740 Mechanisms, Outcomes and Management of Pavement Burns

Autor: Syed F Saquib, Matthew T. Eisenberg, Paul J. Chestovich
Rok vydání: 2020
Předmět:
Zdroj: Journal of Burn Care & Research. 41:S201-S202
ISSN: 1559-0488
1559-047X
DOI: 10.1093/jbcr/iraa024.322
Popis: Introduction Burns from contact with hot pavement are commonly seen at burn centers located in desert climates. Previous work has shown increased risk of pavement burns as ambient temperatures rise above 95 degrees. In direct sunlight pavement absorbs radiant energy causing it to rise to temperatures high enough to cause second degree burns in under 35 seconds. This study aims to review the experience of treating pavement burns in a desert climate. Methods A retrospective chart review was performed on pavement burns at an ABA-verified Burn Center for 5 years from 2014–2018. The data collected included %TBSA, surface area per body region, cause, operative management, comorbidities, complications, incident location and cause of death. Patients were separated by cause into groups which included found down, walked on pavement, heat/dehydration, mechanical fall, syncope, seizure, trauma, substance/psych and unknown. Results A total of 185 patients admitted for pavement burns were identified in the study period. The average length of stay for survivors was 16.7 days. Of the survivors, 23% spent time in the ICU with an average stay of 11.4 days. The average TBSA was 5.5% (IQR 2–7.5%) with a maximum of 25%. TBSA breakdown by body region is shown in figure 1. It was found that 50.5% of admitted pavement burn patients required burn excision and 35.9% required split thickness skin grafting. The leading causes of pavement burn admissions were being found down by EMS and walking on pavement at 21.6% each, followed by mechanical falls at 15.1% (See figure 2). Of the 185 patients admitted 17.8% were under the influence of alcohol or drugs. Comorbidities were common; 32.4% had hypertension, 21.6% had diabetes, 13.5% had neuropathy, 2.2% had coronary artery disease, 5.4% had chronic kidney disease. Of the patients that walked on pavement to receive their burns, 50% also had peripheral neuropathy. Rhabdomyolysis developed in 5.4%, and hospital 30-day mortality was 4.9%. Conclusions Pavement burns are a common burn mechanism in hot and sunny climates, but may be seen in other locations during periods of high heat. Patients at risk are those with medical comorbidities and who come in contact with hot pavement for long time periods. Applicability of Research to Practice Data provided from this study can be used for a public health initiative to help patients who may be at risk of acquiring pavement burns. The data may also be helpful for clinicians gaining information about the management, cause and outcomes of pavement burn patients.
Databáze: OpenAIRE
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