Clinical Analysis of Inhalation Burn

Bae, Sun Young; Kim, Sei Joong; Choi, Sun Keun; Choi, Kwang Ho; Hur, Yoon Seok; Lee, Keon Young; Seo, Jeoun Meen; Ahn, Seung Ik; Hong, Kee Chun; Shin, Seok Hwan; Woo, Ze Hong

Abstract

PURPOSE: The mortality rate of burn patients dying from burn shock or sepsis is declining owing to improved treatment methods such as advances in fluid therapy and antibiotic application. Over the past 10 years, however, damage to the trachea and the lungs caused by inhalation of poisonous gases in closed spaces and the resulting complications have become the primary causes of death for burn patients. The purpose of this study is to appraise the clinical significance of inhalation burn by focusing the analysis on the mass- produced burn patients from a recent short period.
METHODS
This study involved 23 patients who were admitted to the Department of General Surgery from the Emergency Room at the Inha University Hospital after suffering burns in a fire that broke out at a pub in Inchon, Korea, on 30 October 1999.
RESULTS
The average age was 16.6 and most of the patients were adolescents. The average of the total burn surface was 7%, with 17 patients (73.9%) having less than 5%. A bronchoscopy was applied to all the patients. A total of 13 patients (56.5%) had intubation. Of these, 4 had a tracheostomy three days after hospitalization. Of the 23 patients who were the subjects of this clinical study, 12 patients, accounting for 52.2% of the total, developed pneumonia. Two people also developed tracheal stenosis and both of them underwent a tracheal resection and anastomosis. Four patients had to receive psychiatric treatment due to post traumatic stresss disorder. None of the 23 patients died. CONCLUSION: In the case of burns suffered in confined areas, an inhalation burn, rather than the mere size of the burn, will have a greater bearing on fatality and the occurrence of pulmonary complications. For this reason, one cannot overemphasize the importance of preventing fire by taking appropriate safety precautions and keeping the surroundings clear of inflammable materials. However, once burn injury occurs, every effort should be made to ensure that there will be minimum after effects and scars through earliest possible intervention.