Background: Burn injuries in adults can be complicated due to various underlying factors. Of all the co-morbidities complicating wound healing and prognosis of the patient post burn injury, diabetes mellitus is the most common in India. We therefore aimed to explore the epidemiology, interventions, complications, and outcomes in diabetic patients with burn injury. Aim: To analyze demographic characteristics, clinical and microbiological profile and outcome of diabetic burns patients in comparison with nondiabetic burns patients. Materials and methods: This study was a retrospective analysis of diabetic and nondiabetic burns patients admitted to Apollo speciality clinics, Vanagaram, a tertiary care facility in Chennai over a period of 3 years. Data such as age, gender, type and degree of burns, percentage of burns and length of stay, mortality rate, infection rate, type of infections, surgical procedures, and medical complications were analyzed in comparison with nondiabetic burns patients. Results: Among ninety-four burns patients admitted to our hospital over a period of 3 years, 18 patients (19%) were diabetics and 76 patients (81%) were nondiabetics. Mean age of diabetics was 58.2 years (SD-17.1) and nondiabetics was 36.3 years (SD-16.4). Surgical intervention with split skin graft was performed in 50% of diabetics and 48.7% of nondiabetics. Average length of stay of diabetics was 12.6 days and nondiabetics was 16.2 days (p value: 0.334). Diabetic patients with burns were noted to have higher rate of infection (67% vs 61.8%, p value: 0.803) and mortality (44% vs 35.5%, p value: 0.482). Conclusion: The clinical course is different between diabetic and nondiabetic patients with burns injury. Although length of stay and surgical interventions were not significantly different, diabetes as a comorbidity appears to increase the risk of infections and mortality in patients with burns.
Feinstein AR. The pre-therapeutic classification of co-morbidity in chronic disease. J Chronic Dis 1970;23:455–468. DOI: 10.1016/0021-9681(70)90054-8.
Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. AMJ 2014;7(1):45–48. DOI: 10.4066/AMJ.2014.1979.
Joshi SR, Parikh RM. India - diabetes capital of the world: now heading towards hypertension. J Assoc Physicians India 2007;55:323–324.
Anjana RM, Ali MK, Pradeepa R, Deepa M, Datta M, Unnikrishnan R, et al. The need for obtaining accurate nationwide estimates of diabetes prevalence in India—rationale for a national study on diabetes. Indian J Med Res 2011;133:369–380.
Shalom A, Friedman T, Wong L. Burns and diabetes. Ann Burns Fire Disasters 2005;18(1):31–33.
Kimball Z, Patil S, Mansour H, Marano MA, Petrone SJ, Chamberlain RS. Clinical outcomes of isolated lower extremity or foot burns in diabetic versus non-diabetic patients: a 10-year retrospective analysis. Burns 2013;39(2):279–284. DOI: 10.1016/j.burns.2012.06.006.
Maghsoudi H, Aghamohammadzadeh N, Khalili N. Burns in diabetic patients. Int J Diabetes Dev Ctries 2008;28(1):19–25. DOI: 10.4103/0973-3930.41982.
McCampbell B, Wasif N, Rabbitts A, Staiano-Coico L, Yurt RW, Schwartz S. Diabetes and burns: retrospective cohort study. J Burn Care Rehabil 2002;23(3):157–166. DOI: 10.1097/00004630-200205000-00004.
Thng P, Lim RM, Low BY. Thermal burns in diabetic feet. Singapore Med J 1999;40:362–364.
Tan HB, Danilla S, Murray A, Serra R, El Dib R, Henderson TO, et al. Immunonutrition as an adjuvant therapy for burns. Cochrane Database Syst Rev 2014(12):CD007174. DOI: 10.1002/14651858.CD007174.pub2.
Singh O, Gupta SS, Soni M, Moses S, Shukla S, Mathur RK. Collagen dressing versus conventional dressings in burn and chronic wounds: a retrospective study. J Cutan Aesthet Surg 2011;4(1):12–16. DOI: 10.4103/0974-2077.79180.
Memmel H, Kowal-Vern A, Latenser BA. Infections in diabetic burn patients. Diabetes Care 2004;27(1):229–233. DOI: 10.2337/diacare.27.1.229.
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40(5):373–383. DOI: 10.1016/0021-9681(87)90171-8.
Goutos I, Nicholas RS, Pandya AA, Ghosh SJ. Diabetes mellitus and burns. Part I-basic science and implications for management. Int J Burn Trauma 2015;5(1):1–12.
Barsun A, Sen S, Palmieri TL, Greenhalgh DG. A ten-year review of lower extremity burns in diabetics: small burns that lead to major problems. J Burn Care Res 2013;34(2):255–260. DOI: 10.1097/BCR.0b013e318257d85b.
Schwartz SB, Rothrock M, Barron-Vaya Y, Bendell C, Kamat A, Midgett M, et al. Impact of diabetes on burn injury: preliminary results from prospective study. J Burn Care Res 2011;32(3):435–441. DOI: 10.1097/BCR.0b013e318217f954.
Stern LE, Kagan RJ. Rhinocerebralmucormycosis in patients with burns: case report and review of the literature. J Burn Care Rehabil 1999;20(4):303–306. DOI: 10.1097/00004630-199907000-00005.
Ballard J, Edelman L, Saffle J, Sheridan R, Kagan R, Bracco D, et al. Positive fungal cultures in burn patients: A multicenter review. J Burn Care Res 2008;29(1):213–221. DOI: 10.1097/BCR.0b013e31815f6ecb.