Specialised Burn Wound Management and its Outcome: A 3-Year Perspective from a Plastic Surgery Specialist Centre

Objective: Specialised burn wound management is the need of the hour. We conducted this study to present our 3-year experience of burn wound management and its outcome from a specialist burn centre in Peshawar Pakistan. Methods: This is a retrospective analysis of prospectively collected data about burn patients who were managed at Habib Burn Centre Peshawar between January 2013 and December 2015 (3 years). Data was collected prospectively about patient demographics, burn types, burn thickness, total burn surface area (TBSA) and the body sites involvement. The outcome was measured in terms of rates of wound healing, the length of stay, early and late complications and mortality. Data was analysed to observe associations between patient and burn characteristics to the outcome parameters. Results: Mean TBSA was 20.83 ± 10.81 SD, mean total healing time was 18.15 days ± 8.50 SD while mean LOS was 9.51 days ± 5.45 SD. On Chi-square analysis for mortality versus burn thickness, no statistical significance was noted (p=0.53, OR: 0.93, 95% CI, 0.73 to 1.18) while mode of treatment (dressing versus grafting) was significantly affected by the thickness of the burn (p<0.001, OR: 0.69, 95% CI, 0.58 to 0.81). TBSA above 40% was strongly associated with mortality as well as with the presence of inhalational injury. TBSA was also associated with prolonged healing times and increased the length of stay (R2=0.48 and 0.73 respectively). Conclusion: Good outcome can be achieved with antibiotic and silver sulphadiazine dressing technique for partial thickness wounds while those with full thickness or deep partial thickness wounds will ultimately require split skin grafting.