The Importance of Rest and Elevation in the Management of Lower Extremity Burns: A Retrospective Analysis of 167 Lower Extremity Burn Cases

Abstract

OBJECTIVES: The ratio of non-fatal burns compared with fatal ones is increasing especially in high-income countries. In the management of lower leg burns, rest and elevation of affected limbs are thought to be important, but there are few guidelines for mild to moderate lower leg burns. The purpose of this study was to re-evaluate the importance of rest and elevation in the management of lower leg burns.

MATERIALS AND METHODS: We retrospectively studied 167 lower legs with second-degree or third-degree lower leg burns between October 2014 and March 2020. Age, sex, mechanism of injury, percentage of the total body surface area, treatment situation, method of treatment, wound healing period, and complications were investigated.

RESULTS: Of 167 included burns, 111 lower extremities were treated in the outpatient clinic, and 56 were treated in the hospital. Mean percentage of the total body surface area were 1.00% and 1.94%, respectively (P < .05). Seventeen cases were converted from outpatient clinic to admission treatment because of refractory wounds. Mean percentage of the total body surface area for these was larger than that for cases that received outpatient care throughout (1.62% vs 0.89%; P < .05). Patients with more than 1.0% to 1.5% total body surface area of lower leg burn were prone to have infections or have need for surgery.

CONCLUSIONS: Lower leg burns are difficult to treat because of complications. Under outpatient treatment, patients sometimes cannot rest and elevate their affected limbs because of their daily lives. Lower legs burns of >1.5% total body surface area should be treated in the hospital or with a rest level similar to admission even in the outpatient clinic.