TY - JOUR
PY - 2017//
TI - Comparison of four measures in reducing length of stay in burns: an Asian centre's evolved multimodal burns protocol
JO - Burns: journal of the International Society for Burn Injuries
A1 - Chong, Si Jack
A1 - Kok, Yee Onn
A1 - Choke, Abby
A1 - Tan, Esther W. X.
A1 - Tan, Kok Chai
A1 - Tan, Bien-Keem
SP - 1348
EP - 1355
VL - 43
IS - 6
N2 - 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.
Copyright © 2017. Published by Elsevier Ltd. Language: en
LA - en
SN - 0305-4179
UR - http://dx.doi.org/10.1016/j.burns.2017.03.011
ID - ref1
ER -