Evolution of a Burn Care Network

Teachers: 2021 Upchurch Lecture

ABSTRACT

Examples of influential teachings are drawn from the 6 decades of a single surgeon's education.

Glove Dressing for Initial Management of Hand Burns

ABSTRACT

Initial hand dressings for burned hands should be compatible with preservation of skin substitutes and grafts, splinting, and active motion. We have developed a standardized glove dressing directed at these requirements. Early experience with this glove dressing has included feasible clinical application, 7- to 10-minute application time, and 90% preservation of total active range of motion in a normal hand placed in the dressing under test conditions.

Practice Diversity and Burn Center Growth: A 10-Year Profile of a State's Only Burn Center

BACKGROUND

Growth and sustainability of burn practices can be impaired by irregular patterns of patient presentations, resulting in uneven utilization of facilities and staff. Burn care itself may not engage the full capacities of members of burn care teams. To address these problems, we organized a burn and reconstruction center to provide statewide acute care as Mississippi's only burn unit, to fully integrate reconstructive surgery into management of burn patients, and to diversify practice based on plastic surgery scope of practice. The first 10 years of this unit were reviewed to evaluate the performance of this scheme.

METHODS

Burn admissions to and surgical procedures at this unit between July 2009 and June 2019 were analyzed to quantify acute burn care, secondary reconstructive burn care, and categories of practice growth.

RESULTS

The unit admitted 5469 acute burn patients with a mortality rate of 1.49%. Comparing year 10 to year 1 of practice, acute burn admissions increased 58%. Total operations increased 276%. Acute burn procedures increased 176%. Secondary burn procedures increased 405%. Nonburn procedures increased 352%, with the subset of nonburn hand surgery increasing 1062%.

CONCLUSION

Acute burn admissions and procedures increased over this period, but greater growth was seen in secondary burn procedures and nonburn procedures, especially hand cases. Expansion of practice into areas within the overall skill sets of burn team members was an effective growth strategy.