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Outcomes of Outpatient Management of Pediatric Burns

4/17/2015

Authors: Matthew Brown, MD, Tammy Coffee, CNP, Paul Adenuga, BS, Charles J. Yowler. MD, FACS, FCCM

Importance: The literature surrounding pediatric burns has focused on inpatient management. The vast majority of pediatric burns are treated with outpatient management, but there is no characterization of this outpatient burn population or evidence to support this treatment modality.

Objective: To characterize the population of pediatric burns treated as outpatients and assess outcomes validating this method of burn care.

Design: 3-year retrospective review.

Setting: The burn clinic and burn unit of a tertiary care center.

Population: 953 patients, ages 0-18 treated at a tertiary care center burn unit over a 3 year period.

Intervention: Patients were classified as outpatient if they were discharged from the burn clinic upon initial evaluation. All patients directly admitted to the burn unit or admitted from clinic were considered inpatient.

Main Outcome(s) and Measure(s): Patient age, burn etiology, burn characteristics, burn mechanism and referral pattern were recorded. The type of wound care and incidence of outcomes including subsequent hospital admission, infection, scarring, and surgery served as the primary outcome data.

Results: For the outpatient cohort the mean time of burn injury to evaluation in our clinic was 1.8 days with 64% of patients being evaluated within 1 day of injury. Age and gender showed similar distributions between inpatient and outpatient cohorts. Scalds accounted for 53% of the burn mechanism, with burns to the hand/wrist being the most frequent area involved. The mean percentage of total body surface area was 1.4% for the outpatient cohort and 8% for the inpatient cohort. Burns in the outpatient cohort healed with a mean time of 13.4 days. In the outpatient cohort nine (1%) patients had subsequent admissions and three (0.4%) patients had concern for infection. Eight patients from the outpatient cohort were treated with excision and grafting.

Conclusions and Relevance: The vast majority of pediatric burns are small, although they may often involve more critical areas such as the face and hand. Outpatient wound care is effective treatment strategy and results in low rates of complications and should become the standard of care for children with appropriate burn size and home support.

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9th Annual Trauma Symposium

We are having our 9th Annual Trauma Symposium in November. We are currently in the process are developing our agenda. Please feel free to contact us with any ideas. We want this to be YOUR symposium.

Our NOTS mission is to provide the highest quality of care to patients across our region, and this symposium is great way to get your CME requirements while expanding your knowledge in trauma today. Of note: This year we have extended this symposium to healthcare lawyers and social workers.

 

Huntington Convention Center of Cleveland

 

Monday, November 11 from 7:15am to 3:30pm

Tuesday, November 12 from 7:15am to 3:30pm