ABSTRACT
【Objective】 To explore the influencing factors of blood transfusion in burn patients during hospitalization, so as to provide references for the development of individualized blood transfusion strategies. 【Methods】 116 cases of flame burns and 46 cases of high-voltage burns from Jan 2015 to Jan 2019 were retrospectively analyzed. The gender, age, height, weight, body mass index (BMI), burn surface area, burn depth, burn site, intraoperative blood loss, postoperative flow, number of operations, hospital stays, blood transfusion amount, whether complicated with inhalation injury, stress ulcer, amalgamative infection, hypertension, diabetes, cardio-related diseases, abnormal liver and kidney function and hypoalbuminemia in those two groups were statistically analyzed. 【Results】 During hospitalization, the mean blood volume of flame burn cases was (29.26±26.18)U, significantly higher than high-voltage burn cases as (13.26±10.32)U. The mean hemoglobin concentration (g/L) before blood transfusion of flame burn cases was (91.49±15.11)g/L, significantly higher than high-voltage burn cases as (81.70±14.49)g/L. There were statistically significant differences in gender, BMI, burn surface area, burn depth and burn site between flame burn cases and high-voltage burn cases (P<0.05). The average volume of blood transfusion during hospitalization was significantly affected by such factors as large burn area, trunk involvement, total intraoperative blood loss ≥2 000 mL, number of operations ≥6 times, hospital stay≥100 days, hypertension, cardio-related diseases, abnormal liver and kidney function, hypoproteinemia and so on (P<0.05), among which the total amount of intraoperative blood loss had the most significant effect on the flame burn patients (P<0.05), and the burn site had the most significant effect on the high voltage burn patients (P<0.05). 【Conclusion】 Large burn area, deep burn depth, important organs and/or large blood vessels involvement, number of operations ≥6, and the total intraoperative blood loss ≥2 000 mL contribute to the increase of average volume of blood transfusion. The hypertension, cardio-related diseases, abnormal liver and kidney function, and hypoproteinemia were high risk factors for increased blood transfusion volume during hospitalization, which deserves great attention.
ABSTRACT
This study was carried out to examine the effect of early excision and graft for the preservation of the maximal function on the dorsal hand with deep second degree and third degree flame burns. From December 1996 to October 1998, 11 flame burn patients admitted to our hospital burn unit. Nine patients had injured burns less than 20% Total Burn Surface Area, and 2 patients were 70% Total Burn Surface Area(mean 18.4%). We had performed the excision 3-8 days(mean 4.6 days) after burn injury. Ten (90.9%) of eleven patients survived, and 1 patient (Total Burn Surface Area 70%) died of sepsis after early excision. The duration of immobilization was 8-17 days (mean 11.5 days). Twelve months later, the range of motion in all patients has been continued to maintain nearly normal range of motion. We conclude that early excision and grafting was recommended as the preferred form of treatment in patients with deep second degree and third degree on the extensive flame burns of dorsal hand.