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Mobayen M, Torabi H, Bagheri Toolaroud P, Tolouei M, Dehnadi Moghadam A, Saadatmand M, EslamiKenarsari H, Feizkhah A, Ghazanfari MJ, Osuji J, Ghorbani Vajargah P, Karkhah S. Acute burns during the COVID-19 pandemic: A one-year retrospective study of 611 patients at a referral burn centre in northern Iran. Int Wound J 2023; 20:3204-3211. [PMID: 37095647 PMCID: PMC10502268 DOI: 10.1111/iwj.14199] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/26/2023] Open
Abstract
Patients with acute burns are more vulnerable to COVID-19 because of physiologically weak immune systems. This study aimed to assess and compare individual characteristics, clinical features, and clinical outcomes of acute burn among COVID-19 and non-COVID-19 patients. A retrospective study, with data collected from 611 acute burn patients with or without a COVID-19 diagnosis referred to a burn centre in Iran. Data were collected from April 2020 to 2021. The mean age of acute burns patients with COVID-19 was higher compared with acute burns patients with non-COVID-19 (47.82 vs. 32.59 years, P < .001). Acute burns occurred more frequently in COVID-19 patients with comorbidities compared with non-COVID-19 patients (48.72% vs. 26.92%, P = .003). 58.97% of COVID-19 patients and 55.42% of non-COVID-19 patients had grade II & III and II burns, respectively (P < .001). The mean total body surface area of the burn was higher in COVID-19 patients compared with non-COVID-19 patients (32.69% vs. 16.22%, P < .001). Hospitalisation in the intensive care unit (ICU) was higher in COVID-19 patients than in non-COVID-19 patients (76.92% vs. 15.73%, P < .001). Length of stay in hospital and ICU, the cost of hospitalisation, and waiting time for the operating room was higher in COVID-19 patients compared with non-COVID-19 patients (15.30 vs. 3.88 days, P < .001; 9.61 vs. 0.75 days, P < .001; 30 430 628.717 vs. 10 219 192.44 rials, P = .011; 0.84 vs. 0.24 min, P < .001, respectively). Intubation and mortality in-hospital were higher in COVID-19 patients compared with non-COVID-19 patients (41.02% vs. 6.99%, P < .001; 35.90% vs. 6.12%, P < .001, respectively). Therefore, it is recommended that health managers and policymakers develop a care plan to provide high-quality care to acute burns patients with COVID-19, especially in low-income countries.
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Affiliation(s)
- Mohammadreza Mobayen
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Hossein Torabi
- Department of General Surgery, Poursina Medical & Educational CenterGuilan University of Medical SciencesRashtIran
| | | | - Mohammad Tolouei
- Department of General Surgery, Faculty of MedicineGuilan University of Medical SciencesRashtIran
| | | | - Mohammad Saadatmand
- Clinical Research Development Unit of Poursina HospitalGuilan University of Medical SciencesRashtIran
| | - Habib EslamiKenarsari
- Poursina Clinical Research Development UnitGuilan University of Medical SciencesRashtIran
| | - Alireza Feizkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical Physics, School of MedicineGuilan University of Medical SciencesRashtIran
| | - Mohammad Javad Ghazanfari
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| | - Joseph Osuji
- School of Nursing and Midwifery, Faculty of Health, Community, and EducationMount Royal UniversityCalgaryAlbertaCanada
| | - Pooyan Ghorbani Vajargah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Samad Karkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
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Enzymatic Debridement in Severe Burn COVID-19 Patients: A Case Series. Plast Reconstr Surg Glob Open 2023; 11:e4808. [PMID: 36714389 PMCID: PMC9875794 DOI: 10.1097/gox.0000000000004808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/14/2022] [Indexed: 01/26/2023]
Abstract
The presence of a high number of positive SARS-CoV-2 patients is found daily in the emergency room database, finding evidence of infection also in trauma and burns. Surgical debridement remains the gold standard for eschar removal, but it does not come without complications such as bleeding and high heat loss. In recent years, there has been an increase in the use of enzymatic debridement techniques, replacing surgical escharotomy. Early eschar removal is proven to be important; it has been proved that an early and effective burn treatment in COVID-19 patients can reduce other infection. Five clinical cases of patients arrived at our COVID-19 Major Burns Intensive Care Unit. On admission, burns extension and depth were assessed by an expert burn surgeon. We evaluated eschar removal modality, adverse events, and potential side effects. Enzymatic debridement was efficient in all patients treated with complete eschar removal, and no serious adverse events. All patients were treated within 24 hours of arrival at our facility with Nexobrid by specialized personnel in deep sedation and with O2 support using a face mask or nasal goggles. The use of enzymatic debridement in COVID-19-positive burn patients within dedicated pathways through nonsurgical treatment optimizes the treatment time. We believe that the use of enzymatic debridement could be a valid therapeutic option in burn patients, even with SARS-CoV-2 infection, and its use, when indicated, is safe and effective for the patient and optimizes the use of instrumental and human resources in a pandemic emergency.
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Liu S, Wang X, Chen L, Wang W, Song N, Lu Y. Changes in the types of patients in Burn Unit: A single center experience. BURNS OPEN 2022. [DOI: 10.1016/j.burnso.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Bucher F, Dastagir K, Obed D, Dieck T, Vogt P. Sustained high demand for intensive care unit resources for the treatment of burn patients during the COVID-19 pandemic in Northern Germany: A single-centre cross-sectional study. JPRAS Open 2022; 34:82-90. [PMID: 35847563 PMCID: PMC9271355 DOI: 10.1016/j.jpra.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/28/2022] [Accepted: 07/06/2022] [Indexed: 11/03/2022] Open
Abstract
Introduction Patients and methods Results Conclusion
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Erturk A, Demir S, Oztorun Cİ, Erten EE, Guney D, Bostanci SA, Sahin VS, Kiris AG, Bay HK, Bedir Demirdag T, Keskin G, Azili MN, Senel E. Management of a pediatric burn center during the covid-19 pandemic. J Burn Care Res 2021; 43:468-473. [PMID: 34313735 PMCID: PMC8344618 DOI: 10.1093/jbcr/irab137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to evaluate the results of an algorithm that was created to prevent coronavirus disease-2019 (COVID-19) transmission during the management of children with burns in a tertiary pediatric burn center. Children admitted to the burn center between May 2020 and November 2020 were prospectively evaluated for cause, burn depth, total body surface area (TBSA), length of stay, symptoms suggesting COVID-19, suspicious contact history, history of travel abroad, and COVID-19 polymerase chain reaction (PCR) test results. Patients were divided into two groups: unsuspected (Group 1) and suspected (Group 2), depending on any history of suspicious contact, travel abroad, and/or presence of symptoms. A total of 101 patients were enrolled in the study, which included 59 boys (58.4%) and 42 girls (41.6%). Group 1 included 79 (78.2%) patients, and Group 2 consisted of 22 (21.8%) patients. The most common cause of the burns was scald injuries (74.2%). The mean age, TBSA, and length of stay were 4.5 years, 12.0%, and 13.2 days, respectively. Four patients (3.9%) had a positive PCR test (two patients in each group). Comparing groups, males were more commonly found in Group 2 (p=0.042), but no differences were found for the other variables. No patients or burn center staff members developed COVID-19 during the course of hospitalization. In conclusion, every child should be tested for COVID-19 upon admission to a burn unit, and a modified algorithm should be constructed for the handling and management of pediatric burn patients.
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Affiliation(s)
- Ahmet Erturk
- Ankara City Hospital, Children Hospital, Department of Pediatric Surgery, Bilkent, Ankara, Turkey
| | - Sabri Demir
- Ankara City Hospital, Children Hospital, Department of Pediatric Surgery, Bilkent, Ankara, Turkey
| | - Can İhsan Oztorun
- Ankara Yildirim Beyazit University, Medical Faculty, Department of Pediatric Surgery, Ankara, Turkey
| | - Elif Emel Erten
- Ankara City Hospital, Children Hospital, Department of Pediatric Surgery, Bilkent, Ankara, Turkey
| | - Dogus Guney
- Ankara Yildirim Beyazit University, Medical Faculty, Department of Pediatric Surgery, Ankara, Turkey
| | - Suleyman Arif Bostanci
- Ankara City Hospital, Children Hospital, Department of Pediatric Surgery, Bilkent, Ankara, Turkey
| | - Vildan Selin Sahin
- Ankara City Hospital, Children Hospital, Department of Pediatric Surgery, Bilkent, Ankara, Turkey
| | - Atike Gulsah Kiris
- Ankara City Hospital, Children Hospital, Department of Pediatric Surgery, Bilkent, Ankara, Turkey
| | - Hatice Kübra Bay
- Ankara City Hospital, Children Hospital, Department of Pediatric Surgery, Bilkent, Ankara, Turkey
| | - Tugba Bedir Demirdag
- Ankara City Hospital, Children Hospital, Department of Pediatric Infectious Disease, Bilkent, Ankara, Turkey
| | - Gulsen Keskin
- Ankara City Hospital, Children Hospital, Department of Anesthesiology and Reanimation, Bilkent, Ankara, Turkey
| | - Mujdem Nur Azili
- Ankara Yildirim Beyazit University, Medical Faculty, Department of Pediatric Surgery, Ankara, Turkey
| | - Emrah Senel
- Ankara Yildirim Beyazit University, Medical Faculty, Department of Pediatric Surgery, Ankara, Turkey
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Aggarwal N, Srivastava RK. Impact of COVID-19 on Patient Trends and Outcome: Results from a Tertiary Care Burn and Plastic Unit in Northern India. Indian J Plast Surg 2021; 54:172-176. [PMID: 34239240 PMCID: PMC8257301 DOI: 10.1055/s-0041-1729511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background
Burn and trauma injuries need emergency care and resuscitation, which required uninterrupted delivery of inpatient care services during the coronavirus disease 2019 (COVID-19) pandemic. Burn patients are physiologically immunocompromised, increasing the risk of COVID-19 infection in them. This study analyzes the impact of COVID-19 pandemic on patient trends in a burn and plastic unit and assesses the effect of COVID-19 infection in burns.
Methods
This single-center, retrospective observational case–control study was conducted in the Department of Burns, Plastic and Maxillofacial Surgery of a tertiary care hospital in New Delhi, India. Patient data was collected from April 1, 2019 to August 10, 2019 and from April 1, 2020 to August 10, 2020. All data of burns and trauma patients collected was analyzed and compared.
Results
There were total 350 admissions during COVID time period and 562 admissions during non-COVID time period. The admission rate, type of burn injury, and death rate did not vary significantly during the two time periods. Thermal burn was the most common type of burn injury. There were total 18 cases diagnosed to be COVID-19 positive during the pandemic. There were two deaths among COVID-19 positive burn cases.
Conclusion
This study finds no difference in patient patterns during COVID and non-COVID time period. Amongst burn patients, no increased risk of COVID-19 infection is seen with larger body surface area of burns. No increase in mortality is seen in burn patients infected with COVID-19.
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Affiliation(s)
- Nupur Aggarwal
- Department of Burns, Plastic and Maxillofacial Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Rakesh Kumar Srivastava
- Department of Burns, Plastic and Maxillofacial Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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