Burns and amputations: a 24-year experience

J Burn Care Res. 2006 Mar-Apr;27(2):183-8

Kennedy PJ, Young WM, Deva AK, Haertsch PA.
NSW Severe Burn Injury Service, Concord Hospital, Sydney, Australia.


Although the management of the severely burnt extremity poses a significant therapeutic dilemma, burn injuries resulting in amputation are uncommon, In such cases, however, amputation can reduce the rate of mortality. In a total of 1858 patients from January 1980 to January 2004, there were 34 amputations in 27 patients. There were 23 men (age range, 14-64 years) and 4 women (age range, 34-85 years). The majority of amputations from burns caused by flame injury predominantly after motor vehicle accidents, with only eight cases resulting from high-voltage electrical injury. Nine patients required immediate amputations, with the rest being delayed. There were three deaths, with a survival rate of 89%. The majority of single lower-limb amputees and only one of seven bilateral amputees were independently mobile. The presence of pre-existing psychiatric disease significantly impaired rehabilitation. Free tissue transfer and the usage of bioengineered materials may help reduce the incidence of amputations.