Bass Michael J, Phillips Linda G
Division of Plastic Surgery, Department of Surgery, 6.124 McCullough Bldg, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USA.
J Craniofac Surg. 2008 Jul;19(4):888-90. doi: 10.1097/SCS.0b013e318175b58c.
Sustaining a burn injury sets in motion a cycle of pain, disfigurement, and a search for survival. In pediatric burns, the injury extends to the parents where fear, ignorance, and helplessness forever change their lives. Pediatric burn injuries are caused by fire, hot liquids, clothing irons, hair curlers, caustic substances like drain cleaner, the grounding of an electrical source, and exposure to radiation. Efficiency in the delivery of pediatric burn care is critical. Maximizing resource utilization means continual self-evaluation and economic analysis of therapeutic modalities. Griffiths et al found that most childhood burns are due to scalds, which can be treated for $1061 per percent burn. Paddock et al reduced the cost of treating superficial pediatric burns and reduced the length of stay in hospital using silver-impregnated gauze over traditional methods. Barrett et al found improved cosmesis of skin grafts using cultured epithelial autografts but at a substantially increased cost. Corpron et al showed that pediatric burn units that treat burns >10% total body surface area and operative treatment of pediatric burns regardless of size generate positive revenue. There is a paucity of evidentiary pediatric burn economic data. More research is needed to address areas of pediatric burn care inefficiency. Improving knowledge of cost in all health care endeavors will create competition and drive down expenditures.
遭受烧伤会引发疼痛、毁容以及求生的循环。在小儿烧伤中,伤害还会波及父母,恐惧、无知和无助会永远改变他们的生活。小儿烧伤是由火灾、热液、电熨斗、卷发棒、腐蚀性物质(如排水清洁剂)、电源接地以及辐射暴露引起的。提供小儿烧伤护理的效率至关重要。最大限度地利用资源意味着对治疗方式进行持续的自我评估和经济分析。格里菲斯等人发现,大多数儿童烧伤是由烫伤引起的,每烧伤1%的治疗费用为1061美元。帕多克等人使用含银纱布,相较于传统方法,降低了小儿浅度烧伤的治疗成本并缩短了住院时间。巴雷特等人发现,使用培养的自体上皮移植皮肤可改善皮肤移植的美容效果,但成本大幅增加。科尔普龙等人表明,治疗烧伤面积超过体表面积10%的小儿烧伤单位以及无论烧伤大小均进行手术治疗的小儿烧伤单位能产生正收益。小儿烧伤经济数据证据匮乏。需要更多研究来解决小儿烧伤护理效率低下的问题。提高所有医疗保健工作中对成本的认识将创造竞争并降低支出。