MOLTEN-METAL BURNS - EARLY TREATMENT IMPROVES OUTCOME

Molten metal burns have received relatively little attention in the su rgical literature. We performed a retrospective chart review of 150 pa tients who sustained molten metal burns between 1972 and 1997. The inj uries all occurred in male foundry workers, most commonly from molten aluminum (60%). The typical accident was that of a splatter spill, cre ating a full-thickness burn. The mean burn size was 2.3 per cent of th e body surface area (range, 0.25-25%). The lower extremities were the most commonly injured areas (85%), yet 37 per cent of patients had mul tiple sites burned. Patients were often initially treated nonoperative ly and then referred to a surgeon when the wound failed to heal. Hospi talization was necessary in 89 patients at a mean of 16 days after the injury, and 92 patients required an operation, most commonly excision of the wound with skin grafting. The mean length of hospital stay was 11.2 days, and mean absence from work was 72.6 days. Fifty-one patien ts treated by the burn surgeon within 2 weeks of injury had a mean len gth of disability significantly shorter than those referred late (53.5 vs. 83.4 days; P < 0.05). We believe that an underestimation of the s everity of these burns often leads to a delay in correct therapy and e xtends disability.