May 04 2011

Sri Lanka Burn Rehabilitation

Published by Admin

Dear Chandini and Haji
I spent some additional time this morning writing queries to extract information from the Sri Lanka comprehensive burn rehabilitation center that we established in early Feb. 2011 to assess the early outcomes and the challenges that you are currently facing. I will summarize these findings:
130 Total Patients in database currently (partial month of Feb and March)
90 Patients have TBSA documented and those average: 16.3%
No Patient was previously burned
No Family member was previously burned
Of interest, of the 84 women in the database burned:
35 with spouse at time of burn (42% of burns)- I did not assess cause (accident/abuse) or mechanism at this time but as you know, many of these are self immolation with roughly 15% being acid.
14 by themselves
9 with parent
9 with relative
8 with sibling
7 “other”
1 with daughter
1 with friend.
And finally, the most exciting information- Vancouver Scores (Modified)- Initial Evaluations only (130 patients)
Total Database Avg
Itch Pain Pliability Vascularity Height Total VS
1.66 0.81 1.31 1.25 1.05 6.08
Body Parts
Itch Pain Pliability Vascularity Height Total VS
A (Finger) X X X X X X
L (Neck) * 0.80 0.31 0.88 0.56 1.13 3.68
D (Upper Arm) 0.60 0.31 0.94 1.06 0.94 3.85
J (Foot) 2.00 0.29 0.71 0.43 0.43 3.86
I (Calf) 1.40 0.60 0.80 1.40 0.40 4.60
B (Hand) 1.20 0.81 1.49 1.44 1.05 5.99
E (Chest) 1.30 1.17 1.53 1.20 1.20 6.40
G (Buttocks) 2.00 0.50 1.50 1.50 1.00 6.50
K (Face) 1.60 0.71 1.52 1.32 1.36 6.51
F (Abdomen) 2.00 1.33 1.33 1.17 1.50 7.33
C (Forearm) 2.30 2.25 1.75 1.38 1.13 8.81
H (Thigh) 3.10 0.62 2.00 2.31 1.46 9.49
Avg Score 1.66 0.81 1.31 1.25 1.05 6.09

It will be great to see these scores improve with compression therapy (uvex, garments), therapy, surgery etc and time- we have the capability of linking the patient photos with these scores and body parts to visually show the impact of this clinic.

Worth mentioning- the neck (which historically has demonstrated the greatest international challenges that I have seen with severe contractures and scar formation) demonstrates the lowest modified VS results. This a result of early excision and grafting techniques by Dr Perera and her team! These results were clearly recognized by me during my brief stay but the numbers clearly validate it.

The thigh demonstrates the most problematic scores at present- which lends me to believe that we have donor site problems with issues around the dermatome and blade quality as we have seen elsewhere.

I would be very interested in hearing what your thoughts on the above scores are Chandini.

My hope is to have this database accessible via the web and implemented in all of our collective centers.

Great job team.

Rick

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