Amputations in adult burns patients: a 10-year retrospective study.

Introduction: Amputation is an uncommon but potentially life-changing complication of burns. No studies of amputation among UK burns patients currently exist.

Methods: A 10-year review of burns patients with amputations at the Queen Elizabeth Hospital Birmingham was conducted. Descriptive analysis was undertaken to identify patient characteristics. Statistical analysis was conducted to identify relationships between patient and injury details and the number of amputations, and relationships between the number of amputations and patient outcomes.

Results: Thirty-five adult burns patients (mean age 48.1 years, 65.7% male) were identified, 62.9% of whom suffered flame burns. The median total body surface area (TBSA) burned was 24%. The amputation risk among admitted burns patients was 1.2%. Major burns patients (≥25% TBSA burned) underwent more minor (p=0.018) and upper limb amputations (p=0.035) compared with minor burns patients. Median length of hospital stay was 67.5 days. Length of stay was positively correlated with the number of total (p=0.001), minor (p=0.004) and upper limb (p=0.002) amputations. In total, 67.6% of amputees underwent revisional procedures. The number of revisions was positively correlated with the number of major (p=0.010) and lower limb (p=0.001) amputations.

Conclusions: A minority of adult burns patients underwent amputations. Patient and injury information may predict a greater number of amputations, which in turn may predict longer hospital stays and a requirement for more revisional procedures. This information could be used to better counsel patients about their likely outcomes. A multicentre case-control study is required to clarify risk factors for amputation in burns.