TREATMENT OF ONE HUNDRED FORTY-EIGHT BURN CASES IN A COMMUNITY HOSPITAL

• The mortality percentage for this unselected consecutive series is 5.4. When this figure is contrasted with a 35.2% mortality reported by one university hospital in 1924, considerable improvement in burn therapy is indicated.

In the experience of our hospital, a reduction in mortality is a result of improvements in both systemic and local treatment. Systemically, the important thing is the quantity of water and electrolytes given intravenously; lactated Ringer's solution has been preferred. When the total surface burned equaled or exceeded 20%, 6 to 8 liters of solution has been given during the first day, after which the volume has been gradually reduced. Locally, wet dressings have been applied under sheets of Pliofilm. Surfaces have been ready for grafting generally about the 15th day. Antibiotics have been used locally only if the surface showed signs of infection, and have been given systemically only when indicated by known complications such as pneumonia. The postage-stamp method of skin grafting has proved invaluable. The fact that 15 of the 148 burns were caused by bonfires or burning trash suggests an important step toward prevention. Attention to the rehabilitation of the burned patient has also been rewarded by some excellent results.