[Application of damage control surgery strategy in treatment of burn-trauma combined injury]

To explore the application of damage control surgery (DCS) strategy in the treatment of severe burn-trauma combined injury.

From January 2004 to December 2009, 28 patients with severe burn-trauma combined injury received salvage treatment according to DCS, including 12 cases of burn combining injury at 2 sites, 6 cases of burn combining injury at 3 sites, and 10 cases of burn combining injury at 4 sites or above. There were 18 males and 10 females with a median age of 39.5 years (range, 8-56 years). The burn area was 15% to 56% of total body surface area. The injury severity score a (ISS) was 25 to 56, and the traumatic index was 17 to 24. Lethal triad syndrome occurred in all patients. Of them, 16 cases were on admission immediately after first-aid, and 12 cases were transferred from other hospitals. The time from injury to hospitalization was 20 minutes to 36 hours. All patients were treated by immediate fluid resuscitation and emergent operation to control hemorrhage and contaminations. Biological dressings were used to seal the wounds provisionally. The systemic therapy was carried out as soon as the vital signs of the patients became stable.

In 26 survivors, 23 achieved wound healing by first intention, 3 had a little residual wound at discharge. The hospitalization days were 31 to 398 days (62 days on average). However, 1 patient died of multiple organ failure, another 1 patient died of severe cerebral trauma with refractory shock.

The DCS strategy is effective in reducing mortality of patients with severe burn-trauma combined injury.