Burns and Plastic Surgery Unit is among the speciality departments established in Kiruddu Referral Hospital. The Unit is located on the fourth floor of the main Hospital building.It comprises two modalities; Burns and Plastic surgery with a total In-patient bed capacity of 60 for patients’ admission.
The unit is open 24 hours daily with a professional and dedicated team of staff that consists of Senior Consultant Plastic Surgeons, Medical Officers Special Grade, Medical Officers, Clinical Officers, Nurses, Anaesthiologists and Anaesthetists, physiotherapists, occupational therapists and nutritionists. We care for over 60 patients with burn injuries monthly with an average hospital stay of 45 days depending on extent of burn injury and other factors affecting wound healing.
MAJOR CAUSES OF BURNS IN UGANDA;
According to burn injury cases received in the Burns unit at Kiruddu Referral Hospital, over 55% of extensive burn wounds are due to flames mostly started from open burning flames from candles and locally made winked-lamps (Tadooba). These flames often ignite mosquito nets and mattresses. About 40% of the burn cases are scalds from hot liquids mostly hot water, bean soup, and hot cooking oil. The rest 5% are almost evenly distributed with chemical burns taking slightly a higher incidence to electric and/or arch burns, and contact burns usually occur due to a predisposing comorbidity such as a seizure disorder or alcohol intoxication. Radiation burns are very rare.
PREDISPOSING FACTORS TO BURN INJURY
CRITERIA OF ADMISSION
Patients are assessed from our emergency room to determine whether they need admission or not. We admit burns patient either in Burns (Holland) ward or Intensive Care Unit (ICU) depending on severity and/or extent of burn injury. We consider the percentage of Total Burnt Surface Area (TBSA), depth of burns sustained, presence or possibility of inhalation injury, and burns to some critical areas of the body like face. The following burn injuries meet the criteria for admission to Burns (Holland) ward.
The following burn injuries are admitted in ICU.
MANAGEMENT OF BURNS AT OUR CENTRE
We have an emergency team available throughout the day and night that receives all burn patients.
Our patients are not received and assessed from Assessment and Emergency centre on Ground floor, however, they are sent directly to us on Level 4 in the Burns Unit.
We receive all burns as emergencies until deemed out of danger.
On arrival to our unit; We assess for ABCDEFGH. We ensure an open airway and cervical spine stabilization
We resuscitate our burns patients with intravenous fluids preferably Ringers Lactate. We calculate the fluid required for resuscitation in first 24 hours of burn injury using Parkland method and run half of it in the first 8 hours then the remaining half is given in the next 16 hours. We also supplement it with the daily body fluid requirement or maintenance fluid.
Manage pain with analgesics.
ACHIEVEMENTS IN 2019-2020