June 2007, Volume 57, Issue 6

Letter to the Editor

Comment on article "presentation of burn injuries and their management outcome" published in September 2006

Muhammad Ashraf Ganatra  ( Department of Plastic, Reconstructive and Micro Surgery, Dow University of Health Sciences, Karachi. )

Madam, with regard to above mentioned article, I want to point out one major mistake which can jeopardize the creditability of our first international journal indexed in Index Medicus of Bethesda. In article on page 395 in Patients and methods it is mentioned that children less then 10 years of age were included in the study. In the same paragraph it is mentioned that their Total body surface area (TBSA) was estimated by Rule of nine.
Now this is a major mistake and if reviewed by an expert Plastic Surgeon, should have not been missed.
It is a universal teaching that all bum wounds in children up to the age of 12 years should be calculated by using "Lund and Browder chart" which are freely available at every burn center. This is because children have more body surface area involving head and neck. So a child of one year who has sustained burn involving head and neck will be calculated as having 17% bum rather then 9% in adults. This wrong calculation of TBSA will lead to inappropriate fluid calculations and in turn affect the overall outcome. This was a major mistake and should have been corrected.
Few minor mistakes
I. Systemic antibiotics from very first day in bum patients are generally not recommended in burn centers.
2. In a series where bulk of the patients had bums less then 20% TBSA, mean 11 to 20%; mortality of29.7% is quite high.
Furthermore authors have not cited a single reference from any study from Pakistan. Where excellent research monographs and articles has been published.1,2,3,4

References

1. Marsh D,Sheikh A,Khalil A eta!. Epidemiology of adults hospitalized with

burns in Karachi,Pakistan.Burns 1996; 22: 225-9.

2. Durrani KM, Kakalia G: Therapeutic potentialities of topical Gentamycin

sulfate in moderately extensive acute bum wound. Pak Med Forum 1970;

5:51.

3. Durrani.KM: Bum prevention. J Pak Med Assoc 1972; 12: 331.

4. Dnmml KM: Incidence, prevention and therapy of burns. Dow Medical

College 1978.

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: