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Management of Major Burns in 37 Casualties of a Colored Powder Explosion

Experience of the Linkou Burn Center in Taiwan

Chen, Hung-Chang, MD*; Wu, Katie P., MD; Yen, Cheng-I, MD*; Hsiao, Yen-Chang, MD*; Yang, Shih-Yi, MD*; Yang, Jui-Yung, MD*; Chang, Shu-Yin, MD*; Chuang, Shiow-Shuh, MD*

doi: 10.1097/SAP.0000000000001928
Burn Surgery and Research
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SDC

Background On June 27, 2015, a colored powder explosion occurred in Taiwan. As a result, 499 people were injured, and over 200 people were in critical condition because of severe burns. Forty-nine casualties were transported to the Chang Gung Memorial Hospital.

Methods We undertook a single-center retrospective observational study using clinical data for 37 patients with major burns with more than 20% total burn surface area (TBSA). We describe the experience of managing patients with acute burn injuries in these patients. Patient-specific data were analyzed and expressed as mean ± standard deviation.

Results Thirty-seven major burn patients were admitted to our hospital. The mean ± SD age was 22.5 ± 5 years. The mean ± SD TBSA was 48.9% ± 20%. All patients were stabilized within 6 hours after admission, and no patient experienced hypothermia or hypovolemia. We performed 95 debridement procedures and 88 skin grafts. A mean of 5.6 surgeries were performed for each patient. The mean ± SD hospital stay was 62 ± 32 days. The ratio for hospital days/%TBSA was 1.36, and hospital charges/hospital days ratio was US $973 a day for surviving patients. Two mortalities (2/37, 5.4%) were reported: one was related to cardiac insult, and another was caused by sepsis.

Conclusions We share our experience in managing 37 major burn patients in a colored powder explosion to improve the holistic care in modern mass burn casualties. Aggressive early debridement and skin grafting reduced hospital stay and costs.

From the *Department of Plastic and Reconstructive Surgery, and

Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan.

Received May 4, 2018, and accepted for publication, after revision February 14, 2019.

Conflicts of interest and sources of funding: none declared.

Presented at the International Society for Burn Injuries, 18th Congress, August 29 2016, Miami, FL.

Reprints: Shiow-Shuh Chuang, MD, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, 5, Fu-Hsing St, Kweishan, Taoyuan 333, Taiwan. E-mail: firepig@adm.cgmh.org.tw.

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