Early burn wound excision is common practice in most burn centres throughout Australia and New Zealand (ANZ). Early excision may modulate the acute systemic inflammatory response of large burns, and is associated with improvements in survival, complication rates and hospital length of stay. The aim of this study was to determine whether variation exists in the time to first excisional debridement across ANZ burn centres and the effects of variation on patient outcomes.
Data were extracted for acute admissions between July 2016 and June 2017 from the Burn Registry of Australia and New Zealand (BRANZ).
Of the 4,992 cases, 3,840 patients (77.1%) had a surgical burn wound management procedure in theatre, and more than half of these patients underwent excisional debridement. For all patients, the median time to first excision (from time of injury) was 6.41 days (interquartile range (IQR) 2.9 – 12.2 days). After risk adjusting for patient age, gender, primary cause of burn injury, TBSA, inhalation injury, and burn depth, two sites were more than two standard deviations from the risk adjusted mean time to first excision (one above, one below). For patients with a burn equal to or greater than 20% TBSA, the median time to first excision was 1.69 days (IQR 0.91 – 4.03 days).
This presentation will describe the variation in time to excisional debridement across ANZ Burn Centres and effects on patient acute outcomes.