Jolene Lim1, Sarah Liew1, Hayley Chan1, Teresa Jackson2, Sally Burrows3, Dale W Edgar4, Fiona M Wood5. 1. School of Medicine and Dentistry, University of Western Australia, Australia. 2. Fiona Wood Foundation, Australia. 3. School of Medicine and Pharmacology, University of Western Australia, Australia. 4. Royal Perth Hospital, Burn Service of WA, Australia; Burn Injury Research Unit, University of Western Australia, Australia; Fiona Wood Foundation, Australia. 5. Burn Service of WA, Royal Perth Hospital, Australia; Burn Injury Research Unit, University of Western Australia, Australia; Fiona Wood Foundation, Australia. Electronic address: Fiona.wood@health.wa.gov.au.
Abstract
BACKGROUND: Acute wound closure surgery improves outcomes, after burn particularly mortality, but also imposes physiological stress on the patient. The duration of surgery is associated with adverse outcomes in other populations. This study aimed to examine if extended acute burn surgery duration was associated with poorer in-hospital outcomes. METHODS: This retrospective cohort study included adult burn patients who required a single wound closure surgery at Royal Perth Hospital between 2004 and 2011. Multivariable regression analyses were used to assess the influence of patient and injury factors on surgery duration and length of stay (LOS). RESULTS: Surgery duration independently increased LOS (incidence rate ratio [IRR]=1.004, p<0.001). This translates to a predicted 13% increase in LOS for a 30min increase in surgery 'knife to skin' time. Total body surface area (TBSA) was identified as a significant predictor of surgery duration (IRR=1.047, p<0.001), estimating that a 10% TBSA increase results in a 59% increase in surgery duration. CONCLUSION: The results show that surgery duration is associated with LOS after adjusting for size of burn and other factors. The study justifies the need to explore strategies to reduce acute burn surgery duration.
BACKGROUND: Acute wound closure surgery improves outcomes, after burn particularly mortality, but also imposes physiological stress on the patient. The duration of surgery is associated with adverse outcomes in other populations. This study aimed to examine if extended acute burn surgery duration was associated with poorer in-hospital outcomes. METHODS: This retrospective cohort study included adult burn patients who required a single wound closure surgery at Royal Perth Hospital between 2004 and 2011. Multivariable regression analyses were used to assess the influence of patient and injury factors on surgery duration and length of stay (LOS). RESULTS: Surgery duration independently increased LOS (incidence rate ratio [IRR]=1.004, p<0.001). This translates to a predicted 13% increase in LOS for a 30min increase in surgery 'knife to skin' time. Total body surface area (TBSA) was identified as a significant predictor of surgery duration (IRR=1.047, p<0.001), estimating that a 10% TBSA increase results in a 59% increase in surgery duration. CONCLUSION: The results show that surgery duration is associated with LOS after adjusting for size of burn and other factors. The study justifies the need to explore strategies to reduce acute burn surgery duration.
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