A collaborative systems approach to rural burn care

A collaborative systems approach to rural burn care

A collaborative systems approach was created between the regional verified burn center (BC) and the rural verified Level 1 trauma center (TC) to treat minor burns. This study assesses the feasibility of providing outpatient burn care at the TC. A retrospective review was performed from January 2000...

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Bibliographic Details
Published in:Journal of burn care & research Vol. 28; no. 1; pp. 111 - 114
Main Authors: SAGRAVES, Scott G, PHADE, Sachin V, ROTONDO, Michael F, SPAIN, Tamara, BARD, Michael R, GOETTLER, Claudia E, SCHENARTS, Paul J, TOSCHLOG, Eric A, NEWELL, Mark A, CLAIMS, Bruce A, PECK, Michael D
Format: Conference Proceeding Journal Article
Language:English
Published: Philadelphia, PA Lippincott Williams & Wilkins 2007
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Infective Agents, Local - therapeutic use
Appointments and Schedules
Biological and medical sciences
Burn Units - organization & administration
Burns
Burns - complications
Burns - epidemiology
Burns - therapy
Child
Child, Preschool
Cooperative Behavior
Dermatology
Feasibility Studies
Female
Humans
Infant
Male
Medical sciences
Middle Aged
Narcotics - therapeutic use
Outpatient Clinics, Hospital
Patient Transfer
Remote Consultation - organization & administration
Retrospective Studies
Rural Health Services - organization & administration
Skin Transplantation - statistics & numerical data
Trauma Centers - organization & administration
Traumas. Diseases due to physical agents
United States - epidemiology
United States
Burn
Skin disease
Rural environment
Care
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Summary:A collaborative systems approach was created between the regional verified burn center (BC) and the rural verified Level 1 trauma center (TC) to treat minor burns. This study assesses the feasibility of providing outpatient burn care at the TC. A retrospective review was performed from January 2000 to June 2005 of burn patients seen at the TC. Seven trauma/critical care surgeons and a dedicated burn nurse staffed the clinic twice a week. Burn surgeons from the BC provided consultation via email and telephone links and served as the regional resource. In the TC clinic, 314 injuries occurred in 311 patients. 196 patients were male with an average age of 34.5 +/- 1.1 years. The mean burn TBSA was 2.9 +/- 0.2%. Fourteen patients (4%) required skin grafts. Patients averaged 3.5 +/- 0.1 clinic visits over a mean follow-up period of 42.9 +/- 7.4 days from initial injury. There were 1252 scheduled appointments during the study period. Silver sulfadiazine or triple antibiotic ointment was applied in the majority of the cases. Thirty-one patients (9.9%) were documented to have complications, most of which were local wound infections. Long-term sequelae (scarring, chronic pain, and contractures) occurred in 13.4% of patients. Clinical success in outpatient burn care can be achieved at a non burn center with dedicated personnel. The successful collaboration between the BC and TC can unload some minor burn care from the burn center, while providing good clinical care to the local rural population.
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ISSN:1559-047X
1559-0488
DOI:10.1097/BCR.0B013E31802C893B