The Incidence, severity, outcome and preventive measures of burn injuries in epileptic patients: An experience of burn unit in Govt. Medical College Srinagar.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 5
Abstract
Background: Burn injury among epileptic patients is very common and results in significant morbidity and mortality. Epileptics constitute a group of people who are vulnerable to injuries during seizures. The aim of this study was to evaluate, the incidence, severity, outcome and preventive measures of burn injuries in epileptic patients. Methods: This study was conducted in burn unit of Post Graduate Department of surgery, Government Medical College Srinagar between May 2010 and April 2017. A total of 107 patients were enrolled in the study. All patients, irrespective of severity of their burn injuries with a diagnosis of epilepsy and/or history of epilepsy that admitted to our hospital were included in the study. Patients excluded from the study were those for whom there were insufficient data regarding the diagnosis or incorrect diagnosis of epilepsy. Patients characteristic, the mechanism of burn injury, the activity in which patient was engaged at the time of burn, and the energy source used was noted. Type, total body surface area (TBSA), severity and morbidities of burn injuries, operative procedures performed and their outcomes were evaluated from the patient’s treatment files and annual admission register. All patients were taken to physician for consultation on the treatment of epilepsy. Statistical Software SPSS (Version 20.0) and Microsoft Excel were used to carry out the statistical analysis of data. Results: A total of 107 Epileptic patients were included in the study over a period of 7 years, with mean age of 35 years, and female and male ratio (F:M) of 4:1. 64(59.81%) were illiterate and 43(40.18% were literate. Generalized tonic clonic seizure was most common type of seizure disorder 78(72.89%) followed by absence seizures, complex partial seizures and simple seizures. Flame was the most common cause of burn injuries in epileptic patients 45(42.05%).The most common organ involved upper limb 31(28.97%). Most of the patients 81 (75.70%) had a TBSA involvement of < 20% and majority of injuries were second degree deep burns 37(34.57%). The most common complication was post burn ulcer 26(24.29%) followed by post burn contracture and gangrene. 53 (49.53%) patients required surgical intervention and rest of the patients were managed conservatively. Mortality in our study was 6 (5.60 %). Conclusion: Epileptic patients were identified as a vulnerable group for burn injuries. Females are at greater risk than males of sustaining such an injury, as they are most frequently performing domestic work like cooking. The open flames as an energy source in rural areas increases the risk. The epileptic patients should be categorized as a high risk group in view of sudden and unpredictable attack of epileptic seizures, which leads to loss of consciousness and accidental burn injuries. Had these patients been identified as belonging to a high risk group, the majority of them could have been saved. These injuries are morbid, and may impact on long-term functionality. Although superficial burn injuries can be managed by conservative means, deeper burn injuries require surgical interventions. The best outcomes are achieved through early surgical intervention in selected groups of patients, as well as through targeting all epileptic patients for education and instituting specific preventive measures.
Authors and Affiliations
Zahid Mohd Rather
Keywords
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