Management of necrotising fasciitis within a burns centre: do outcomes differ?
| Autor: | John A G Gibson, Dai Q Nguyen, Joseph Alexander Ward |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Burn injury business.industry Mechanical Engineering lcsh:Surgery Energy Engineering and Power Technology Necrotising fasciitis lcsh:RD1-811 030230 surgery Management Science and Operations Research lcsh:RL1-803 medicine.disease burns centre management clinical outcomes 03 medical and health sciences 0302 clinical medicine Internal medicine Cohort medicine lcsh:Dermatology Original Article 030212 general & internal medicine business |
| Zdroj: | Scars, Burns & Healing, Vol 6 (2020) Scars, Burns & Healing |
| ISSN: | 2059-5131 |
| Popis: | Introduction: Many similarities exist between the care of necrotising fasciitis (NF) and burn injury patients. Each group represents a small but complex cohort requiring multiple theatre trips, specialist reconstruction, meticulous wound care and multidisciplinary management. Over a six-year period, we sought to examine the clinical outcomes of NF patients managed within a burns centre against those managed by a plastic surgery service. Methods: A retrospective case-note review was performed for all identifiable patients referred to our institution’s designated burns centre or plastic surgery service between 2008–2014. Patient characteristics, length of stay, wound-related and clinical outcomes were extracted and descriptively presented with statistical analysis performed for survival and length of stay. Results: Twenty-nine patients were included in the study (burns centre [B]: 17 patients; plastic surgery service [P]: 12 patients). Median total length of stay (B: 37 vs. P: 50 days, P=0.38), local length of stay (27 vs. 19 days, P=0.29) and survival till discharge (94.4% vs. 100%, P=0.73) demonstrated no statistically significant difference. Conclusion: Caring for NF patients within a burns centre facilitated easier access to specialist reconstructive expertise and multidisciplinary care but did not lead to statistically significant differences in length of stay or survival. The management of NF within a burns centre facilitated provision of high-quality care to a highly challenging patient group. Lay Summary Research background: Looking after patients with flesh-destroying infections (necrotising fasciitis [NF]) and burns frequently require very similar expertise and clinical resources. A small but increasing number of specialist burns centres will currently accept NF patients for surgical reconstruction and rehabilitation. Question being asked: Does performing the surgical reconstruction and rehabilitation of NF patients in burns centres improve patient survival and reduce hospital stay? How work was conducted: The medical notes of NF patients referred to our hospital during 2008–2014 were reviewed following a change of practice (acceptance of NF to our burns centre in 2010). The survival, hospital-stay, wound healing and complications of patients managed by our plastic surgery and burns services were compared and statistically analysed. What we did we learn: Caring for NF patients in a burns centre improved access to specialist expertise and allowed provision of high-quality care but did not lead to measurable improvements in patient outcome. |
| Databáze: | OpenAIRE |
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