Eight years experience of a regional burns unit in Saudi Arabia: clinical and epidemiological aspects.

A retrospective analysis of 435 consecutive admissions to a regional burns unit over an 8-year period is presented. The majority were domestic accidents, while a few were suicidal and two were due to child abuse. Scalds were commoner than flame burns, 70.6 per cent were children under 12 years, 12.4 per cent had > 40 per cent TBSA affected, 66.9 per cent were deep partial or full thickness burns, 24.4 per cent had signs of shock on admission, 13.6 per cent had smoke inhalation injury. In spite of these known adverse factors the overall outcome was satisfactory, with a case fatality rate of 7.4 per cent and a residual disability rate of 10.8 per cent. Good initial resuscitation, a low infection rate (18.4 per cent) and the ready availability of appropriate surgical intervention (35.6 per cent), with good intensive care support, could account for the satisfactory outcome.

Initiating a new renal transplant program: problems and results.

Patients from the North-West area of Saudi Arabia had to travel to Riyadh or Jeddah for renal transplantation and post-transplant follow-up. The administration of the North-West Armed Forces Hospitals Program provided medical expertise and financial support to set up a renal transplant program in this area. Suitable staff members including nephrologists, transplant surgeons, staff nurses social workers and laboratory personnel were recruited. A strong link was established with the Saudi Canter for Organ Transplantation in Riyadh. At the end of two years since establishment, 25 renal transplants (11 cadaver donor and 14 living donor) have been performed. During follow-up, nine patients developed serious infection including pneumonia, wound infection and tubercu-losis; all were managed successfully. Three grafts were lost necessitating graft nephrectomy and there were four deaths. The two-year graft survival is 83.3% and patient survival, 84%. These results are highly satisfactory taking into consideration the fact that our transplant program is new.

Outcome of commercial renal transplantation: two years follow-up.

The results of living non-related renal transplants from India involving unethical exploitation of the donor are inferior. We followed-up 12 patients from our unit who went to a center in Bombay for renal transplantation and compared the results with our local new renal transplant programme. Two-year graft survival was 70% compared to 88% with our new renal transplant program. Also, we emphasised the human side of the problem. We addressed the problem of shortages of organ donation locally because failure to obtain consent from relatives and the need for intensive public education is required to overcome this problem. Finally, Islamic principles and rules that are related to organ transplantation have been discussed in detail, and the main purpose is to enlighten the Western reader.

Analysis of 105 patients admitted over a 2-year period to a modern burns unit in Saudi Arabia.

This is an epidemiological survey of 105 burned patients treated between May 1986 and May 1988 in a modern Burns Unit in Saudi Arabia. Hospitalization time ranged from 1 to 100 days with a mean of 17 days. The mean age of the patients was 9 years. Sixty (57 per cent) of the patients were males and 45 (43 per cent) were females. The main causes of injury were hot liquids (57.7 per cent) and fire (33 per cent). The mean extent of injury was 19 per cent TBSA. Burns covered less than 40 per cent TBSA in 91 out of 105 patients (87 per cent). Deep burns did not exceed 100 units of burned skin in 48 out of 55 patients (87 per cent). Urgent escharotomy was done in 14 patients. Early excision and skin grafting was carried out in 34 patients. Complications included six cases (5.7 per cent) with septicaemia, one (0.9 per cent) with disseminated intravascular coagulopathy, three (2.9 per cent) with amputation and one (0.9 per cent) with stress gastric ulcer. Seven patients discharged themselves against medical advice. Five patients died. The favourable results in this series were attributed mainly to the low severity of burns and partially to the short delay between injury and admission, early surgery and remarkably good facilities. Childhood scalds in this region of the world could possibly be reduced by changing the family habit of having tea at floor level and recommending wide-based tea-pots.