Bums Vol. 22. No. 5, pp. 376-380, 1996 Copyright 0 1994 Elsevier Science Ltd for ISBI. Al1 ri&ts reserved Printed in Great Britain 0305~4179/95 $15.00 + 0.00 03054179[95)00169-7 Eight years experience of a regional burns unit in audi Arabia: clinical and epidemiological aspects S. Al-Shlash, N. I?. Warnasuriya, Z. Al Shareef, P. Filobbos, E. Sarkans and S. Al &sari North West Armed Forces Hospital Programme, Tabuk, Saudi Arabia .A retrospective aplalysis of 435 consecutive admissions to a regional brims mit over an S-year period is presented. The majority were dome&c accidenfs, ivhile a few were suicidal and two were due to child abuse. Scalds wete commoner tkan $‘ame bums, 70.6 per cenf were children under 12 years, 12.4 per cent had >&I per cent TBSA aj&zted, 66.9 per cent were deep partial orfuli thicbzess bums, 24.4per cenf had signs o.? shock on admission, 13.6 per cent had smoke inkalafion injury. In spife of these lsnown aduerse factors the overall ozrfcome WRS safis.factory,zaith a casefat&y rate of 7.4 per cent and a residual disability rate of 10.8 per cent. Good initial reswcitafion, a low infection rafe (18.4 per cent) and fhe ready availability of appropriate surgiral intervention (35.6 per cenf), with good intensive care su~porf, could accomt for fke satisfacfory mcfcome. Copyrighf 0 1996 Elsevier Science for Efd for ISBI. Bums, vol. 22, No.5, 376-350, 1996 Intaoductisn Saudi Arabia is presently undergoing a rapid epidemiolo- gical transition. Infections and nutritional disorders,which are the hallmarksof an adverse environment, are becoming less common, while hereditary and chronic degenerative diseases are increasingl. Accidental injuries continue to play a significa.nt role in morbidity+. Burns constitute one of the commonest domestic accidentsj. In response to this increasing community need, several regional burns units have been developed during the past TO years. Somehave reported their experience during this period4-‘. The North West Armed Forces Hospital Programme (NWAFHP), Tabuk opened a fully equipped bums unit in 1986. Sinceits inception, the unit hasserved asthe regional bums centre. It is a five-bedded unit with individual cubicles and monitoring facilities with a central consul at the nursing station. Facilities available include treatment with Arjo hydrotherapy and Clinitron (fluidized) beds. A fully equipped minor surgica1 room is also available. All major bum injuries that occurred in the Tabuk region are eligible for admissionto the unit. Some are admitted directly d th an o ers transferred from other hospitals. The unit is managed by a team consisting of a plastic surgeon, anaesthetist, surgical resident and specially trained nursing staff. All patients are managedaccording to a standardized protocol, A retrospective analysis of 435 admissions to this unit has been carried out during an b-year period. The objective was to describe epidemiological and clinical features of bum injury, with a view to identifying preventable factors and prognostic factors for an adverse outcome. Methodology of study Medical record numbers of all bum injury patients admitted to the bums unit at NWAFHP from May 1986 to December 1994 were identified from hospital records and the medical records retrieved. The relevant epidemiolo- gical and clinical data were extracted from the medical records on to a pre-prepared structured questionnaire by a senior nurse. The data was concurrently fed into a computer and analysed using standard spread sheet software. The data regarding fatalities was analysed separately and compared with those from the general population of patients, in order to identify factors predis- posing to death. Significancewas determined by the Z test, and for factors with significant differences the odds ratios were calculated. Results Epidemiological aspects Of the 435 patients who were admitted with bum injury during this period, 260 (59.8 per cent) were male, 175 ($0.2 per cent) were female; 403 (92.6 per cent) were Saudis and 32, (7.4 per cent) were expatriates. Three hundred and seventy-four (85.9 per cent) were from Tabuk city, 39 (9 per cent) from Tabuk region and 22 (5.1 per cent) were from other regions in the Kingdom. Three hundred and seven (70.6 per cent) were admitted directly, while I.28 (29.4 per cent) were transferred from other hospitals. The age distribution of the patients is shown in Table 1; 309 (70.6 per cent) were under 12 years of age, while 83 (19 per cent) were young adults (IS-40 years of age). Four hundred and seventeen (95.9 per cent) were accidental injuries while 16 (3.7 per cent) were suicidal and two (0.4 per cent) were intentional child abuse.Four hundred and fifteen (95.4 per cent) of the accidentsoccurred in the home and 4.6 per cent in the workplace. CIinical aspects Clinical detaiIsof the bum injury-type, degree and extent - are shown in Tables II-1V. Scalds numbered 253 (58.2 per cent). The majority (66.9 per cent) were deep partial or full