Burn Center Patients at Risk for Upper Extremity Amputations

Area of Science:

• Trauma Surgery
• Burn Care
• Infectious Diseases

Background:

• Burn center patients face complex conditions beyond burns, including necrotizing infections and trauma.
• Limb salvage is not always possible, necessitating amputations for burn patients.
• Identifying factors predicting amputation risk is crucial for optimizing patient care.

Purpose of the Study:

• To determine factors predisposing burn patients to extremity amputations.
• To compare characteristics of patients requiring upper extremity amputation versus those who do not.

Main Methods:

• Retrospective registry review of burn center patients from 2000-2019.
• Pair-matched comparison of upper extremity amputee patients (APs) and non-amputees (NAPs) based on age, sex, %TBSA, and injury type/location.
• Statistical analysis to identify significant differences between groups.

Main Results:

• Upper extremity amputee patients experienced significantly longer hospitalizations and intensive care unit stays.
• Amputee patients had a higher incidence of cardiac, renal, and pulmonary comorbidities.
• Acquired infections, escharotomies, and fasciotomies were significantly more prevalent in the amputee group.

Conclusions:

• Escharotomies, fasciotomies, and various infections (sepsis, pneumonia, wound, urinary tract) are associated with prolonged hospitalizations.
• These interventions and complications significantly increase the risk for upper extremity amputations in burn patients.
• Understanding these risk factors can guide preventative strategies and treatment decisions in burn care.