to-female ratio of 1.3:1. Thirty-five records (36.5%) included no burn size estimation by the referring physician. There was a statistically significant difference in TBSA estimation between referring physicians and burn unit physicians (P = .015). Burn wounds were more likely to be overestimated than underestimated (P = .016). Overestimation is more likely with minor burns and in pediatric patients. Underestimation was more likely in adults. CONCLUSION: There is a significant difference in burn size estimation between burn unit physicians and referring physicians. This finding underscores the need for continuous education on burn estimation to aid proper referral and management.

Changing Epidemiology and Outcome of Pediatric Thermal Burn Injury in South Western Nigeria.

The pediatric age group has been noted to be particularly vulnerable to burn injuries. Burn is the fifth most common cause of childhood injuries. Nigeria has a very young population with a median age of 18.1 years. Scald is the most common form of burn injuries in this age group globally; however, previous reports from our institution found flame to be the most common form of burn in pediatric age. The most recent report from 13 years ago still maintained flame as the most common cause of pediatric burn injury. This study was carried out to determine the changes in epidemiology and outcome of pediatric thermal burn injury. This was a retrospective study carried out between January 2013 and December 2022. Data were analyzed using the statistical package for social sciences software version 23. The significance was set at a P-value of .05. Two hundred and sixty-five children presented with thermal burn with a male-to-female ratio of 1.3:1. 63.4% occurred in children 0-5 years. Scald (59.6%) was the most common cause of injury. Most flame injuries in females were due to liquified petroleum gas cookstove explosion, while petrol explosion was the most common cause in males (P ≤ .001). There is a yearly increase in burn depth (P = .009). Most inhalation injuries occurred in those aged 11-16 years (P = .006). Mortality rate was 10.2%, with total body surface area burned (P ≤ .001), burn depth (P ≤ .001), and inhalation injury (P ≤ .001) associated with increasing mortality. Scald is now the most common cause of thermal burn in our institution, with a remarkable reduction in mortality rate.

Current Trend in the Epidemiology of Thermal Burn Injury at a Tertiary Hospital in South Western Nigeria.

Worldwide, thermal burn is the leading etiological type of burn injury accounting for 86% of burn injuries requiring admissions. Flame, Scald, and contact burn are the leading causes of thermal burn. Changes in the sociodemographic characteristics of societies have led to alterations in the epidemiology of burn. An understanding of such changes in the epidemiology of burn is essential in formulating and executing adequate burn prevention programs. We sought to establish the current trend in the etiology, gender distribution, age, occurrence of inhalation injury, burn surface area, burn depth, and mortality rate of thermal burns at Ibadan. This was a retrospective study carried out between January 2013 and December 2022. Thermal burns constitute 92% of burn injuries. The male-to-female ratio was 1.4:1. There were 265 (45%) patients in the pediatric age group and 323 adults (55% of the patients). The proportion of flame, scald, and contact burns were 378 (58%), 203 (32%), and 14 (2%), respectively. Flame burns resulting from liquified petroleum gas (LPG) explosion show a rising trend, with a decline in flame burns from kerosene (P < .001). One hundred and ninety (32%) patients had inhalation injury. The overall mortality was 19% (N = 114). Kerosene flame, 38% (17 of 45 patients), and LPG, 32% (41 of 130 patients), were the most lethal causes of flame injuries (P < .043). The study shows the increasing contribution of LPG to the etiology of thermal burn injuries. Burn prevention programs should target safe use of LPG stoves and cylinders.

Glycerolised Skin Allografts for Extensive Burns in Low- and Middle-income Countries.

Introduction: There has been a significant improvement in the outcome of treatment of large surface area burns in developed countries. A major contributory factor is an early excision and skin grafting of burn wounds. The initial coverage of large surface area deep burn wounds requires the use of temporary skin substitutes such as allografts due to limited skin autografts. Cadaveric skin allografts are the commonest source of skin allografts in use; however, there may be religious, cultural, cost, or other factors mitigating its availability and routine use in low- and middle-income countries (LMICs). Human skin allografts may be used fresh or stored in tissue banks to ensure its ready availability. The purpose of this review is to promote glycerolised skin allografts as a means of skin preservation in low-resource countries above other modalities cryopreservation due to its cost advantages and relative ease of operation. Materials and Methods: A literature search for articles related to human skin allograft use in burn care, skin banks, and glycerolised skin allografts in LMICs was done using PubMed, EMBASE, and Web of Science databases. The key words used were 'allograft' and 'burn' with a filter in the search for human studies. The relevant references in the articles obtained were also searched for and included in the review. Results: Sixty-three journal articles were reviewed for contents in line with the objectives of this study. Conclusion: Glycerolised skin graft is a viable option for coverage of extensive burns in LMICs.