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Article
Evaluating Real-World National and Regional Trends in Definitive Closure in U.S. Burn Care: A Survey of U.S. Burn Centers
Journal of burn care & research : official publication of the American Burn Association
  • Jeffrey E Carter, University Medical Center Burn Center, New Orleans, Louisiana, USA.
  • Hamed Amani, Lehigh Valley Health Network Regional Burn Center, Allentown, Pennsylvania, USA.
  • Damien Carter, Maine Medical Center, Portland, USA.
  • Kevin N Foster, Arizona Burn Center at Valleywise Health Medical Center, Phoenix, USA.
  • John A Griswold, UMC Timothy J. Harnar Regional Burn Center, Lubbock, Texas, USA.
  • William L Hickerson, University of Tennessee Health Science Center: Firefighters Regional Burn Center, Memphis, USA.
  • James H Holmes, Wake Forest Baptist Medical Center Burn Center, Winston-Salem, North Carolina, USA.
  • Samuel Jones, North Carolina Jaycee Burn Center, Chapel Hill, USA.
Document Type
Article
Publication Date
1-5-2022
Institution/Department
Trauma & Acute Care Surgery
MeSH Headings
Benchmarking; Burn Units (economics, trends); Burns (therapy); Community Resources; Humans; Practice Patterns, Physicians' (statistics & numerical data); United States
Abstract

To better understand trends in burn treatment patterns related to definitive closure, this study sought to benchmark real-world survey data with national data contained within the National Burn Repository version 8.0 (NBR v8.0) across key burn center practice patterns, resource utilization, and clinical outcomes. A survey, administered to a representative sample of U.S. burn surgeons, collected information across several domains: burn center characteristics, patient characteristics including number of patients and burn size and depth, aggregate number of procedures, resource use such as autograft procedure time and dressing changes, and costs. Survey findings were aggregated by key outcomes (number of procedures, costs) nationally and regionally. Aggregated burn center data were also compared to the NBR to identify trends relative to current treatment patterns. Benchmarking survey results against the NBR v8.0 demonstrated shifts in burn center patient mix, with more severe cases being seen in the inpatient setting and less severe burns moving to the outpatient setting. An overall reduction in the number of autograft procedures was observed compared to NBR v8.0, and time efficiencies improved as the intervention time per TBSA decreases as TBSA increases. Both nationally and regionally, an increase in costs was observed. The results suggest resource use estimates from NBR v8.0 may be higher than current practices, thus highlighting the importance of improved and timely NBR reporting and further research on burn center standard of care practices. This study demonstrates significant variations in burn center characteristics, practice patterns, and resource utilization, thus increasing our understanding of burn center operations and behavior.

Citation Information
Carter JE, Amani H, Carter D, Foster KN, Griswold JA, Hickerson WL, Holmes JH, Jones S, Khandelwal A, Kopari N, Litt JS, Savetamal A, Shupp JW, Sood R, Ferrufino CP, Vadagam P, Kowal S, Walsh T, Sparks J. Evaluating Real-World National and Regional Trends in Definitive Closure in U.S. Burn Care: A Survey of U.S. Burn Centers. J Burn Care Res. 2022 Jan 5;43(1):141-148. doi: 10.1093/jbcr/irab151. PMID: 34329478; PMCID: PMC8737084.