D. Ulrich et al., Life threatening burn injuries on holidays: problems of primary care, homeland referral and treatment at a domestic burn centre, BURNS, 27(3), 2001, pp. 277-282
Life threatening burn injuries during vacations abroad raise special proble
ms. Depending on the infrastructure of the country, adequate medical care c
an be delayed and communication between the patient and the medical staff i
s frequently impossible due to language barriers. Often the patient finds h
imself in a critical condition, isolated from supporting relatives and fina
ncial difficulties may occur. By summarising three cases referred to our ce
ntre, we aim to emphasise particularities of the primary management of burn
ed victims at foreign hospitals, their transport, and following therapy at
a domestic burn unit. Primary shock treatment and vital surgical interventi
ons, e.g, escharotomy or treatment of the concomitant trauma, are subject t
o the facility of the hosting country. After management of the acute phase
and initiation of local wound treatment, the next step should be to stabili
se and prepare the patient for transport. Aeromedical transportation with p
hysician attendency, as well as contact with a domestic burn centre can be
established via responsible organisations. At the domestic hospital, every
burn victim from abroad deserves special attention. Wound colonisation with
different bacterial species or fungi than the usual spectrum of the centre
and the risk of crossinfections should be taken in account of the treating
medical team. An structure plan for appropriate and continuing surgical tr
eatment is necessary to prevent deterioration of the patient's condition an
d to optimise wound closure with autologous skin grafts or allogenic materi
als. (C) 2001 Elsevier Science Ltd and ISBI. All rights reserved.