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Regional and National Review of Factors Associated With Burn Wound Cellulitis

Heard, Jason P. BS*; McDonald, Kara M. BSN; Xing, Yunfan BS; Kluesner, Karen M. RN; Liao, Junlin PhD; Wibbenmeyer, Lucy A. MD, FACS

doi: 10.1097/BCR.0000000000000115
2014 NBR Best Paper-Nonphysician

Burn wound cellulitis (BWC) is the second leading complication reported in burns. In this study we sought to identify demographic variables, burn factors, and other factors that may predispose patients to BWC. Regional data was obtained through retrospective medical record review of burn patients treated between May 2009 to April 2013 for BWC within 8 days of the injury. The patients were matched 1:2 with contemporaneously treated patients. Similarly, the National Burn Repository was queried to identify burn patients with BWC between the years 2002 to 2011, which were then compared to the remaining entries who did not have BWC reported. The data sets were analyzed separately. Univariate and multiple variable analyses were performed to evaluate risk factors for BWC. The risk factors that were consistent regionally and nationally were older age, male sex, African-American race (protective), lower extremity burns, scald burns, and full thickness burns. The treatment delay was only collected regionally, and was associated with an eight times increased risk. The factors that were inconsistent or significant in one sample only were smoking status, psychiatric conditions, upper extremity burns, and the place of injury. Cellulitis remains a significant problem for the burn community. Future prospective analyses need to clarify the impact of these factors as well as other factors on the development of BWC. Preventing BWC from occurring through earlier intervention or targeted prophylactic antibiotics may help reduce morbidity and decrease associated healthcare costs.

From the *Department of Surgery, University of Iowa Carver College of Medicine; Department of Surgery, University of Iowa College of Nursing; and Department of Nursing, University of Iowa Hospitals and Clinics, Iowa City.

This study was funded by the University of Iowa’s Carver College of Medicine’s Summer Research Fellowship Program.

Address correspondence to Jason P. Heard, BS, 8JCP Burn Treatment Center, 200 Hawkins Drive, Iowa City, Iowa 52246.

© 2015 The American Burn Association