WITHDRAWN: Acute management of deep periorbital burns – A 10 year review of experience

Abstract

• Deep periorbital burns account for three-fourths (74.8%) of hospitalized deep facial burns, i.e. for 10.9% of all inpatient burns. • Groups at risk are toddlers of 1– 3 years and men within the age of 30-45 years. • The prevailing amount of surgery is done before the 10 th day post-injury. • Timely and judicious acute treatment reduces initial damage and late sequelae. • Preservation of vision is a determining factor for the effectiveness of treatment. Deep periorbital burns are an important issue mainly due to the presence of the eyes in the region, and the crucial importance of preservation of vision. There is no consensus regarding their treatment. A retrospective analysis of the treatment and outcome of 446 patients with deep burns of the periorbital region admitted in the Department of Burns and Plastic Surgery of St George’s University Hospital in Plovdiv, Bulgaria over 10 years was conducted. The study covers 446 patients, 162 female (36.5 %) and 284 - male (63.5 %) aged from 5 months to 92 years. Deep periorbital burns accounted for three-fourths (74.8%) of hospitalized deep facial burns, i.e. for 10.9% of all inpatient burns. The age break down shows peak values for toddlers (1-3 years) and adults over 45 years Most frequent burn agents were hot liquids and flames. The mean total body surface area affected was 19.6% (min 0.5%, max 80.0%). Concomitant ocular pathology was diagnosed in 14% (n=63) of the patients. An early, staged and precised surgical approach was preferred aimed at fast wound closure without sacrificing survived tissues. Follow up time ranged from 3 months to 5 years, median 37 months. Late ocular sequelae occurred in 7.4% (n=33) of the patients. There was no incidence of secondary corneal perforation or definitive loss of vision. Timely and adequate treatment during the acute period can minimize initial damage and late sequelae. Favor is given to the early, balanced surgical approach aimed at rapid wound closure between day 2 and 10 post burn. Preservation of vision is a determining factor for the significance of trauma and the effectiveness of treatment.