BURN INJURIES IN THE ELDERLY

This study has shown that elderly males were more likely to be admitted to the Royal Brisbane Hospital Barns Unit than females. No high-risk period of the day, week or year could be identified for this group. Flame burns and scalds were most common as was the association with cooking and bathing activities. Predisposing factors were found to be common in the elderly barn population. Prevention programmes need to be directed to the home with safer cooking facilities and lower temperature or temperature outlet controls to lessen bathing scalds, as these patients found it difficult to escape a hot bath. Mortality rates were related to the percentage total body surface area burned and inhalation injury, and were well predicted by the Burn Severity Index. Complications were mainly pneumonias and venous thrombosis and reflect the need in this age group of maintaining active mobility and a quick resolution of the barn injury. Good nutrition, often lacking in this age group, mast be maintained, along with meticulous wound care if infection is to be prevented Early wound coverage is vital to prevent sepsis. Our approach is towards an early skin grafting programme while the patient is fit. This is aggressive, with as much skin coverage as possible, before the patient's condition deteriorates Every effort is made to maintain the patient's health as near normal as possible. However, if deterioration occurs, then the patient is supported and grafting delayed until the patient is again fit for surgery. When this study was undertaken, it was hoped that an answer to the controversial subject of early versus late surgery could be answered Unfortunately, the data varied so much due to the unstable condition of many of the patients, that no valid conclusion could be reached in this regard.