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. 2010 Jun 30;23(2):59-66.

A new era in the management of burns trauma in kumasi, ghana

P Agbenorku  1 , J Akpaloo, D Yalley, A Appiah
Affiliations

A new era in the management of burns trauma in kumasi, ghana

P Agbenorku et al. Ann Burns Fire Disasters. .

Abstract
in English, French

The aim of the study was to investigate the factors affecting the outcome of treatment of burns patients admitted to the Burns Intensive Care Unit (BICU) of the Komfo Anokye Teaching Hospital, Kumasi, Ghana. Information on patients admitted to the BICU from February 2001 to January 2006 was recorded. Parameters recorded included: admission record and demographics, causes of the injury, burned surface area, laboratory investigations, treatment regime, and record of discharge/death. The data were analysed with SPSS version 12.0 and Spearman's rank correlation. A total of 826 patients were recorded; males (n = 492, 60%) outnumbered females (n= 334, 40%). The mean age was 10.5 ± 5 yr, the majority (n = 441, 53%) in the range 0-10 yr. Flame burns (n = 587, 71%), scalds (n = 209, 25%), and chemicals (n = 19, 2%) were the three significant causes of burn injuries. The mean range of the total body surface area (TBSA) burned was 11-20%; 94% (n = 775) had up to 60% TBSA; 64% (n = 527) had only wound dressings for treatment; 21% (n = 174) had early excision with skin grafting, while 15% (n = 125) had delayed excision with skin grafting. The majority (n = 563, 68%) of the patients stayed for less than 10 days after admission. The mortality rate fell over the years, decreasing drastically between 2001 (20.4%) and 2002 (8.6%) and remaining at single digit level in 2003 (7.6%), 2004 (7.9%), and 2005 (7.4 %). The factors affecting the mortality trends were proper case management, increases in the number of professional medical personnel, and their greater dedication.

Les Auteurs de cette étude, dans le but d'examiner les facteurs qui influaient sur les résultats du traitement des patients hospitalisés dans l'unité de soins intensifs auprès du Centre des brûlés (SICB) de l'hôpital universitaire Komfo Anokye, Kumasi, Ghana, ont enregistré les informations sur les patients admis au Centre entre février 2001 et janvier 2006. Les paramètres enregistrés incluaient: dossier d'admission et démographie, causes de l'accident, extension de la surface brûlée, les analyses de laboratoire, le régime de traitement, et le résultat final (sortie de l'hopital ou décès). Les données ont été analysées avec SPSS version 12,0 et corrélation de rang de Spearman. En tout, 826 patients ont été enregistrés; les mâles (n = 492, 60%) étaient plus nombreux que les femelles (n = 334, 40%). L'âge moyen était de 10,5 ± 5 ans, la majorité (n = 441, 53%) dans l'intervalle 0-10 ans. Les trois causes les plus importantes des brûlures étaient les flammes (n = 587, 71%), les ébouillantements (n = 209, 25%) et les produits chimiques (n = 19, 2%). L'extension moyenne de la surface corporelle totale brûlée (SCTB) variait entre 11 et 20%; dans 94% des cas (n = 775) la SCTB n'excédait pas 60%; 527 patients (64%) ont été traités seulement avec des pansements; et 174 patients (21%) ont subi l'excision précoce suivie de greffe cutanée et 125 (15%) l'excision retardée suivie de greffe cutanée. La plupart des patients (n = 563, 68%) ont été hospitalisés moins de 10 jours. Le taux de mortalité a diminué au fil des ans, en manière marquée entre 2001 (20,4%) et 2002 (8,6%) pour rester au niveau d'un seul chiffre en 2003 (7,6%), 2004 (7,9%) et 2005 (7,4%). Une prise en charge plus adéquate et l'incrément du personnel médical et de son dévouement ont constitué les facteurs majeurs qui influaient sur les tendances de la mortalité.

Keywords: burns intensive care unit; burns trauma; early surgical intervention; mortality; total burned surface area.

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Figures

Fig. 1
Fig. 1. Age distribution of patients admitted to the Komfo Anokye Teaching Hospital Burns Intensive Care Unit.
Fig. 2
Fig. 2. Sex distribution of patients in the various years.
Table I
Table I. Percentage of total body surface area (TBSA) burned and burns degree in the various years (2001-2005)
Fig. 3
Fig. 3. Aetiology of the burn injuries.
Fig. 4
Fig. 4. "Types of burns treatment administered in the various years (WD = wound dressing; EE = early excision and split-thickness skin grafting; DE = delayed excision and split-thickness skin grafting)."
Fig. 5
Fig. 5. Burns treatment trends in the various years (WD = wound dressing; EE = early excision and split-thickness skin grafting; DE = delayed excision and split-thickness skin grafting).
Fig. 6
Fig. 6. Duration of hospital admission.
Table II
Table II. Total number of deaths recorded in the various years (2001-2005)
Fig. 7
Fig. 7. Graph of mortality rate measured against TBSA (%).
Fig. 8
Fig. 8. Graph of mortality rate measured against age (yr).
Fig. 9
Fig. 9. Graph of TBSA (%) against duration of hospital stay.
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