Comparison of four measures in reducing length of stay in burns: An Asian centre’s evolved multimodal burns protocol / Si Jack Chong, Yee Onn Kok, Abby Choke, Esther W.X. Tan, Kok Chai Tan, Bien-Keem Tan
Material type:
Continuing resourceISSN: 0305-4179
In:
Burns. Journal of the International Society for Burn Injuries -- 2017, v. 43, p. 1348-1355Summary: Introduction: Multidisciplinary burns care is constantly evolving to improve outcomes given the numerous modalities available. We examine the use of Biobrane, micrografting, early renal replacement therapy and a strict target time of surgery within 24h of burns on improving outcomes of length of stay, duration of surgery, mean number of surgeries and number of positive tissue cultures in a tertiary burns centre.
Methods: A post-implementation prospective cohort of inpatient burns patients from 2014 to 2015 (n=137) was compared against a similar pre-implementation cohort from 2013 to 2014 (n=93) using REDCAP, an electronic database.
Results: There was no statistically significant difference for comorbidities, age and percentage (%) TBSA between the new protocol and control groups. The protocol group had shorter mean time to surgery (23.5–38.5h) (p<0.002), 0.63 fewer operative sessions,
shorter mean length of stay (11.8–16.8 days) (p<0.04), less positive tissue cultures (0.59–1.28) (p<0.03).
Discussion/Conclusion: The 4 measures of the new burns protocol improved burns care and validated the collective effort of a multi-disciplinary, multipronged burns management supported by surgeons, anesthetists, renal physicians, emergency physicians, nurses, and allied healthcare providers. Biobrane, single stage onlay micrograft/allograft, early CRRT and
surgery within 24h were successfully introduced. These are useful adjuncts in the
armamentarium to be considered for any burns centre.
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Bibliografía: p. 1355
Introduction: Multidisciplinary burns care is constantly evolving to improve outcomes given the numerous modalities available. We examine the use of Biobrane, micrografting, early renal replacement therapy and a strict target time of surgery within 24h of burns on improving outcomes of length of stay, duration of surgery, mean number of surgeries and number of positive tissue cultures in a tertiary burns centre.
Methods: A post-implementation prospective cohort of inpatient burns patients from 2014 to 2015 (n=137) was compared against a similar pre-implementation cohort from 2013 to 2014 (n=93) using REDCAP, an electronic database.
Results: There was no statistically significant difference for comorbidities, age and percentage (%) TBSA between the new protocol and control groups. The protocol group had shorter mean time to surgery (23.5–38.5h) (p<0.002), 0.63 fewer operative sessions,
shorter mean length of stay (11.8–16.8 days) (p<0.04), less positive tissue cultures (0.59–1.28) (p<0.03).
Discussion/Conclusion: The 4 measures of the new burns protocol improved burns care and validated the collective effort of a multi-disciplinary, multipronged burns management supported by surgeons, anesthetists, renal physicians, emergency physicians, nurses, and allied healthcare providers. Biobrane, single stage onlay micrograft/allograft, early CRRT and
surgery within 24h were successfully introduced. These are useful adjuncts in the
armamentarium to be considered for any burns centre.
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