A Pediatric Burn Outpatient Short Stay Program Decreases Patient Length of Stay With Equivalent Burn Outcomes

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 AgTM 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% total body surface area (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.

Nanocellulose‐based wound dressing for conservative wound management in children with second‐degree burns

“…High stress levels could lead to a dysregulation of biomarkers and thereby to an impairment of the healing process. 12,[19][20][21][22] Even when leaving the dressing in place for 7 days, no adverse events related to the used material had been detected, potentially underlining its high biocompatibility. Additionally, the material we used in our study was easy to handle in clinical practice performing dressing changes.…”

“…High stress levels could lead to a dysregulation of biomarkers and thereby to an impairment of the healing process. 12 , 19 , 20 , 21 , 22 …”

“…[5][6][7] A wide variety of materials are used for the conservative treatment of burns, with dressings containing silver seem to be most frequently used. 3,[8][9][10][11][12] Until today, no unified "gold standard" could be determined. 7 However, over the past years, significant progress has been made developing new and innovative dressings.…”