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YANIK TRAVMALARINDA HAYATI TEHLİKE KARARINA YENİ YAKLAŞIM

THE NEW VIEW TO VITAL RISK CRITERIA IN BURN INJURIES

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Abstract (2. Language): 
Objective: In forensic cases, trauma’s degree is very important to determine if it is a life threatening injury or not. Definition of life threatening injury is as important as the treatment of a patient. One of the most important life threatening injuries is burn injuries. At least, 20% second degree and 10% third degree burn traumas are accepted as life threatening injuries. We wanted to determine how much percentage of burn degree is enough for life threatening injury. Materials and methods: This study has been performed between 14.10.2004 and 31.12.2006 on all the burned cases who came to Istanbul University Medical Faculty Emergency Surgery Burn Unite to take treatment. This descriptive study has been created by comparing socio-demographic features of cases (sex, age, place of residence, health insurance, job) with burn criteria (percentage of and kind of burn, degree of burn). Results: In all the cases, percentage of men and women were 69.5 and 30.5. The age of average was 15.33 + 18.2 (R: 0-81) and the age of median was 5. 68 (53.5 %) cases were injured by scalding with hot water and 36 (28.3 %) cases were injured by catching fire. 109 (85.2 %) cases had burns which were between I and II degree and 19 (14.8 %) cases had burns which were between II and III degree. 103 (80.5 %) cases have been discharged either getting better or recovering completely but unfortunately 25 (19.5 %) cases died. In 24 cases, burned area has been 20% or more and frequency of death was 49%. Conclusion: In our study we determined that life threatening injury criteria is meaningful both clinically and statistically when compared with burned area percentage.
Abstract (Original Language): 
Amaç: Adli olgularda, travman›n a¤›rl›¤›n› belirten en önemli kriter olan, “hayati tehlike” kavram›n›n tespiti çok önemlidir. Hayati tehlikenin do¤ru olarak belirlenmesi ma¤durun tedavisi kadar önemlidir. Yan›k nedenli travma olgular›nda II. derece %20, III. derece %10 dan fazla yan›k hayati tehlike kapsam›nda de¤erlendirilmektedir. Çal›flma bildirilen bu yan›k yüzde de¤erlerinin, hayati tehlike kavram›n› ne ölçüde karfl›lad›¤›n› araflt›rmak amac› yla yap›lm›flt›r. Gereç ve yöntem: Çal›flma 14.10.2004 (Yan›k Ünitesinin Aç›lma Tarihi) ile 31.12.2006 tarihleri aras›nda, tan›mlay› c› epidemiyolojik yöntemle, ‹stanbul Üniversitesi ‹stanbul T›p Fakültesi Acil Cerrahi Servisi Yan›k Ünitesine gelen tüm olgular de¤erlendirilerek gerçeklefltirilmifltir. Olgular›n sosyo-demografik özelikleri (cinsiyet, yafl, yaflad›¤› yer, sa¤l›k güvencesi, mesle¤i) ile yan›¤a ait klinik özelliklerini ortaya koyan (yan›k türü, derecesi, yüzdesi) kriterlerin araflt›r›lmas› ile yap›lm›flt›r. Bulgular: Olgular›n %69,5 (n: 89) u erkek, %30,5 (n:39) u kad›nd›r. Yafl ortalamas› 15,33 + 18,2 (R:0-81) ortanca yafl 5 olarak bulunmufltur. Olgular›n %53,5 (n:68) inde yan›¤›n s›cak su ile hafllanma sonucunda meydana geldi¤i; %28,3 (n:36) ünde alev yan›¤› oldu¤u belirlenmifltir. Olgular›n %85,2 (n: 109) sinde I-II derece yan›k; %14,80 (n:19) inde II-III derece yan›k oldu¤u belirlenmifltir. Olgular›n %19,5 (n:25) inin öldü¤ü, %80,5 (n:103) inin ise salah ya da flifa ile taburcu edildi¤i bulunmufltur. Yan›k yüzdesi %20 nin alt›nda olan olgularda %1,3 (n:1) oran›nda, %20 ve üzerinde hesaplanan olgularda %49,0 (n=24) oran›nda ölüm görülmüfltür (P=0,0001). Sonuç: Yan›k yüzdelerinde verilen hayati tehlike kavram›n›n hem klinik hem de istatistiksel olarak anlaml› oldu- ¤unu tespit edilmifltir.
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