• Jared R Gallaher, Stephen Mjuweni, Mansi Shah, Bruce A Cairns, and Anthony G Charles.
• Department of Surgery, University of North Carolina, School of Medicine, CB# 7228, Chapel Hill, NC, USA.
• Burns. 2015 Sep 1; 41 (6): 1353-9.

BackgroundThis study sought to establish appropriate timing of burn wound excision and grafting in a resource-poor setting in sub-Saharan Africa.MethodsAll burn patients (905 patients) admitted to Kamuzu Central Hospital (KCH) Burn Unit in Lilongwe, Malawi over three years (2011-2014) were studied.Results275 patients (30%) had an operation during their admission. In patients who received an operation, median age was 5 years (IQR, 2.7-19) and median total body surface area burn was 15% (IQR, 8-25). 91 patients (33%) had early excision (≤5 days) and 184 patients (67%) had late excision (>5 days). Mortality was significantly greater in the early group (25.3% vs. 9.2%, p=0.001). Controlling for total body surface area burn and age, the adjusted predictive probability of mortality were 0.256 (CI 0.159-0.385) and 0.107 (CI 0.062-0.177) if operated ≤5 and >5 days, respectively (p=0.0114). The odds ratio for mortality if operated >5 days is 0.34 (CI 0.15-0.79, p<0.000).ConclusionsEarly excision and grafting in a resource-poor area in sub-Saharan Africa is associated with a significant increase in mortality. Delaying the timing of early excision and grafting of burn patients in a resource-poor setting past burn day 5 may confer a survival advantage.Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

36 keywords...

hide…