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每1%体表面积烧伤对应1天住院时间的目标是否真的达成了?对苏格兰东南部儿童热烧伤情况的一项综述。

Is the target of 1 day length of stay per 1% total body surface area burned actually being achieved? A review of paediatric thermal injuries in South East Scotland.

作者信息

Louise Caton Nadine, David McGill, John Stewart Kenneth

机构信息

Department of Otolaryngology, St Mary's Hospital Paddington London.

Department of Plastic Surgery, CanniesburnPlastic Surgery Unit Glasgow.

出版信息

Int J Burns Trauma. 2014 Feb 22;4(1):25-30. eCollection 2014.

Abstract

OBJECTIVES

Length of stay is a standard variable used to evaluate outcomes in burn care. Is the target of 1 day length of stay per 1% total body surface area burned actually being achieved?

METHODS

A retrospective analysis of 328 paediatric thermal injuries admitted to the South East Scotland Regional Burn Unit between January 2003 and March 2007 to assess whether the target is met and if not, which factors are contributing to a prolonged hospitalisation.

RESULTS

57% achieved the target and 43% failed the target. Factors associated with a lengthened hospital stay were burn depth, burn location, presence of infection/sepsis and the need for theatre visits for either dressing change or surgical intervention.

CONCLUSIONS

Many factors can contribute to patients' length of hospital stay. It is valuable to identify areas of practice which can be altered to minimise the impact of these factors. For example, consider the use of laser Doppler imaging to help assess burn depth more accurately; this leading to potentially more accurate requirements for surgery or not, early excision of deep burns, improved infection control and use of dressings may all contribute to reduce the length of inpatient stay with a view to improving patient outcome.

摘要

目的

住院时间是用于评估烧伤护理结果的一个标准变量。每烧伤1%体表面积目标住院时间为1天这一目标实际是否达成?

方法

对2003年1月至2007年3月间收治于苏格兰东南部地区烧伤科的328例儿童热烧伤病例进行回顾性分析,以评估该目标是否达成,若未达成,哪些因素导致住院时间延长。

结果

57%的病例达成目标,43%未达成目标。与住院时间延长相关的因素包括烧伤深度、烧伤部位、感染/脓毒症的存在以及因换药或手术干预而需要进手术室。

结论

许多因素可导致患者住院时间延长。识别可改变的医疗实践领域以尽量减少这些因素的影响很有价值。例如,考虑使用激光多普勒成像来更准确地评估烧伤深度;这可能会对手术需求产生更准确的判断,早期切除深度烧伤、改善感染控制及使用敷料都可能有助于缩短住院时间,以期改善患者预后。

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Excision and skin grafting of thermal burns.热烧伤的切除与皮肤移植
N Engl J Med. 2009 Feb 26;360(9):893-901. doi: 10.1056/NEJMct0804451.
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