The impact of the timing of surgical intervention and operative surgical time on patient outcomes in burn wound repair

Jessica Kierath 1, Aaron Berghuber 2, Fiona Wood 3

1 Burns Service of Western Australia, Fiona Stanley Hospital, 12 Australind Street, Swanbourne, WA 6010, jessicakierath@gmail.com
2 Burns Service of Western Australia, Fiona Stanley Hospital, Murdoch, WA Aaron. Berghuber @heath.wa.gov.au
3 Burns Service of Western Australia, Fiona Stanley Hospital, Murdoch, WA Fiona.Wood@heath.wa.gov.au

Background

Early surgical intervention is associated with improved patient outcomes, and  associated improved mortality. In planning surgical intervention it is essential to understand the potential risks and how the risk profile relates to the time since the injury. The duration of surgery has been reported to be associated with adverse outcomes in other populations. This study aimed to examine if the time from injury to the surgical intervention and the duration of the procedure had an influence on patient outcomes.

Methods

This retrospective cohort study includes data of 3500 cases admitted to the adult burns service from 2004 to 2014 Royal Perth Hospital and 2015 Fiona Stanley Hospital. The cohort investigated were adult burn patients who required a single procedure to achieve wound closure. Date of injury, date of intervention, in-hospital and long-term outcome measures were collected.

Results

Time to initial surgery was seen to be associated with improved long-term outcomes. The duration of surgery it was independently seen to increase LOS. This translates to a predicted 13% increase in LOS for a 30 min increase in surgery time. As expected total body surface area (TBSA) was identified as a significant predictor of surgery duration.

Discussion

The results of this study show that the time taken to undertake surgery and surgical duration, are both significant factors to consider as an independent variables with a direct impact on patient outcomes

This study highlights the importance of effective surgical planning and the consideration of multiple surgical teams in burns of >20%TBSA.

Biography

Jessica Kierath is a service registrar in plastic surgery at Royal Perth Hospital. She has burns experience as a registrar in Princess Margaret Hospital, Royal Perth Hospital and Fiona Stanley Hospital. She is also an instructor for the EMSB course.

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