Citation

Chong SJ, Kok YO, Choke A, Tan EWX, Tan KC, Tan BK. Burns 2017; 43(6): 1348-1355.

Affiliation

Department of Plastic, Reconstructive, and Aesthetic Surgery, Singapore General Hospital (SGH), Singapore.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.burns.2017.03.011

PMID

28668445

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.

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

Keywords

Biobrane; Micrograft; Protocol; Renal replacement therapy