Goswami Prasenjit, Sahu Seelora, Singodia Pankaj, Kumar Manjeet, Tudu Tukulu, Kumar Abinash, Sinha Pankaj Kumar
Department of Plastic Surgery and Burns, Tata Main Hospital, Jamshedpur, Jharkhand, India.
Department of Anesthesiology, Tata Main Hospital, Jamshedpur, Jharkhand, India.
Indian J Plast Surg. 2019 Sep;52(3):337-342. doi: 10.1055/s-0039-3402707. Epub 2019 Dec 26.
To compare the burn patients undergoing early excision and grafting (within 7 days of burn injury) with the patients undergoing late surgeries (more than 7 days after burn injury) to see if there was any difference in surgical and outcome parameters including length of stay, expenditure, and overall outcome of the patients. A retrospective analysis of the data collected from the burn care unit records over a period of one year was done. Fifty-eight patients who matched with our inclusion criteria were divided into two groups. An early excision group who underwent surgery within 7 days of sustaining burn injury ( = 24) and a late excision group who underwent excision and grafting/debridement after 7 days of sustaining burn ( = 34). Data recorded included demographic variables like age, sex, percentage total body surface area (TBSA) burn; nature of burn; date of sustaining burn; date of admission to the burn care unit; and treatment and outcome parameters like date of surgery, days from burn injury to first surgery, number of surgeries, type of surgery, percentage of TBSA resurfaced with skin graft, blood products used, length of stay, outcome, and total expenditure incurred by patients. There was no statistically significant difference in the number of surgeries done, the units of packed cell used, and the number of fresh frozen plasma (FFP) used between the early excision group and the late excision group. The length of stay was significantly low in the early excision group as compared with the late excision group. The expenditure incurred in the treatment of the early excision group was significantly lower than the cost of treatment of the late excision group. Early excision and grafting in burn cases reduces the length of the stay of burn patients and, in turn, reduces the cost of treatment. However, having a dedicated burn care unit is important for the hospitals and both public and private hospitals should make a move in that direction.
比较早期切除并植皮（烧伤后7天内）的烧伤患者与接受晚期手术（烧伤后7天以上）的患者，观察手术及预后参数（包括住院时间、费用和患者的总体预后）是否存在差异。对从烧伤护理单元记录中收集的为期一年的数据进行了回顾性分析。58名符合纳入标准的患者被分为两组。一组是早期切除组，在烧伤后7天内接受手术（n = 24）；另一组是晚期切除组，在烧伤7天后接受切除并植皮/清创术（n = 34）。记录的数据包括人口统计学变量，如年龄、性别、烧伤总面积百分比（TBSA）；烧伤性质；烧伤日期；入住烧伤护理单元的日期；以及治疗和预后参数，如手术日期、从烧伤到首次手术的天数、手术次数、手术类型、植皮覆盖的TBSA百分比、使用的血液制品、住院时间、预后以及患者产生的总费用。早期切除组和晚期切除组在手术次数、使用的红细胞单位数和新鲜冰冻血浆（FFP）使用量方面没有统计学上的显著差异。与晚期切除组相比，早期切除组的住院时间显著缩短。早期切除组的治疗费用明显低于晚期切除组的治疗费用。烧伤病例的早期切除并植皮可缩短烧伤患者的住院时间，进而降低治疗成本。然而，拥有一个专门的烧伤护理单元对医院很重要，公立和私立医院都应朝这个方向努力。
