Management of Burn Injuries by Daily soaking in Normal Saline prior to Dressing

Abstract

A review of 121 children with burn injuries admitted over a five-year period (January 1992 – December 1996) at the Wesley Guild Hospital, Ilesa was undertaken. The patients were soaked in normal saline for at least one hour daily, prior to dressing with topical application of silver sulphadiazine. Scalds were responsible for 67 per cent of the cases while naked flame, including kerosene explosion and therapeutic burns were responsible for the rest. The burns were categorised as major in 58 per cent of cases. The trunk was affected in 66 per cent of cases, the upper and lower limbs were each affected in 51 per cent, the head and neck in 30 per cent, and the hands and feet in 25 per cent. Wound infection was the commonest complication occurring in 16.5 per cent, while mortality was 6.6 per cent; these were lower than the 24.4 per cent and 7.7 per cent respectively, obtained in previous studies in the Unit when saline solution was not used. Similarly, the rates of contractures and severe anaemia were lower among those whose burns were soaked in saline (5 per cent vs 10.9 per cent, and 2.5 per cent vs 10.3 per cent, respectively). Although the rates were lower in the present study except for septicaemia, the differences did not reach statistical significance except for severe anaemia. However, the study thus indicates that soaking of burn injuries in saline prior to dressing may improve prognosis.

Nigerian Journal of Paediatrics 2001; 28:115.pp. 115-118