Experience of multidisciplinary cooperation in treating 15 extensively burned casualties：The Zhejiang LNG tanker explosion on 13 June 2020

Background

On June 13, 2020, an explosion involving a liquefied natural gas (LNG) tanker truck occurred in eastern China. Fifteen patients with extremely severe burns (referred to as “June 13” patients) were treated in the burn-intensive care unit (ICU) joint ward within the general ICU.

Methods

A multidisciplinary treatment team comprising 129 doctors, 126 nurses, and 165 auxiliary staff members was assembled. Additionally, 15 burn and ICU experts from various regions of China joined us. After concluding the treatment, patient data were collected and analyzed. The differences in clinical data between the deceased and surviving patients were retrospectively compared. Subsequently, the clinical data of 177 non-“June 13” patients with total burned body surface area (TBSA) > 50 % treated in the burn department from 2016 to 2023 were collected to compare the efficacy of our multidisciplinary collaborative treatment model.

Results

The average TBSA of 15 “June 13” patients was 85.07 ± 15.85 % (range 50–98 %). Among them, 11 patients had a TBSA greater than 90 %, with 6 exceeding 95 %. Seven patients succumbed to their injuries, while 8 patients survived. The incidence of severe complications, such as multiple organ failure (MOF) and fungal infections, was higher in the deceased group than in the survival group. The surviving patients exhibited larger burn wound areas repaired by skin grafting on the 30th and 60th days, with significantly less residual wound area than the deceased group. In comparison with the non-“June 13” patients, the “June 13” patients were notably older and had larger TBSA, as well as larger areas of third-degree TBSA and higher mean revised Baux scores. After 1:2 matching for revised Baux score, the “June 13” group underwent a significantly higher number of operations (p-value =0.007). The “June 13” group showed a lower mortality rate, although not statistically significant (20 % vs 55 %, p = 0.119; log-rank p = 0.059 for Kaplan-Meier curves).

Conclusion

Multidisciplinary collaboration, guided by a comprehensive treatment plan, may improve the management of patients with extensive burns. Timely and effective surgical management is crucial for reducing mortality and improving patient prognosis.