• Jonas M Getzmann, Ksenija Slankamenac, Kai Sprengel, Lijo Mannil, Pietro Giovanoli, and Jan A Plock.
• Department of Plastic Surgery and Hand Surgery, Burn Center, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland; University of Zurich, Pestalozzistrasse 3, CH-8091 Zurich, Switzerland.
• J Plast Reconstr Aesthet Surg. 2019 Mar 1; 72 (3): 438-446.

IntroductionCombined burn trauma is rather uncommon and frequently difficult to manage. Historically combined burn trauma contributed to high mortality rates in severely injured patients. The purpose of this study was to determine the incidence, mechanisms and impact of non-thermal injuries in patients with severe burns.MethodsThe charts of 2536 patients admitted to the Burn Center of the University Hospital Zurich between 1977 and 2013 were reviewed and retrospectively analyzed. Patients with additional injuries were identified and analyzed statistically.ResultsOver 35 years from 1977 to 2013 a total of 100 burn patients (3.9%) with additional trauma were identified. Motor vehicle crash was the most common mechanism of injury (44%) from 1977 to 1995, compared to electrical injury (33%) from 1996 to 2013. Skeletal trauma including spinal and pelvic injury was the most common form (71%). Additional thoracic or abdominal trauma represented the highest risk factor for in-hospital mortality (adjusted RR 2.2, 95% CI 0.6-7.6). However, after 1995 the presence of any form of additional injury did not have a significant impact on in-hospital mortality (unadjusted RR 0.97, 95% CI 0.5-1.7, p = 0.914).ConclusionsConcomitant trauma did not reveal a significant impact on in-hospital mortality in our burn center recently. Retrospectively, trauma mechanisms shifted from motor vehicle crashes to electrical injuries in our population. Safety measures for motor vehicles and adequate emergency room algorithms seem to have contributed to a reduction of severity of injury and mortality.Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

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