Dr Isobel Yeap1, Dr Aruna Wijewardana1, Anne Darton1, Dr John Vandervord1
1Royal North Shore Hospital, St Leonards, Australia
Background: As well as allowing one to see, hear, speak, eat and breathe, the face is central to one’s ability to communicate expression and emotion. Consequently, burns to the face are especially debilitating and are associated with poorer functional and psychological outcomes.
Method: We conducted a retrospective chart review on 726 patients with facial burns who presented to Royal North Shore Hospital’s Severe Burns Unit during a ten-year period (2008 to 2017). Data were analysed using SPSS®. Multiple linear regression and binary logistic regression models were used.
Results: 82% of patients were male and 64% of patients had < 10% total body surface area (TBSA) burned. Amongst patients with TBSA > 10%, those with non-accidental burns were at a 5.27 times increased chance of dying during initial admission. The presence of inhalational injury was found to have no effect on mortality, once TBSA % burned and facial burn depth was accounted for. Amongst patients with TBSA < 10%, the presence of inhalational injury increased length of stay by 4.70 days on average, while those with non-accidental burns had an increased length of stay of 4.83 days.
Conclusions: Special care should be taken when treating patients whose burns are due to non-accidental causes, since they have a much higher chance of dying during initial admission. While the presence of inhalational injury increases a patient’s length of stay, it does not influence mortality, suggesting that our current treatment approach to inhalational injury may be highly successful.
Isobel is a resident medical officer who has worked with the Severe Burns Unit and Plastic Surgery Department at Royal North Shore Hospital. Prior to studying medicine, she completed her Bachelor (Honours) in Economics.