M. Thomsen

The total number of burn injuries in a Scandinavian population—a prospective analysis

During the period 1 September 1982 to 31 August 1983 the total number of burn injuries in the municipality of Copenhagen was recorded prospectively. The social changes and the constitution of the population are illustrated. The total number of burn injuries showed a decrease of 33 per cent compared to the investigation in 1974/75. Scalds are still the most frequent cause of burn accidents, small children are especially vulnerable. Seventy-two per cent of all accidents occurred at home. Only a few patients required antishock therapy. No patients with work-related burn injuries died. Preventive measures have eliminated or reduced the number of some types of thermal injury.

The total number of burn injuries in a Scandinavian population: a repeated estimate

Abstract From 1965 to 1975 the population of Copenhagen decreased from 700 000 to 560 000 inhabitants. Small children under 6 years still constitute 6 per cent of the population but the percentage of old people over 60 years increased from 21 to 29 per cent. As a result of a thorough study of the case records of all outpatients treated at each of the outpatient casualty wards in Copenhagen, the total number of burn injuries treated as outpatients in the area during 1974 and 1975 has been recorded and compared with the number treated during 1964 and 1965. In spite of a 75 per cent increase in the total number of all types of injuries treated, the number of burn injuries treated is unchanged, and the number of severe burn injuries has decreased considerably. Burn injuries sustained by small children now constitute only 16 per cent of all burns, compared to 23 per cent previously. The conclusion is drawn that the pursuant prophylaxis which was practised has been effective, and also that the public has become generally familiar with the use of cold water as the best first aid remedy for burns.

Colonization priority among Staphylococcus aureus strains—correlation with phage-type

We have studied the distribution of phage-type patterns among strains of Staphylococcus aureus isolated from patients in a burns unit. From 51 patients the same phage-type was isolated from succeeding swabs during the observation period. In 20 patients new types were introduced, but the original strain remained. In 23 patients the first strain was replaced by one other strain, in eight patients two or more. Strains of type 95 seemed to have a high colonization priority, whereas strains of group III had a low one. In 1986 phage-typing was performed on two or more S. aureus strains from the same patient, in 4561 instances. Recurrence of strains of the same phage-type pattern was demonstrated in 70% of the patients when the first and the fourth sample were compared. The newer epidemic strains of phage-type 95 and of the 94,96 complex had the highest percentage of recurrence (more than 80%) when adjacent samples were compared, and 68-69% when the first and the fourth sample were compared. The good colonization capacity of these strains might be one of the explanations why they occur frequently today although they are resistant only to penicillin.

Dextran Solutions in the Treatment of Burn Shock

In relation to a previous publication on the treatment of burn shock with saline solution, we have treated—from 1964 to 1966–43 patients exclusively with dextran-saline solutions.The efficacy of this treatment was assessed on the basis of renal function, pulmonary function, blood volume, and mortality.It is concluded that the dextran therapy is sufficient and easy to administer. The authors point out the remarkable finding that treatment with saline solution without colloids, calculated on the basis of body weight, gives equally good results as treatment with dextran-saline calculated exclusively on the basis of the extent of the burn.

The cost of burn injuries in Denmark

Abstract Based on previous analysis of the incidence of burn injuries in the Municipality of Copenhagen during the years 1974/5 we have tried to estimate the economic consequences of the annual number of burn injuries to society. In the Municipality of Copenhagen, with 560 000 inhabitants, direct expenses for hospital treatment of inpatients and outpatients amounted to 2 1 4 million Danish crowns (DKr. ∗ ) per year, maintenance allowances and damages paid due to working accidents 3 4 million DKr. per year and the total loss of earnings according to the total number of days off work 4 1 2 million DKr. per year. Thus, the total economic loss to society could be estimated to be 13 1 4 million DKr. per million inhabitants per year (13·25 DKr. per inhabitant per year).

Two Major Burn Cases

Case histories of two patients admitted to the Burns Unit in 1976 and 1982, with very extensive and very deep burns, are described. The philosophy behind the usual treatment plan of the Unit and the unorthodox ideas that had to be devised in order to treat the 2 patients are described.