Review of Major Burns Management Protocols
Sinem Gultekin1, Elizabeth Concannon2, Lindsay Damkat Thomas3, 1Tasmanian Burns Unit, Royal Hobart Hospital, Hobart, Tasmania, Australia2Adult Burns Centre, Royal Adelaide Hospital, Adelaide, South Australia, Australia3New Zealand National Burn Service, Middlemore Hospital, Auckland New Zealand
Abstract
Aim
Major burns are a significant healthcare concern worldwide, with severe implications for patient morbidity and mortality. There is a growing body of evidence supporting early burn excision in optimising outcomes for patients, where feasible. Developing burns centre protocols for the early management of major burns is essential to plan, streamline and provide timely effective treatment. Variations exist in the management of major burn patients across burns centres depending on resources. This study aims to survey current protocols for adult major burns management across Australasian burns centres, focusing on the timing of burn debridement and wound closure strategies.
Methods
This study design involves a mixed-methods approach, combining a literature review and burn centre survey of existing protocols for major burns with supplementary burn centre expert interview.
Results
The results of this study report on variations in existing protocols of major burn management across modern Australsian burn centres, combined with a review of the evidence base supporting current strategies. Documentation of wound closure strategies such as autologous skin graft, cadaveric allograft, dermal and epidermal substitutes using a simple yet novel diagram is proposed. This diagrammatic record could facilitate a more accurate, standardised approach to recording and reporting burn outcome measures, such as scar quality, as well as identifying complications.
Conclusion
Knowledge of existing major burn management protocols across Australasian burn centres, including standardised documentation, strengthens the evidence base to support the variety of current practice to ultimately improve burn patient outcomes and broaden the collective knowledge of the burns community.
1) Tomer Lagziel, Sophie L Cemaj, BS, Laura M Mafla, BS, Alexander K Karius, BS, Charles S Hultman, MD, MBA, 800 Immediate/Ultra-Early v. Early Burn Excision: A Systematic Review of Surgical Outcomes, Journal of Burn Care & Research, Volume 43, Issue Supplement_1, April 2022, Page S206, https://doi.org/10.1093/jbcr/irac012.349
2)https://anzba.org.au/#:~:text=There%20are%20approximately%2050%2C000%20burns,across%20Australia%20and%20New%20Zealand.
Biography
Sinem Gultekin is a current plastic surgery registrar at Royal Hobart Hospital. She holds an honorary research position at The Alfred. She has an interest in general plastics and burns.