Citation

Zens T, Yan A, Lee C, Schmitz C, Faucher L, Gibson A. J. Burn Care Res. 2018; 39(3): 353-362.

Affiliation

From the *Division of Trauma, Acute Care Surgery, Burn and Surgical Critical Care, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison; and †University of Wisconsin School of Medicine and Public Health, Madison.

Copyright

(Copyright © 2018, American Burn Association, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/BCR.0000000000000599

PMID

28598952

Abstract

Traditionally, small pediatric burns are managed with inpatient admission and daily dressing changes. In 2011, our burn center implemented an outpatient short stay (OSS) program in which small pediatric burns were managed as an outpatient utilizing Mepilex Ag dressings changed under moderate sedation every 5 to 7 days. Pediatric burn cases were queried for 2 time periods: before the OSS program (2009-2010) and after the OSS program (2013-2014). Burns > 15% TBSA, children with polytrauma, and children > 10 years old were excluded. Independent t tests and chi-square tests were conducted to analyze differences in patient demographics, burn management, and burn outcomes between these groups. Two hundred nineteen cases were included in the analysis (77 pre-OSS and 142 post-OSS). There was no difference in patient age (P = 0.872) or TBSA (P = 0.786) between the groups. The post-OSS group had shorter inpatient length of stay (2.93 days vs 5.21 days; P < 0.001) and fewer dressing changes (2.32 vs 4.71; P < 0.001). There were no changes in readmission rates (P = 0.375) or burns requiring grafting (P = 0.155). Although not reaching statistical significance, less children in the post-OSS group had infectious complications (P = 0.054) or required reoperation in a 2-year follow-up period (P = 0.081). Patient and family satisfaction with the program was high. Children treated after the implementation of an OSS burn program at the University of Wisconsin had decreased inpatient length of stay and fewer painful burn dressing changes. These patients exhibited equivalent, if not superior burn outcomes.

Language: en