Burn injuries in patients with spinal cord injury: a single institution experience from a combined Burns Unit and Spinal Cord Rehabilitation Service
Michael Cheung1, Bish Soliman1, Alice Chang1, Varun Harish1, 1Royal North Shore Hospital
Abstract
Introduction
There is limited available literature regarding the demographics, aetiology and management of burn injuries in patients with spinal cord injury (SCI). (Formal et al., 1989) We review our experience of management of these group of patients at Royal North Shore Hospital (RNSH), a quaternary referral centre for both burn injuries and spinal cord injuries.
Method
A retrospective review was undertaken on all burn injuries treated at RNSH between 2016 – 2022 using a dedicated clinical database. Relevant cases were extracted by searching SCI within patient comorbidities and 25 patients were identified.
Result
The median age was 50 (Interquartile range, IQR 42 – 60) with 17 males and 8 females. On average, patients were reviewed 4.5 days after the injury. The most common burn mechanism was scald (40%), followed by contact (20%) and radiant heat or flash (16%). All injuries occurred below the spinal cord lesion. The median total body surface area (TBSA) of burn was 1.5% (IQR 1 – 4). 14 patients (56%) sustained full thickness burn injury on presentation. Only 8 patients (32%) had appropriate first aid and 21 patients (84%) underwent debridement and skin graft surgery. The median TBSA grafted was 1% (IQR 0.5 – 3.5).
Discussion
Patients with SCI account for a small proportion of all burn injuries. Our data indicates that these injuries are associated with delayed presentation, inadequate first aid and a high need for surgical intervention, suggesting these burn injuries are more severe than the non-spinal cord injured population. Anatomical, geospatial and sociocultural issues may contribute to this finding.
Reference
FORMAL, C., GOODMAN, C., JACOBS, B. & MCMONIGLE, D. 1989. Burns after spinal cord injury. Arch Phys Med Rehabil, 70, 380-1.
Biography
Plastic Surgery and Burns Registrar (unaccredited) at Royal North Shore Hospital