Epidemiological Study of Mass Casualties at A Tertiary Burn Center in Ain-Shams University: Management and Outcomes

Document Type : Original Article

Authors

The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract

Purpose: To report, analyze different aspects of mass
casualty incidents resulting from household fires due to
explosion of gas cylinders presented to our Burn Unit from
2013 to 2017.
Methods: Data of all burn mass casualty incidents from
admitted to the Burn Emergency Unit of Ain Shams University,
Cairo, Egypt; from January 2013 to December 2017 were
collected from the Burn Unit and its Intensive Care Unit
records, reviewed and described.
Results: Six incidents from flame burn caused by household
explosion of gas cylinders took place in the past 5 years.
33 victims were involved in the incidents and admitted to our
unit; male: female ratio was 2.7:1. The ages of the admitted
patients ranged from 2.6y-51y. The extent of burns ranged
from 10-68% of TBSA affecting head and neck, torso and
extremities. A total numbers of 44 operations were performed
to all the patients during their stay in the form of emergency
escharotomies in 12 patients and 32 sessions of excision of
the deep partial and full thickness burns and split-thickness
skin grafting in 19 patients. All patients survived and discharged
uneventfully except only for 4 deaths (12%) with
mean hospital stay duration of 30 days. Complications that
developed in the admitted cases include wound infections
(12.50%), hypertrophic scars (12.50%), altered skin color
(8.33%) and psychotic manifestations (6.24%).
Conclusion: Retrospective analysis of the therapeutic
data of these cases demonstrates that management of mass
burn causalities requires pre-designed disaster planning, well
equipped center, trained personnel and these are the key
elements in successful management.

Keywords

Main Subjects


Esselman P.C., Thombs B.D., Magyar-Russell G. and
Fauerbach J.A.: Burn rehabilitation: State of the science.
American Journal of Physical Medicine and Rehabilitation,
85: 383-413, 2006.
2- Munster A.M. and Smith-Meek M.: The effect of early
surgical intervention on mortality and cost effectiveness
in burn care 1978-1991. Burns, 20: 61-4, 1994.
3- Thomas S., Barrow R.E. and Herndon D.N.: Introduction:
History of the treatment of burns. In: Herndon D.N. (ed).
Total Burn Care, 2nd edn. Saunders: London, pp. 1-1,
2002.
4- Gunn S.W.A.: The scientific basis of disaster medicine:
Definition, damage, assessment and relief operations. In:
Masellis M., Gunn S.W.A. (eds), “The Management of
Mass Burn Casualties and Fire Disasters”, Chapter 1,
Kluwer Academic Publishers, Boston, Dordrecht, London,
1992.
5- Advanced Life Support Group (Ed.): Major Incident
Medical Management and Support, the Practical Approach
at the scene. Plymouth, UK: BMJ Publishing Group,
Second 2002.
Egypt, J. Plast. Reconstr. Surg., October 2019 369
6- Keramitsoglou I., Kiranoudis C.T., Sarimveis H. and
Sifakis N.: A multidisciplinary decision support system
for forest fire crisis management. Environ Manage, 33:
212-25, 2004.
7- Wu J., Previte J.P., Adler E., Myers T., Ball J. and Gunter
J.B.: Ignition, explosion, and fire with sevoflurane and
barium hydroxide lime. Anesthesiology, 101: 534-7, 2004.
8- http://www.reference.com/browse/wiki/Al_Ayyat_train_
disaster.
9- Lau Y.S.: An insight into burns in a developing country:
A Sri Lankan experience. Public Health, 120 (10): 958-
65, 2006.
10- Forjuoh S.N.: Injury control in developing nations: What
can we learn from industrialized countries? Inj. Prev., 2:
90-1, 1962.
11- Ahuja R.B. and Bhattacharya S.: Burns in the developing
world and burn disasters. B.M.J., 329: 447-9, 2004.
12- Kalayi G.D.: Mortality from burns in Zaria: An experience
in a developing economy. East Afr. Med. J., 83: 461-4,
2006.
13- Jeanine C.: UN office for the coordination of humanitarian
affairs. OCHA situation report no. 1. Kenya: Fire, 2
February 2009.
14- Benito-Ruiz J., Navarro-Monzonis A., Baena-Montilla P.
and Mirabet-Ippolito V.: An analysis of burn mortality:
A report from a Spanish regional burn centre. Burns, 17:
201-4, 1991.
15- Bull J.P. and Fisher A.J.: A styudy of mortality in a Burns
Unit: A revised estimate. Annals of Surgery, 139 (3): 269,
1954.
16- Atiyeh B.S., Costagliola M. and Hayek S.N.: Burn prevention
mechanisms and outcomes: Pitfalls, failures and
successes. Burns, 35 (2): 181-93, 2009.
17- O'Sullivan S.B. and Schmitz T.J.: Physical rehabilitation,
5th ed., Philadelphia: F.A. Davis Company, pp. 1098,
2007.
18- Olaitan P.B. and Jiburum B.C.: Analysis of Burn Mortality
in a burn centre. Annals of burns and fire disasters, 19
(2): 159-241, 2006.
19- Moi A.L., Wentzel-Larsen T., Salemark L., Wahl A.K.
and Hanestad B.R.: Impaired generic health status but
perception of good quality of life in survivors of burn
injury. Journal of Trauma, 61 (October (4)): 961-8, 2006