Amputation Caused by Burn Injuries
Burn injuries resulting in amputation are uncommon and are typically reserved for extreme cases of burn injuries. However, in some instances amputation can reduce the rate of mortality and thereby become a necessity to save the patient’s life.
A small percentage of burn victims are burned badly enough that their injuries result in complex medical complications, one of which can be the amputation of one or more limbs. Amputation occurs when burns are so extensive that circulation cannot be restored or other similar damage occurs. Trauma surgeons have traditionally worked on the premise that limbs should be saved whenever possible, and that amputation is an absolute last resort. However, maximizing function once the patient has completed rehabilitation is the guiding principle.
The two most common amputations required due to burns are to the fingers and ears, but the loss of arms and legs can result from extensive deep burns as well.
A study conducted over a seven year period from 2000 to 2007 by Mohammad Mian, MD, PhD, MPH and Joseph M. for the Still Research Foundation, concluded that adequate early decompression before admission could salvage a number of extremities. In a total of 10,765 acute burns admissions, 182 patients required amputation and among them 61% suffered major amputations. The majority of amputations were done on patients who suffered thermal burns and electrical injuries. Interestingly, most of the patients who required amputation received delayed decompression treatment.
In any medical condition, regardless of whether it was caused by a burn injury, the decision to amputate is never easy because this procedure will have a major impact on the patient’s future. If a patient does require amputation, a team care approach is widely acknowledged as the best method of care due to the myriad of challenges that patients face.
Prosthetic care is just part of what burn victims have to deal with. Pain management, shock, trauma and psychological issues all need to be taken into consideration. Having the support of a team of professionals allows specialty care in different areas of need and also provides resources for the family as the patient progresses through the rehabilitation process. According to a 24-year study of Burns and Amputations conducted by NSW Severe Burn Injury Service, Concord Hospital, Sydney, Australia, the presence of pre-existing psychiatric disease significantly impaired rehabilitation. This highlights how difficult the rehabilitation process is for amputee burn victims.
Due to a better understanding of the management of traumatic amputation, early emergency and critical care management, new surgical techniques, early rehabilitation, and new prosthetic designs, the long-term outcome for amputees has improved. New limb re-plantation techniques have been moderately successful, but incomplete nerve regeneration remains a major limiting factor.
Often, the patient will have a better outcome from having a well-fitting, functional prosthesis than a nonfunctional replanted limb.
The emotional trauma which accompanies any type of burn injury is significant, but amputation causes a great many additional challenges which will require years of ongoing treatment and therapy, not to mention the lifetime cost incurred by prosthetics.
Often the most serious burn injuries, such as those requiring amputation, involve workplace accidents, flammable liquid explosions, or some other preventable incident. In those instances it is critical to consult with a burn injury specialist as soon as possible. For a free consultation with an attorney from the Burn Injury Firm, call us at 866-293-2615.