Effect of prehospital topical application of water and other agents on outcome in burn injured patients: A prospective study

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns Pub Date : 2024-12-16 DOI:10.1016/j.burns.2024.107357

O.A. Olawoye , C.P. Isamah , S.A. Ademola , A.O. Iyun , A.I. Michael , R.O. Aderibigbe , O.M. Oluwatosin

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引用次数: 0

Abstract

Introduction

Topical agents applied to the burn wound as first aid measures have been noted to impact outcomes. The application of cool running water is effective when administered for at least 20 min within 3 h of burn as recommended by the Australian and New Zealand Burn Association. However, the American Burn Association recommends running water for 5 min, and only in minor burns. In Nigeria, there are no guidelines for duration of water application. Other agents are often applied in the prehospital setting despite education against such practices. This study was carried out to determine the practice of prehospital first aid and its impact on outcome of burn injuries.

Method

This was a prospective observational study of all burn injured patients admitted to our burn unit between February 2013 and March 2020.

Result

A total of 335 burn injury patients were included in this study, with a median age of 22 years. Males constituted 54.3 % of the patients. Flame injuries accounted for 60 % of cases, and median TBSA was 20.5 %. Majority of the patients received first aid (80.2 %), with 78.9 % receiving first aid within 30 min of injury. Water was applied for first aid in 53.2 % of patients. Application of water for a period of 5 min was associated with reduced rate of infection(P = 0.023), hospital length of stay (P = 0.012, and mortality(P = 0.001) compared with water application for 10 min, 20 min or just to extinguish flame. The use of running tap and water from a clean container were associated with reduced rate of infection (P = 0.041) and reduced mortality rate (P = 0.006) compared with other sources of water. Other agents applied were raw pap (a local custard) over the wound, honey, and raw egg, amongst others. These other agents were used either singly or in combination for a combined total of 205 times in 126 patients. These other topical agents had no statistically significant impact on outcome compared with those who did not receive these agents as first aid.

Conclusion

The application of water for approximately 5 min and the use of running tap water or water from a clean container were associated with improved burn injury outcomes. The use of non-water agents had no statistically significant impact on the outcome measures.

查看原文本刊更多论文

院前局部应用水和其他药物对烧伤患者预后的影响：一项前瞻性研究。

简介：局部药物应用于烧伤创面作为急救措施已经注意到影响结果。根据澳大利亚和新西兰烧伤协会的建议，在烧伤后3 小时内，使用冷却的自来水至少20 分钟是有效的。然而，美国烧伤协会建议自来水5 分钟，并且仅限于轻微烧伤。在尼日利亚，没有关于用水时间的指导方针。其他药剂经常用于院前环境，尽管教育反对这种做法。本研究旨在确定院前急救的做法及其对烧伤预后的影响。方法：这是一项前瞻性观察研究，研究对象是2013年2月至2020年3月期间在我们烧伤病房住院的所有烧伤患者。结果：本研究共纳入335例烧伤患者，中位年龄22岁。男性占54.3% %。火焰伤占60% %，中位TBSA为20.5% %。绝大多数患者接受了急救（80.2% %），其中78.9% %的患者在受伤后30 min内接受了急救。53.2 %的患者用水进行急救。应用水5 分钟感染与降低率(P = 0.023),医院住院时间(P = 0.012,和死亡率(P = 0.001)与水申请10 分钟相比,20 min或扑灭火焰。与其他水源相比，使用流动水龙头和清洁容器中的水与降低感染率（P = 0.041）和降低死亡率（P = 0.006）相关。其他使用的药物包括涂在伤口上的生pap（一种当地的蛋奶冻）、蜂蜜和生鸡蛋等。126例患者单独或联合使用这些药物共计205次。与没有接受这些药物作为急救的患者相比，这些其他局部药物对结果没有统计学上显著的影响。结论：应用水约5 min和使用自来水或清洁容器的水与改善烧伤结局有关。非水剂的使用对结果测量没有统计学上显著的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Burns 医学-皮肤病学

CiteScore

4.50

自引率

18.50%

发文量

304

审稿时长

72 days

期刊介绍： Burns aims to foster the exchange of information among all engaged in preventing and treating the effects of burns. The journal focuses on clinical, scientific and social aspects of these injuries and covers the prevention of the injury, the epidemiology of such injuries and all aspects of treatment including development of new techniques and technologies and verification of existing ones. Regular features include clinical and scientific papers, state of the art reviews and descriptions of burn-care in practice. Topics covered by Burns include: the effects of smoke on man and animals, their tissues and cells; the responses to and treatment of patients and animals with chemical injuries to the skin; the biological and clinical effects of cold injuries; surgical techniques which are, or may be relevant to the treatment of burned patients during the acute or reconstructive phase following injury; well controlled laboratory studies of the effectiveness of anti-microbial agents on infection and new materials on scarring and healing; inflammatory responses to injury, effectiveness of related agents and other compounds used to modify the physiological and cellular responses to the injury; experimental studies of burns and the outcome of burn wound healing; regenerative medicine concerning the skin.