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022			_a0305-4179
040			_cSalus Infirmorum
245	0	0	_aComparison of four measures in reducing length of stay in burns: An Asian centre’s evolved multimodal burns protocol / _cSi Jack Chong, Yee Onn Kok, Abby Choke, Esther W.X. Tan, Kok Chai Tan, Bien-Keem Tan
500			_aPDF en biblioteca
504			_aBibliografía: p. 1355
520	8		_aIntroduction: 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.
773			_g-- 2017, v. 43, p. 1348-1355 _tBurns. Journal of the International Society for Burn Injuries
942			_2udc _cARTÍCULO
999			_c12900 _d12900