title: Predictors of mortality: a comparison between two burn wound treatment policies.
abstract: Retrospective review of outcomes and experiences of a single burn centre between two time periods during which a new wound care technique was employed after the first period. The time period was divided into two: 1977-1984 and 1984-1990. Due to the use of cerium nitrate-silver sulphadiazine, the introduction of serial excision and grafting became possible in the second time period. Multivariate risk-analysis was done by logistic regression analysis. The mortality rate decreased from 13.7% (1997-1983) to 4.7% (1984-1990). Results of multiple logistic regression analysis indicate that the change in periods was advantageous for patients with >50% TBSA, within the age group, 0 to 30 years. Obviously, the care which a patient receives has improved significantly. Many developments occurred simultaneously and it appears impossible to conclude that only the use of cerium nitrate-silver sulphadiazine was the reason for improved survival. Nevertheless, the use of cerium nitrate-silver sulphadiazine enables sequential excision and grafting and in consequence allows for many of these developments to occur.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hand Surgery, University Hospital Maastricht, Postbus 5800, 6202 AZ Maastricht, The Netherlands. info@vehmeijer.nl
authors.forename: M
authors.initials: M
authors.lastname: Vehmeyer-Heeman
authors.forename: C
authors.initials: C
authors.lastname: Van Holder
authors.forename: F
authors.initials: F
authors.lastname: Nieman
authors.forename: E
authors.initials: E
authors.lastname: Van den Kerckhove
authors.forename: W
authors.initials: W
authors.lastname: Boeckx
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002053:Burn Units; D002056:Burns / Q000401:mortality* / Q000628:therapy; D002563:Cerium / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D004359:Drug Therapy, Combination; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016134:Organizational Policy; D012044:Regression Analysis; D012189:Retrospective Studies; D012837:Silver Sulfadiazine / Q000627:therapeutic use*; D016038:Skin Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects; D014946:Wound Infection / Q000517:prevention & control
chemical_list: D000891:Anti-Infective Agents, Local; C032786:cerium nitrate; D002563:Cerium; D012837:Silver Sulfadiazine