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Amputation Following Burn Injury.

Colleen N Bartley1, Kenisha Atwell1, Laura Purcell1

  • 1Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, Chapel Hill, NC, USA.

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Amputation after burn injury is rare, affecting 1.4% of patients. Key risk factors for amputation include electrical burns, black race, and larger burn size (total body surface area).

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Area of Science:

  • Trauma Surgery
  • Burn Care
  • Reconstructive Surgery

Background:

  • Amputation following burn injury is an uncommon but severe complication.
  • Previous research has focused on electrical burn injuries, necessitating a broader investigation into amputation risk factors across various burn etiologies.
  • Understanding these factors is crucial for improving patient outcomes and resource allocation in burn centers.

Purpose of the Study:

  • To determine the incidence of amputation following burn injury.
  • To identify and evaluate risk factors associated with amputation in burn patients.
  • To analyze the distribution and types of amputations in a large regional burn center population.

Main Methods:

  • Retrospective analysis of 8,313 adult patients (≥17 years) admitted to a regional burn center between January 2002 and December 2015.
  • Comparison of demographic, burn characteristics, and outcomes between patients who underwent amputation and those who did not.
  • Multivariate logistic regression analysis to identify independent risk factors for amputation, including burn etiology, race, and percentage of total body surface area (%TBSA) burned.

Main Results:

  • A total of 1.4% (n=119) of patients underwent amputation.
  • Amputees were older and had a higher proportion of black race compared to non-amputees.
  • Significant risk factors for amputation included black race (OR: 2.29), electrical burn etiology (OR: 13.54), and increased %TBSA (OR: 1.03). Flame burns were the most common etiology among amputees.

Conclusions:

  • Burn etiology, particularly electrical injuries, black race, and increased %TBSA, are significant risk factors for amputation post-burn.
  • The findings highlight disparities and specific vulnerabilities that warrant targeted interventions and further research, especially concerning the role of race.
  • Further investigation is needed to elucidate the complex interplay of factors contributing to amputation risk in burn survivors.