J.Jpn. Surg. Soc.. 85(8): 739-748, 1984

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Original article

A CLINICAL STUDY ON 164 PATIENTS WITH EXTENSIVE BURN
―WITH SPECIAL REFERENCE TO IMPROVED SURVIVAL FACTORS―

One handred and sixty four patients with extensive burn were treated over 6 years, 1976 through 1981. Clinical data were analized, dividing into successive period ; Grod : Group I (83 patients, 1976－1978) and Group II (81 patients, 1979－1981). The mean age was 28.9 years, the mean burn area was 52.6% body surface area (% BSA) and Burn Index was 38.7 in group I, whereas in Group II 33.7 years, 56.0% BSA, 41.8, respectively. There are no statistical difference between the two groups. The mortality of the 164 patients was 50.6%. That of Group I was 55.4% and 45.7% in Group II. Excluding patients with almost fatal burns over 70% BSA or over 60 years of age, the former mortality is 33.3% and the latter is 21.3%. When a mortality rate was analyzed in patients with 50－70% BSA and aged less than 60 years in Group I, it was 65.0% and in Group II 36.8%.
The main difference in the treatment between the two periods are as follows. Air fluidized beds were used in the latter period. As topical agents, silver sulfadiazine cream was administered in the former period, and silver sulfadiazinecerium nitrate was administered in the latter period.
Concerning debridement and skin graft, surgery was carried out 2－3 weeks after burn in the former period, while it started within one week in the latter period. In the latter period, active nutritional support and new generation of Cephem were used. These facts reveal that progress in various aspects of the treatments in the latter period have resulted in improvement of the mortality rate.

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