The BAPRASSummer Meeting 2015 was held in conjunction with the Royal Belgian society for Plastic Surgery (RBSPS) in the outstandingly beautiful city of Bruges from 25th to 27th of June 2015.  The venue for the meeting was the Concertgebouw, Bruges.  It was also the 60th anniversary of the RBSPS.

The Meeting was attended by Dr Levi Ankrah.  Dr Ankrah, from Ghana, is a Registrar in plastic surgery whom the charity has supported to undertake post-fellowship training at Canniesburn Hospital in Glasgow.

Dr Levi Ankrah writes:

“My presentation was on the afternoon of day 1, 25th June, in a parallel session on Burns, Skin and Vascular. It was my first time in Belgium and the first time I was making a presentation abroad at an international conference. I had previously submitted an epidemiological study on burn-related injuries in the National Reconstructive Plastic Surgery and Burns Centre (NRPSBC), Korle Bu Teaching Hospital (KBTH) which had been accepted as an oral presentation. The title of the paper was “Liquefied petroleum gas-related burn injuries: An experience from an emerging oil and gas economy” and it had previously been accepted (though not presented) for oral presentation at the ISBI meeting 2014. “

Liquefied petroleum gas related burns: An experience from a burns unit in an emerging oil and gas economy

Levi Nii Ayi ANKRAH, Edem ANYIGBA, Kwame DARKO, Opoku Ware AMPOMAH, Albert PAINTSIL

National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Accra, Ghana.

Introduction

Liquefied petroleum gas (LPG) has gained widespread acceptance and usage in Ghana. As a domestic fuel, consumption rates have risen four-fold in urban areas within the first decade of this millennium. In 2008, the transport sector accounted for about a third of LPG-consumption, with many commercial drivers using hybrid engines that run on both petrol/gasoline and LPG. However, unpublished data from our unit indicated a rising trend in the incidence of LPG-related burn injuries (12.8% in 2008, 15.1% in 2009 as presented at the 1st and 2nd Ghana Burns Conferences respectively). With the recent discovery and drilling of commercial quantities of crude oil along the Ghanaian coastline, we anticipated an increase in consumption as a result of greater availability and cheaper prices. This we hypothesized might eventually lead to a possible increase in LPG-related burns. Data on burn injuries was therefore required to inform national policy.

Method

A prospective study was conducted over a 20 month period (January 2013 to August 2014) in 480 patients. Data was collected on the patient’s demographics, aetiology of injury, extent of burns (%TBSA), presence of inhalation injury, length of hospital stay and mortality. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21.

Results

The commonest cause of burn injury was scalds (52.3%) and LPG-related burns as the second (21.7%). This was a significant difference from earlier results where burns from open flame (e.g. being trapped in a burning building) ranked second. Furthermore, in combination with burns from other petroleum-related products (such as petrol, diesel or kerosene related fires), these accounted for a quarter (26.1%) of all burn injuries presenting to our centre. Children under 5 made up 42.1% of all burn injuries, with 72% of these from scalds.

The LA50 for our centre was a %TBSA of 24.27%. The mean hospital stay was 28.8 days. The mortality rate was 26.5%, more than a third of all deaths (36.8%) resulted from LPG-related burns. The average TBSA burn percentage in LPG-related burns was 30.56% (range of 6 to 95%) which was second only to petrol-related burns. There was a significant difference in survival and %TBSA based on the aetiology of burn (p <0.01).

Conclusion

This is the first study that investigates the epidemiology of burn injuries in Ghana’s largest teaching hospital and indicates a worrying trend in the increase in LPG and other petroleum-related burn injuries. In light of the recent mass casualties resulting from petrol explosions and the high incidence of LPG-related burn injuries, significant national policy guidelines and protocols need to be developed in order to curb this trend. Our centre is also faced with some peculiar challenges in managing severe burn injuries and with the recent steps to establish a Burns Intensive Care Unit, we expect some improvements in morbidity and mortality figures. Targeted interventions are also required in children under 5 to reduce the incidence of scalds.