Predictors of mortality: A comparison between two burn wound treatment policies

Retrospective review of outcomes and experiences of a single burn centre between two time periods during which a new wound care technique was employed after the first period. The time period was divided into two: 1977–1984 and 1984–1990. Due to the use of cerium nitrate-silver sulphadiazine, the introduction of serial excision and grafting became possible in the second time period. Multivariate risk-analysis was done by logistic regression analysis. The mortality rate decreased from 13.7% (1997–1983) to 4.7% (1984–1990). Results of multiple logistic regression analysis indicate that the change in periods was advantageous for patients with >50% TBSA, within the age group, 0 to 30 years. Obviously, the care which a patient receives has improved significantly. Many developments occurred simultaneously and it appears impossible to conclude that only the use of cerium nitrate–silver sulphadiazine was the reason for improved survival. Nevertheless, the use of cerium nitrate–silver sulphadiazine enables sequential excision and grafting and in consequence allows for many of these developments to occur.