The Burns Unit in Copenhagen: III. Treatment and Mortality

Abstract

During the 5–year period 1962–1966 a total of 1326 in-patients were treated in the Burns Unit, Copenhagen. This paper reports to what extent it was possible to carry through exposure therapy consistently. The patient material is divided by healing time before and after 3 weeks postburn. Excision and grafting were done, from 1964, in all cases on the 14th day postburn. The number of grafting procedures is reported. The trend has been towards ever more grafting activity. For restoring appearance as well as function we now prefer excision and grafting also in deep partial thickness burns. The influence of age upon the healing time is demonstrated for spontaneously healed as well as grafted patients. Owing to the altered therapeutic principle, the number of bed days for major burns has been reduced by half since 1964, when multiple excisions were abandoned in favour of total excision and grafting on the 14th day postburn. The changes in the therapeutic principles are discussed. The mortality (55 patients out of 1326) is evaluated on the basis of a comparison with Bull & Fischer's calculations (1954). It proved to be 58% of that expected according to these calculations. Probit analyses on our material are compared with corresponding analyses from previously published materials. The best results appear to have been reported by Birke et al. (1964). Our material is compared with theirs in a Z² test. This shows no significant difference. Birke et al. reported that their therapeutic results depended upon the antishock therapy given, but this does not apply to our material.