Burns to the elderly: a reappraisal.

Admissions to the McIndoe burns unit over the period 1975 to 1984 were reviewed and 123 patients over the age of sixty-five were studied in detail. Comparison with standardised mortality curves showed no difference in survival rates, but review of individual cases suggests that regular examination of elderly patients could shorten admission times and reduce the mortality by encouraging prompt identification and treatment of medical complications. Patients with burns of greater than 5% of surface area should be resuscitated with intravenous fluids as this age group is very susceptible to hypotensive renal damage. Excision of burns on or before the fifth day resulted in longer admissions and increased the number of procedures per patient. Disagreement in the recent literature on this point suggests the need for a randomised, controlled trial of early excision in the elderly patient.