Periorbital burns - A 6 year review of management and outcome

Edmund Fitzgerald O'Connor, Q. Frew, A. Din, J. Pleat, S. Ashraff, S. Ghazi-Nouri, N. El-Muttardi, B. Philp, Peter Dziewulski

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction Periorbital burns are an infrequent but potentially devastating injury. This study aimed to elucidate the spectrum of such injuries presenting to a UK burns centre and the outcome achieved in the cases requiring periorbital reconstruction for the restoration of function and form. Methods Patients admitted to a UK regional burns centre between January 2005 and January 2011 with periorbital burns were identified from the Patient Administration System (PAS), theatre logs and the International Burns Injury database (IBID). Multiple parameters were assessed using patient notes, ITU and hospital image databases. Results Over 6 years, 167 patients with facial burns requiring surgery were treated, including 103 patients with eyelid burns. The mean burn size was 33% total body surface area. The eyelid burn depth varied; 67% superficial partial thickness, 17% deep dermal and 16% full thickness. Two patients lost complete vision in one eye, one patient underwent amniotic membrane grafting. In total 16 patients required periorbital reconstruction to maintain eye closure, with 1.8 operations on average per patient. Acute surgery was required in 11 patients, whilst late intervention (>3 months) was needed in 5, 2 patients had both acute and delayed surgery. Of the 5 late intervention patients 4 were treated with full thickness skin grafts and 1 with a Z plasty. Average time for final reconstruction with delayed surgery was 4.5 months. Conclusion The goal in management of periorbital burns is preservation of vision, prevention of future complications and restoration of an acceptable aesthetic outcome. Total visual loss is thankfully rare, but early ophthalmology intervention is vital given the evidence of corneal damage as a brief therapeutic window exists.

Original languageEnglish (US)
Pages (from-to)616-623
Number of pages8
JournalBurns
Volume41
Issue number3
DOIs
StatePublished - May 1 2015
Externally publishedYes

Fingerprint

Burns
Burn Units
Eyelids
Wounds and Injuries
Databases
Skin
Amnion
Body Surface Area
Ophthalmology
Esthetics
Transplants

Keywords

  • Burns
  • Facial burns
  • Ocular injury

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Fitzgerald O'Connor, E., Frew, Q., Din, A., Pleat, J., Ashraff, S., Ghazi-Nouri, S., ... Dziewulski, P. (2015). Periorbital burns - A 6 year review of management and outcome. Burns, 41(3), 616-623. https://doi.org/10.1016/j.burns.2014.08.022

Periorbital burns - A 6 year review of management and outcome. / Fitzgerald O'Connor, Edmund; Frew, Q.; Din, A.; Pleat, J.; Ashraff, S.; Ghazi-Nouri, S.; El-Muttardi, N.; Philp, B.; Dziewulski, Peter.

In: Burns, Vol. 41, No. 3, 01.05.2015, p. 616-623.

Research output: Contribution to journalArticle

Fitzgerald O'Connor, E, Frew, Q, Din, A, Pleat, J, Ashraff, S, Ghazi-Nouri, S, El-Muttardi, N, Philp, B & Dziewulski, P 2015, 'Periorbital burns - A 6 year review of management and outcome', Burns, vol. 41, no. 3, pp. 616-623. https://doi.org/10.1016/j.burns.2014.08.022
Fitzgerald O'Connor E, Frew Q, Din A, Pleat J, Ashraff S, Ghazi-Nouri S et al. Periorbital burns - A 6 year review of management and outcome. Burns. 2015 May 1;41(3):616-623. https://doi.org/10.1016/j.burns.2014.08.022
Fitzgerald O'Connor, Edmund ; Frew, Q. ; Din, A. ; Pleat, J. ; Ashraff, S. ; Ghazi-Nouri, S. ; El-Muttardi, N. ; Philp, B. ; Dziewulski, Peter. / Periorbital burns - A 6 year review of management and outcome. In: Burns. 2015 ; Vol. 41, No. 3. pp. 616-623.
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abstract = "Introduction Periorbital burns are an infrequent but potentially devastating injury. This study aimed to elucidate the spectrum of such injuries presenting to a UK burns centre and the outcome achieved in the cases requiring periorbital reconstruction for the restoration of function and form. Methods Patients admitted to a UK regional burns centre between January 2005 and January 2011 with periorbital burns were identified from the Patient Administration System (PAS), theatre logs and the International Burns Injury database (IBID). Multiple parameters were assessed using patient notes, ITU and hospital image databases. Results Over 6 years, 167 patients with facial burns requiring surgery were treated, including 103 patients with eyelid burns. The mean burn size was 33{\%} total body surface area. The eyelid burn depth varied; 67{\%} superficial partial thickness, 17{\%} deep dermal and 16{\%} full thickness. Two patients lost complete vision in one eye, one patient underwent amniotic membrane grafting. In total 16 patients required periorbital reconstruction to maintain eye closure, with 1.8 operations on average per patient. Acute surgery was required in 11 patients, whilst late intervention (>3 months) was needed in 5, 2 patients had both acute and delayed surgery. Of the 5 late intervention patients 4 were treated with full thickness skin grafts and 1 with a Z plasty. Average time for final reconstruction with delayed surgery was 4.5 months. Conclusion The goal in management of periorbital burns is preservation of vision, prevention of future complications and restoration of an acceptable aesthetic outcome. Total visual loss is thankfully rare, but early ophthalmology intervention is vital given the evidence of corneal damage as a brief therapeutic window exists.",
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