Pavement Burns in New Mexico: Our Experiences, Treatments, and Outcomes

Abstract

This study focused on patients treated at the University of New Mexico Burn Center who sustained burn injuries from contact with environmentally heated pavement. We report on our patient demographics and outcomes as well as describe our institutional staged surgical approach to treatment. We provide a comparison of our results with other case reports as well as other findings. A retrospective review of patients admitted to the University of New Mexico Burn Center with injuries suffered from contact with hot pavement was performed. Patients were stratified on the presence or absence of altered mental status (AMS) and additional inciting factors. A total of six patients were reviewed from 2018 to 2019. We looked at patient demographics and comorbidities, time of contact with hot pavement, inciting factors, total body surface area (TBSA) burned, location of areas burned, depth of burn injury at the time of presentation and at the time of initial operative debridement, percentage of autograft take, complications, length of stay (LOS), and final disposition. The patients in our study had a mean TBSA of 9.82% corresponding to pressure points of the body. All patients had nearly 100% conversion to full-thickness burns at the time of initial operative debridement. With staged excision and split-thickness autografting, our patients had nearly 100% take of their skin grafts with minimal graft loss or related complications. At the time of presentation, 100% of patients had AMS and 66% (4/6) had a drug- or alcohol-related inciting event. Finally, the average LOS was 19.5 days in comparison to 7 to 9 days for uncomplicated burns of equivalent size at our burn center. Despite an initial appearance of a partial-thickness burn, pavement burns had a high propensity to convert to full-thickness burns. Patients with AMS contributed to our patient population being found with pavement burns. Patients with pavement burns had a distinct anatomic pattern corresponding to pressure points of the body which were often areas at high risk for skin and wound breakdown and complications. Staged excision and split-thickness autografting in the treatment of pavement burns yielded excellent results. Finally, our data showed that providers must be prepared for an extended LOS for patients with pavement burns.