@article{ref1,
title="Comparison of four measures in reducing length of stay in burns: an Asian centre's evolved multimodal burns protocol",
journal="Burns: journal of the International Society for Burn Injuries",
year="2017",
author="Chong, Si Jack and Kok, Yee Onn and Choke, Abby and Tan, Esther W. X. and Tan, Kok Chai and Tan, Bien-Keem",
volume="43",
number="6",
pages="1348-1355",
abstract="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. <br><br>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. <br><br>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). <br><br>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.<br><br>Copyright © 2017. Published by Elsevier Ltd.<p /> <p>Language: en</p>",
language="en",
issn="0305-4179",
doi="10.1016/j.burns.2017.03.011",
url="http://dx.doi.org/10.1016/j.burns.2017.03.011"
}