Dr Peter Meier1, Dr Helen Douglas1, Professor Suzanne Rea1, Professor Fiona Wood1
1State Burns Service WA, Murdoch, Australia
The prevalence of diabetes mellitus (DM) in Australia is increasing: from 4.5% in 2012 to 5.1% in 2015. Associated complications of DM, such as peripheral vascular disease and diabetic neuropathy, increase the risk of sustaining burns and the complications associated with these injuries and can result in poorer outcomes.
Data was retrospectively collected on 35 consecutive diabetic patients between 2015 and 2017 from the State Burns Service of Western Australia (WA) using an electronic case note database.
Thirty-six diabetic patients were admitted with lower extremity burns and the average TBSA was 2.4%. The mean length of stay (LOS) was eight days; over two and half times what would be expected in our unit for that size of injury. Nearly 30% of patients required IV antibiotics for significant wound infection and 20% required a second operation. Of the 27 patients who required operative management, 6 required amputation of their toes; one an amputation of their forefoot and one proceeded to a below knee amputation.
Burn injuries in diabetic patients are challenging; they cause significant morbidity to patients and utilise substantial service resources, both in the acute and long-term setting. A multidisciplinary approach and early effective management is paramount. An algorithm for treatment is proposed.
Peter Meier is a registrar at the state burns unit in WA