title: Impact of a Newly Implemented Burn Protocol on Surgically Managed Partial Thickness Burns at a Specialized Burns Center in Singapore.
abstract: OBJECTIVE
  This study evaluated the impact of a newly implemented protocol for superficial to mid-dermal partial thickness burns which involves early surgery and rapid coverage with biosynthetic dressing in a specialized national burns center in Singapore.
  
  
  METHODS
  Consecutive patients with 5% or greater total body surface area (TBSA) superficial to mid-dermal partial thickness burns injury admitted to the Burns Centre at the Singapore General Hospital between August and December 2014 for surgery within 48 hours of injury were prospectively recruited into the study to form the protocol group. Comparable historical cases from the year 2013 retrieved from the burns center audit database were used to form the historical control group. Demographics (age, sex), type and depth of burns, %TBSA burnt, number of operative sessions, and length of stay were recorded for each patient of both cohorts.
  
  
  RESULTS
  Thirty-nine burns patients managed under the new protocol were compared with historical control (n = 39) comparable in age and extensiveness of burns. A significantly shorter length of stay (P < 0.05) per TBSA burns was observed in the new protocol group (0.74 day/%TBSA) versus historical control (1.55 day/%TBSA). Fewer operative sessions were needed under the new protocol for burns 10% or greater TBSA burns (P < 0.05).
  
  
  CONCLUSIONS
  The authors report their promising experience with a newly implemented protocol for surgically managed burns patients which involves early surgery and appropriate use of biosynthetic dressing on superficial to mid-dermal partial thickness burns. Clinically, shorter lengths of stay, fewer operative sessions, and decreased need for skin grafting of burns patient were observed.
authors.affiliation: From the Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital.
authors.forename: Khwee-Soon Vincent
authors.initials: KS
authors.lastname: Tay
authors.forename: Si-Jack
authors.initials: SJ
authors.lastname: Chong
authors.forename: Bien-Keem
authors.initials: BK
authors.lastname: Tan
mesh_terms: D000328:Adult; D002053:Burn Units; D002056:Burns / Q000601:surgery* / Q000628:therapy; D002985:Clinical Protocols; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012846:Singapore; D016038:Skin Transplantation; D016896:Treatment Outcome
chemical_list: C042816:Biobrane; D020099:Coated Materials, Biocompatible