title: Periorbital burns – a 6 year review of management and outcome.
abstract: BACKGROUND
  Periorbital burns are an infrequent but potentially devastating injury. This study aimed to elucidate the spectrum of such injuries presenting to a UK burns centre and the outcome achieved in the cases requiring periorbital reconstruction for the restoration of function and form.
  
  
  METHODS
  Patients admitted to a UK regional burns centre between January 2005 and January 2011 with periorbital burns were identified from the Patient Administration System (PAS), theatre logs and the International Burns Injury database (IBID). Multiple parameters were assessed using patient notes, ITU and hospital image databases.
  
  
  RESULTS
  Over 6 years, 167 patients with facial burns requiring surgery were treated, including 103 patients with eyelid burns. The mean burn size was 33% total body surface area. The eyelid burn depth varied; 67% superficial partial thickness, 17% deep dermal and 16% full thickness. Two patients lost complete vision in one eye, one patient underwent amniotic membrane grafting. In total 16 patients required periorbital reconstruction to maintain eye closure, with 1.8 operations on average per patient. Acute surgery was required in 11 patients, whilst late intervention (>3 months) was needed in 5, 2 patients had both acute and delayed surgery. Of the 5 late intervention patients 4 were treated with full thickness skin grafts and 1 with a Z plasty. Average time for final reconstruction with delayed surgery was 4.5 months.
  
  
  CONCLUSIONS
  The goal in management of periorbital burns is preservation of vision, prevention of future complications and restoration of an acceptable aesthetic outcome. Total visual loss is thankfully rare, but early ophthalmology intervention is vital given the evidence of corneal damage as a brief therapeutic window exists.
authors.affiliation: St. Andrews Centre for Burns & Plastic Surgery, Mid Essex NHS Hospitals Trust, Broomfield, Chelmsford, Essex CM1 7ET, United Kingdom; St Andrew's Anglia Ruskin (StAAR) Research Group. Electronic address: edmundfitz@doctors.org.uk.
authors.forename: Edmund
authors.initials: E
authors.lastname: Fitzgerald O'Connor
authors.affiliation: St. Andrews Centre for Burns & Plastic Surgery, Mid Essex NHS Hospitals Trust, Broomfield, Chelmsford, Essex CM1 7ET, United Kingdom; St Andrew's Anglia Ruskin (StAAR) Research Group.
authors.forename: Q
authors.initials: Q
authors.lastname: Frew
authors.affiliation: St. Andrews Centre for Burns & Plastic Surgery, Mid Essex NHS Hospitals Trust, Broomfield, Chelmsford, Essex CM1 7ET, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Din
authors.affiliation: Frenchay Hospital, Bristol BS16 1LE, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Pleat
authors.affiliation: St. Andrews Centre for Burns & Plastic Surgery, Mid Essex NHS Hospitals Trust, Broomfield, Chelmsford, Essex CM1 7ET, United Kingdom.
authors.forename: S
authors.initials: S
authors.lastname: Ashraff
authors.affiliation: Broomfield Hospital, Court Road, Broomfield, Chelmsford, Essex CM1 7ET, United Kingdom.
authors.forename: S
authors.initials: S
authors.lastname: Ghazi-Nouri
authors.affiliation: St. Andrews Centre for Burns & Plastic Surgery, Mid Essex NHS Hospitals Trust, Broomfield, Chelmsford, Essex CM1 7ET, United Kingdom.
authors.forename: N
authors.initials: N
authors.lastname: El-Muttardi
authors.affiliation: St. Andrews Centre for Burns & Plastic Surgery, Mid Essex NHS Hospitals Trust, Broomfield, Chelmsford, Essex CM1 7ET, United Kingdom.
authors.forename: B
authors.initials: B
authors.lastname: Philp
authors.affiliation: St. Andrews Centre for Burns & Plastic Surgery, Mid Essex NHS Hospitals Trust, Broomfield, Chelmsford, Essex CM1 7ET, United Kingdom; St Andrew's Anglia Ruskin (StAAR) Research Group.
authors.forename: P
authors.initials: P
authors.lastname: Dziewulski
mesh_terms: D000328:Adult; D000650:Amnion / Q000637:transplantation*; D002053:Burn Units; D002056:Burns / Q000150:complications / Q000601:surgery*; D002648:Child; D015331:Cohort Studies; D019468:Disease Management; D005126:Eye Burns / Q000150:complications / Q000601:surgery*; D005141:Eyelid Diseases / Q000601:surgery*; D005151:Facial Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D016896:Treatment Outcome; D006113:United Kingdom; D014786:Vision Disorders / Q000209:etiology
keywords: Burns; Facial burns; Ocular injury