Setting up a Modified Burns Unit in the Chingola Mine Hospital of Zambia

A study of burns in an industrial region  in Zambia in which we studied burn patients coming to Nchanga South hospital  to see  the cause of burns and  our success in managing them in a setting without a burns unit. The study was from 2003 to 2008 of admitted adult burn patients.  Side wards were used to isolate all those admitted with burns. The linen used was washed, ironed and autoclaved. The burn wounds were soaked with saline and cleaned twice daily.  The patients were then covered with plastic sheets. Prophylactic antibiotics were not routinely used. The number of visitors to the wards was restricted. Outcome was deemed to be good if the wound healed within three weeks but poor if it took more than three weeks or had severe contractures, or resulted in death. Infection was only recorded if it was severe.  There were 55 patients admitted for burns, five females and fifty males. Mean age was 36 years.  68% were burned at work and 32% at home, the most common burns at work were electrical followed by chemical ones of which burns with Sulphuric acid were commonest. In the domestic environment hot water was the commonest cause. Complications were most commonly seen in electrical burns.72% of our patients had a favorable outcome. In those who had burns of 40% body surface area and above only 40% survived. Adults burns occurred more in males, mostly at work. The most common cause of injury was electrical burns which caused significant morbidity and mortality but patients with chemical burns tended to stay longer.The patients with 40% or more burned body surface area had a higher rate of complications and death.