Changing concept in Burns Management- An Analytical study of Epidemiology, Morbidity, Mortality and Treatment in a period of forty years in the Indian state of Assam
Notice bibliographique
Résumé
There is an improvement in the morbidity and mortality in burns in the recent past due to better fluid resuscitation, use of better burn wound covers and early excision and skin grafting for full thickness burns. Burn care in the North Eastern Indian state of Assam was disorganized in the eighties, but individual efforts by some surgeons of the state, have improved outcome. This is a retrospective analysis of 8569 cases of burn injuries treated in three hospitals of Assam over a period of 40 years. The study intends to analyze the epidemiological pattern of burn injuries in order to plan preventive strategies and also to compare the results of treatment with and without an organized burn care unit. There were 7071 (82.3%) minor burns and 1518(17.7%) major burns in the series. The period of study was divided into three blocks - Block I- first 14 years of disorganized management, before establishment of Burns Unit, Block II -next 16 years of organized management after establishment of Burns Unit and Block III - last 10 years of advanced care with introduction of newer burn wound covers and early excision of burns. The data were analyzed and compared. The overall incidence of burns was more in males, but a greater number of females were the victims of major burns.77.2% of patients were below 40 years of age. The number of accidental burns remaining constant in the three blocks, there was a significant increase in the suicidal burns in the last two blocks. Flame burns (56.7%) constituted the majority of injuries, while scald (31.3%) and electrical burns (9.3%) followed. Domestic burns (73.1%) were of most common occurrence, followed by Industrial (10.8%), Diwali related (9.6%) and Traffic burns (6.4%). Though the overall mortality in the three blocks were almost same (Block I- 9.4%, Block II- 7.8% Block III-9.4%), mortality in major burns were reduced significantly after introduction of modern methods of management (Block I- 79.7%, Block II-52.0% Block III-38.4%). The quality of wound healing showed improvement in the subsequent years as evident by increase in number of patients with no scar (Block I -10%. Block II-20%, Block III- 37%) and decrease in number of patients with extensive scar (BlockI-18%, Block II- 15%, Block III-5%), measured by Vancouver Scar Scale. This analytical study has given us an understanding of the magnitude of the problem of burns in the region, which will help to plan treatment and preventive strategies. It also concludes that, dedicated individual care and introduction of newer methods of treatment have improved results of burn management. Key words: Epidemiology, treatment, morbidity and mortality
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,008 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».