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Systematic burn trauma management saves lives

Deaths caused by fire injuries claim 300 000 lives worldwide every year. World Trauma Day, commemorated annually on 17 October, provides an opportunity to raise awareness of the need to apply essential life-saving measures without delay to deal with burn injuries.

"The first forty eight hours after injury are critical in stabilising the patient," says Victoria Makhalima, assistant director at the Johnson & Johnson Burn Treatment Centre (JJBTC) at Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto which this year acknowledges 21 years of patient care and management.

The National Injury Mortality Profile for South Africa 2008 Report says that burns are one of the leading causes of non-natural deaths in infants and children under five years.

According to the World Health Organisation, efficient and systematic management of trauma patients can save lives. This is achieved by having trained medical and nursing specialists in facilities geared for trauma management.

Burn trauma creates a breach in the surface of the skin which causes disruption or loss of some or all of the skin's essential functions. The alteration of these physiological functions leaves the patient exposed to a host of infections.

Most vulnerable types of wounds

The loss of protective skin makes burn wounds among the most vulnerable types of wound and prone to infections. Patients with serious burn wounds must be taken to a specialised burn unit immediately in order to increase their chances of survival.

Although there is still debate around the issue of lapsed time after injury, it is recommended that patients come to hospital within three hours of injury so that the burns can be immediately cooled with tap water to stabilise the temperature of the wound.

"All burn patients are treated as multiple trauma patients. After the initial assessment and resuscitation of the patient's airways and breathing, treatment starts by focusing on stopping external bleeding, followed by examining for further internal injuries and bleeding," explains Sister Makhalima.

Due to the high infection risk associated with burn wounds, recent research studies recommend that modern burn unit designs allow all intensive and burn care procedures to be carried out within the unit itself.

"Having a dedicated burns unit has changed the lives of the patients of Soweto. They no longer have to wait for theatre time to be treated, we have our own theatre here where burn injury patients are always a priority," says Sister Asnath Churu, manager in the paediatric ward at JJBTC .

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