Journal of burn care & research : official publication of the American Burn Association
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The coronavirus disease pandemic has affected our practice as healthcare professionals. As burn surgeons, we are obliged to provide the best possible care to our patients. ⋯ This warrants special caution to the burn team while managing such patients. In this review, we aim to highlight the key considerations for burn care teams while dealing with burn patients during the COVID-19 pandemic.
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Preburn comorbidities increase the risk of death in the acute phase, and negatively impact quality of life among survivors. Investigations to date have only evaluated comorbidities as indices, limiting the ability to target conditions and develop strategies for risk reduction. Therefore, we aimed to evaluate the differential effects of specific conditions on long-term, patient-reported outcomes after burn injury. ⋯ Smoking, alcohol use disorder, and diabetes were associated with lower PCS scores 6 months after injury; diabetes persisted as a negatively associated covariate at 12 months. Mental component summary scores were negatively associated with mental illness 6 and 12 months postinjury. Integrated models of postdischarge comorbidity management need to be tested in burn patients.
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In 2018, the World Health Organization (WHO) launched the Global Burn Registry (GBR). Its purpose is to help improve the understanding of burn injury worldwide. The purpose of this study was to identify early findings from this database. ⋯ New Innovations may be necessary to increase participation from burn centers in LR countries. This report provides an early look at burn care across the globe based on cases in the GBR. It may inform further efforts to characterize and improve burn care in LR countries.
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This study establishes important, national benchmarks for burn centers to assess length of stay (LOS) and number of procedures across patient profiles. We examined the relationship between patient characteristics such as age and total body surface area (TBSA) burned and number of procedures and LOS in the United States, using the American Burn Association National Burn Repository (NBR) database version 8.0 (2002-2011). Among 21,175 surviving burn patients (TBSA > 10-60%), mean age was 33 years, and mean injury size was 19.9% TBSA. ⋯ After adjusting for sex, age, and comorbidities, predicted LOS for adults (18+) was 12.1, 21.7, 32.2, 43.7, and 56.1 days for 10, 20, 30, 40, and 50% TBSA, respectively. Similarly, predicted LOS for pediatrics (age < 18) was 8.1, 18.8, 33.2, 47.6, and 56.1 days for the same TBSA groups, respectively. While average estimates for adults (1.12 days) and pediatrics (1.01) are close to the one day/TBSA rule-of-thumb, consideration of other important patient and burn features in the NBR can better refine predictions for LOS.
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American Burn Association (ABA) guidelines recommend that all pediatric burns be transferred to a burn center if their presenting hospital lacks the necessary personnel or equipment for their care. Our institution often treats small burns (<10% TBSA) in pediatric patients in an ambulatory setting with a nondaily dressing. The aim of this study was to determine whether small pediatric burns could be safely managed on an outpatient basis. ⋯ The patients who were successfully managed in an ambulatory setting had a mean TBSA of 3%, whereas the patients who failed outpatient care had a mean TBSA of 4%. The primary reason for the subsequent admission of these patients was nutrition optimization (61%). The vast majority of small pediatric burns can be effectively treated on an outpatient basis with a nondaily dressing.