Burn injuries remain a significant cause of morbidity and mortality, particularly among patients requiring intensive care. This retrospective study analyzed 66 burn patients admitted to the Burn ICU at Cipto Mangunkusumo Hospital, Indonesia, from January 2023 to December 2024, aiming to identify the primary causes of death, including sepsis, acute respiratory distress syndrome (ARDS), renal failure, gastrointestinal bleeding, and inhalation injury. The cohort had a mean age of 40.8 years, with a predominance of male patients (65.2%). The average total body surface area (TBSA) burned was 51.1%, and half of the patients sustained full-thickness burns. Inhalation injuries were present in 48.5% of cases. Sepsis emerged as the most common complication (83.1%), followed by ARDS (40.0%) and kidney failure (15.4%). Surgical interventions were performed in 69.7% of patients, with early tangential excision conducted in over half. Despite these efforts, the mortality rate remained high at 69.2%, and the mean abbreviated burn severity index (ABSI) score was 9.58. These findings highlight the critical burden of sepsis in burn-related deaths and underscore the need for enhanced infection control, early surgical management, and comprehensive ICU protocols to improve outcomes in this high-risk population.
Foot burns involve a small total body surface area but may cause significant functional impairment. Deep thermal foot burns often require surgical excision and split-thickness skin grafting, yet the optimal timing of grafting remains debated. Our objective is to describe patient characteristics, surgical management and healing outcomes of isolated deep thermal dorsal foot burns treated at a single burn centre. We conducted a retrospective cohort study including all patients surgically treated for partial- or full-thickness dorsal thermal foot burns at the Burn Centre of the University Hospital of Lille between 2021 and 2023. Two surgical strategies were used: excision followed by delayed grafting and single-stage excision with immediate grafting. Healing times were analyzed per burned foot. Sixty-three patients (75 feet) were included. Patients treated with delayed grafting were older and more frequently had bilateral foot burns. Burn severity was comparable between groups. Post-operative healing time was significantly shorter after single-stage excision and grafting, whereas total healing time from burn injury did not differ significantly. Dermal matrix use was not associated with differences in healing time. In this real-life retrospective cohort, single-stage excision and immediate grafting were associated with faster post-operative healing, while overall healing time remained similar between surgical strategies. Differences between groups reflect clinical decision-making based on patient and wound characteristics rather than a protocol-driven approach.
This retrospective descriptive epidemiological study aimed to investigate the incidence of burns during the cold season compared to other times of the year and to identify associated risk factors and clinical characteristics among hospitalized patients. A total of 402 medical records of patients admitted to the burn unit at the Department of Surgery, Udon Thani Hospital, between January 1, 2022, and December 31, 2024, were reviewed. Descriptive statistics were used to analyze demographic characteristics and incidence. Comparisons between the cold season and other seasons were conducted, and associations between risk factors and clinical outcomes were tested using the Chi-square test. The incidence of burns increased over the three-year period. Incidence during the cold season was 1.65 times higher than in other seasons (OR=1.65). Most patients were elderly females, and the majority of burns occurred due to domestic accidents. Adults were significantly more likely to sustain severe burns than other age groups (χ2=28.45, df=15, p=0.019). Complications were significantly associated with burn severity (χ2=45.78, df=3, p<0.001) and treatment costs (χ2=89.34, df=2, p<0.001). These findings indicate a higher burden of burn injuries during the winter, particularly among the elderly and women. Targeted prevention efforts, such as public safety education and improved first-aid training, are needed. Enhancing treatment protocols and referral systems could further reduce complications and the economic impact of burn injuries.
Indonesia, a country with a high incidence and burden of burn injuries, still faces limited numbers and uneven distribution of burn units, as well as the absence of operational guidelines. This review analyzes global burn unit operational systems to identify best practices that can be adapted for the development and optimization of burn units in Indonesia. A systematic search was conducted in electronic databases, including PubMed, Science Direct, Sage Journals, and MEDLINE. Inclusion criteria comprised studies focusing on managerial aspects of burn units. Literature search was done according to PRISMA guidelines, and included studies were critically appraised. Following screening and eligibility assessment of 1,046 studies, 20 studies were included in the review. A total of 6 guidelines provided recommendations for burn unit operational systems, and 13 studies offered recommendations for developing burn unit operational systems that could be implemented in Indonesia. Indonesia can adopt approaches from international guidelines to establish more burn units in priority areas based on needs, with operational design guidelines aligned with global standards to enhance the quality of care nationwide. Analysis of global burn unit operational systems successfully identified guidelines and recommendations for the development and management of burn units in Indonesia.
Management of burn wounds is challenging. Dressing changes, especially in paediatric burn patients, are a major concern. To address these challenges, numerous methods and advanced dressing materials have been developed. Collagen, a biocompatible material easily derived from natural sources, has emerged as a promising option. The primary goals are early wound healing, reduced pain sensitivity, and fewer dressing changes in the paediatric population. A prospective observational study was conducted among 38 paediatric patients, under 12 years of age, with scald burns. The study was conducted from 1st January 2024 to the end of October 2024. When a patient was admitted with scald burn, the wound was cleaned with normal saline and collagen materials were applied over the wound. This was followed by paraffin impregnated gauze and dry dressing. The first dressing was opened on day 5 and followed by dressing every 3 to 4 days until the wound healed. Thirty-three out of 38 patients (87%) were discharged within 12 days. Infection was found in 5 patients. No adverse reaction due to the application of collagen was observed. Collagen-based dressing is an important dynamic for burn wound management. Frequent change of dressing is avoided, with a significant impact on pain and psychological trauma among the paediatric population.
