A report of 115 consecutive autopsies in burned children: 1966-80

The overall mortality rate at the Shriners Burns Institute, Galveston Unit, decreased from 14 per cent in 1966, to 2.8 per cent in 1980. In all, 74.8 per cent of the deaths were associated with sepsis, and pulmonary lesions were the most frequent fatal complications (75.6 per cent). The burn wound was the major source of sepsis (62.7 per cent). Pseudomonas, E. coli, Klebsiella, Candida spp. and Staphylococcus aureus were the most common cultured bacteria. After a new standard fluid resuscitation programme, tangential excision and surgical management of the burn wound sepsis were adopted, the fatalities decreased from an average annual mortality rate of 11.5 per cent in the years 1966-75, to an average annual mortality rate of 2.8 per cent in the period 1976-80. After the routine antacid and milk diet were adopted (1970), the percentage of stomach and duodenal ulcers found at autopsy decreased from 2.0 per cent to 0.8 per cent, and from 3.5 per cent to 0.5 per cent respectively. The morphological alterations in the lymphoid tissue, reflecting a defect in T-cell function and stimulation of B-cell function, were present up to 114 days post burn.