The First Burns Unit Practice in Our Province from the Perspective of A General Surgeon

Öz

Background: To share the first burn unit practice in Yozgat province and emphasize the importance of the "burns unit" in the treatment of burn injuries.
Materials and Methods: The study was carried out retrospectively at Yozgat City Hospital between June 2020 and April 2021. The patients who were inpatient or outpatient in our burns unit during this period were included in the study. Patients' age, gender, cause of the burn, total burn surface area, burn location, length of hospital stay, treatment methods were determined from electronically recorded patient data.
Results: A total of 107 patients were treated as outpatients or inpatients, 57 (53.3%) were male, 50 (46.7%) were female, and the median age was 24 (range, 1-88). Of all burn injuries, 85 (79.4%) were caused by scalding, 21 (19.6%) from flame, and 1 (0.9%) from electricity. In terms of the burn severity, the most common was second-degree burns and were determined in 58 (54.2%) patients. The trunk was the most frequently affected area and was seen in 47 (45.8%) patients. Of the burn injuries, 43 (40.2%) were treated by hospitalization and the median length of stay was 3 days (1-90). Of the inpatients, 24 (55.8%) were scalded, 18 (41.9%) had flame burns, and 1 (2.3%) had electrical burns. It was found that standard medical dressing treatment was applied to 33 (76.7%) of the hospitalized patients, graft treatment was applied to 4 (9.3%), and placenta application was applied to the burned area in 6 (14%) patients. No mortality was seen in any of the patients.
Conclusions: A successful treatment of many burn injuries in "burns room" units with a competent team will significantly decrease unnecessary referrals to advanced burn centers. Thus, the workload of these centers will be reduced and the country's resources will be used more efficiently.

Genel Cerrah Perspektifinden İlimizin İlk Yanık Birimi Pratiği

Öz

Amaç: İlimizin ilk yanık tedavi birimi deneyimini paylaşarak yanık yaralanmalarının tedavisinde “yanık odasının” önemini vurgulamak amaçlandı.
Materyal ve metod: Çalışma Haziran 2020- Nisan 2021 tarihleri arasında Yozgat Şehir Hastanesi’nde retrospektif olarak gerçekleştirildi. Bu süreç içerisin de yanık birimimizde yatırılarak veya ayaktan tedavi edilen hastalar çalışmaya dahil edildi. Hastaların yaş, cinsiyet, yanık nedeni, toplam yanık yüzey alanı, yanık bölgesi, hastane yatış süresi, uygulanan tedavi yöntemleri elektronik kayıtlı hasta verilerinden belirlendi.
Bulgular: Toplam 107 hasta ayaktan veya yatırılarak tedavi edildiği, bunların 57’sinin (% 53,3) erkek, 50’sinin (% 46,7) kadın ve ortanca yaş değerinin 24 (aralık, 1-88) olduğu görüldü. Tüm yanık yaralanmalarının, 85’i (% 79,4) haşlanma, 21’i (% 19,6) alev ve 1’i (%0,9) elektrik kaynaklıydı. Yanık derinliği yönünden en sık karşılaşılan 2.dereceden derin yanıklardı ve 58 (% 54,2) hastada saptandı. Gövde bölgesi en sık etkilenen bölgeydi ve 47 (%45,8) hastada görüldü. Yanık yaralanmalarının 43’ü (% 40,2) yatırılarak tedavi edildiği, yatış süreleri ortanca 3 gün (1-90) olduğu saptandı. Yatarak tedavi alan hastaların 24’ünü (% 55,8) haşlanma, 18’ini (% 41,9) alev yanıkları ve 1’ini (% 2,3) elektrik yanıkları oluşturmaktaydı. Yatan hastaların 33’üne (% 76,7) standart pansuman tedavisinin, 4’üne (% 9,3) greft tedavisinin ve 6’sına (% 14) plasenta uygulamasının yapıldığı görüldü. Hastaların hiçbirinde mortalite görülmedi.
Sonuç: Birçok yanık yaralanmasının, yetkin bir ekiple “yanık odası” birimlerinde başarıyla tedavi edilmesi, ileri yanık merkezlerine gereksiz sevkleri önemli oranda azaltılacaktır. Böylece bu merkezlerin iş yükü azaltılmış ve ülke kaynakları daha verimli kullanılmış olacaktır. 

Anahtar Kelimeler

• Haşlanma yanığı
• alev yanığı
• yanık birimi
• yanık yaralanması
• yanık

Kaynakça

1. Dissanaike S, Ha D, Mitchell D, Larumbe E. Socioeconomic status, gender, and burn injury: A retrospective review. The American Journal of Surgery. 2017;214(4):677-81.
2. Algoritması. SHDBT. YANIK YARALANMALARI TEDAVİ ALGORİTMASI T.C. SAĞLIK BAKANLIĞI; 2012 [cited 2012].
3. Alexander M, Chaudry IH, Schwacha MG. Relationships between burn size, immunosuppression, and macrophage hyperactivity in a murine model of thermal injury. Cellular immunology. 2002;220(1):63-9.
4. Sıkar HE, Yurdakul Sıkar E. Afyonkarahisar Devlet Hastanesi’nde yanık nedeniyle tedavi edilen hastaların değerlendirilmesi: retrospektif çalışma. Kocaeli Tıp Dergisi. 2018;7(1):92-5.
5. Özçetin B, Tihan D, Demirci H, Altİntaş MM, Arayİcİ V, Taha A. Yeni kurulan bir yanık merkezinde 2.5 yıllık deneyim. Turkish Journal of Surgery/Ulusal Cerrahi Dergisi. 2012;28(3).
6. Çınal H, Barın EZ. Bir Yanık Ünitesinin 5 Yıllık Deneyimi: 667 Yanık Olgusunun İncelenmesi. Van Tıp Dergisi.27(1):56-62.
7. Crowe CS, Massenburg BB, Morrison SD, Naghavi M, Pham TN, Gibran NS. Trends of burn injury in the United States: 1990 to 2016. Annals of surgery. 2019;270(6):944-53.
8. Alipour J, Mehdipour Y, Karimi A. Epidemiology and outcome analysis of 3030 burn patients with an ICD-10 approach. Annals of burns and fire disasters. 2020;33(1):3.

9. Bahçe ZŞ, Öztaş T. Epidemiological analysis of patients with burns in third‐line hospitals in Turkey. International wound journal. 2020;17(5):1439-43.
10. Park JO, Do Shin S, Kim J, Song KJ, Peck MD. Association between socioeconomic status and burn injury severity. Burns. 2009;35(4):482-90.
11. Knowlin L, Stanford L, Moore D, Cairns B, Charles A. The measured effect magnitude of co-morbidities on burn injury mortality. Burns. 2016;42(7):1433-8.
12. Forbinake NA, Ohandza CS, Fai KN, Agbor VN, Asonglefac BK, Aroke D, et al. Mortality analysis of burns in a developing country: a CAMEROONIAN experience. BMC Public Health. 2020;20(1):1-6.
13. Williams FN, Strassle PD, Knowlin L, Napravnik S, van Duin D, Charles A, et al. Sex-based differences in Inpatient burn Mortality. World journal of surgery. 2019;43(12):3035-43.
14. Mohammadi AA, Pakyari MR, Jafari SMS, Tavakkolian AR, Tolide-Ie HR, Moradi Z, et al. Effect of burn sites (upper and lower body parts) and gender on extensive burns’ mortality. Iranian journal of medical sciences. 2015;40(2):166.
15. Mohammadi AA, Johari HG. Interesting differences between the burns involving the upper versus lower extremities. The Journal of trauma. 2009;66(6):1746-7.
16. Braza ME, Fahrenkopf MP. Split-Thickness Skin Grafts. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2021, StatPearls Publishing LLC.; 2021.
17. Klama-Baryła A, Łabuś W, Kitala D, Kraut M, Nowak M, Kawecki M. Experience in Using Fetal Membranes: The Present and New Perspectives. Transplantation proceedings. 2018;50(7):2188-94.