14-Year Review: Characterization and Prevalence of Isolated Head and Neck Burns

Characterization and Prevalence of Isolated Head and Neck Burns

Statement of Problem: There is limited data in oral and maxillofacial surgery (OMS) literature characterizing head and neck burns in the United States. 

Purpose: To report prevalence of isolated head and neck burns and associated sequelae and to assess patient outcomes useful in facial burn management.

Materials and Methods: A retrospective cross-sectional study was conducted at Grady Memorial Hospital, a major metropolitan burn referral center. Data of patients admitted with a primary diagnosis of head and neck burns from 2000 to 2014 was reviewed. Demographic (age, gender), burn (mechanism, depth, total body surface area), airway and respiratory management (intubation, tracheostomy, ventilator days), surgical (procedure, timing), and outcomes (length of stay, mortality) details were recorded.

Results: There were 205 patients with head and neck who met inclusion criteria. The majority of burns occurred in males (66%) with mean age of 40 years (range, 2 months to 88 years). The majority of burns were accidental (n=196, 96%) and caused by flame (n=136, 66%). The superficial partial thickness burn was the most frequently reported depth (n=165, 80%). The average total body surface area was 3%. Patients were intubated (n=29, 14%) and required tracheotomy (n=9, 4%). After intubation, patients averaged 7.5 days on the ventilator (range, 1 to 85 days). Mean length of stay was 4.4 days (range 1 to 112 days). Surgical management in the operating room was required for 25 (12%) patients. Inhalation injury was the most common associated injury, occurring in 32 (16%) patients and had a 22% mortality rate. Overall mortality was 2%.

Conclusions: Superficial partial thickness head and neck burns were more common in males, older than 55 years. Most head and neck burns were accidental and the most frequent mechanism was flame. The majority of head and neck burns are managed outside of the operating room via local wound debridement and dressing changes. Due to an increased risk and mortality of inhalation injury, airway protection and respiratory management are critical considerations of head and neck burn management. 

References

Prevalence and pattern of facial burns: a 5-year assessment of 808 patients. Motamedi K, Heydari, Heydari, Ebrahimi: J Oral Maxillofac Surg. 2015 ;73(4): 676-82. doi: 10.1016/j.joms.2014.11.015. Epub 2014 Dec 6 

Ong Y S, Samuel M, Song C: Meta-analysis of early excision of burns. Burns 32(2): 145-150, 2006