Medicolegal evaluation of thermal burn patients

Aim: We aimed to reveal and improve the criteria used for medico legal evaluation of patients with thermal burn injuries by the help of international protocols as burn center referral criteria.Method: A retrospective review of all medical records of patients admitted with acute thermal burns to Dokuz Eylul University School of Medicine, Ataturk Training Hospital and Behçet Uz Pediatric Training Hospital in 2009 was carried out. Patient demographics, etiology of burn, burn extent, body sites affected, and hospitalization status were reviewed. Referral status according to burn center referral criteria and medico legal evaluation to determine the severity of clinical status and lesions were performed for each patient.Results: The 588 burn victims admitted with a mean age of 20.68 ± 21.30 SD years and 314 (53.4%) of them were male. The most common etiologies were hot liquid contact burns (%82.5), flames (%12.6) and hot matter contact burns (%4.9) and women were mostly affected with hot liquids (x²:17.070, p<0.001). The mean total body surface area in all burns was 6.06.± 6.40 % SD (range 1-55%). Of the patients 41.8% were hospitalized and the mean hospital stay was 4.17 ± 7.93 SD days (9-34). Flame contact injuries resulted more hospitalization than other burns and positive, high correlation was found between hospitalizations with total burn surface area in all age groups. Predominant anatomical sites involved were more than one part of body site and 98 of the patients with effected special body site (as face, hands, feet, genitalia, perineum, or major joint) showed only one degree burn. Of the patients, 75.4% had special body site burn and were under 5 years old and had second degree and total body surface area was lower than 5%. Severity of lesions was determined as mild injury by medico legal evaluations in this group however all of them met the burn referral center criteria.Discussion and Conclusion: We recommended using the special body sites and age groups (0-5, 6-15 and over 65) for determining the severity of burn injuries in medico legal evaluations. Burn referral center criteria and physiological score systems could improve determining the severity of burn injuries instead of medico legal evaluation criteria currently used.Key words: Burn, forensic medicine, medicolegal evaluation, burn center.