A collaborative systems approach to rural burn care.

Area of Science:

• Trauma Surgery
• Burn Care Management
• Rural Health Systems

Background:

• Regional burn centers (BC) often face high patient volumes, impacting their capacity to manage minor burn cases.
• Rural Level 1 trauma centers (TC) possess the infrastructure to potentially manage less severe injuries, but require specialized support.
• A collaborative model can optimize resource allocation and improve access to care for rural populations.

Purpose of the Study:

• To evaluate the feasibility and clinical success of establishing an outpatient burn clinic at a rural Level 1 trauma center.
• To assess the effectiveness of a collaborative system between a regional burn center and a rural trauma center for minor burn treatment.
• To determine the impact of this collaboration on patient outcomes and resource utilization.

Main Methods:

• Retrospective review of burn patients treated at a rural Level 1 trauma center from January 2000 to June 2005.
• Establishment of a dedicated burn clinic staffed by trauma/critical care surgeons and a burn nurse.
• Teleconsultation and email support provided by burn surgeons from the regional burn center.

Main Results:

• 311 patients with 314 injuries were treated, with a mean burn Total Body Surface Area (TBSA) of 2.9%.
• The majority of patients required conservative management, with only 4% needing skin grafts.
• Complications (9.9%) and long-term sequelae (13.4%) were documented, with local wound infections being the most common complication.

Conclusions:

• Outpatient burn care for minor injuries can be successfully delivered at a non-specialized rural trauma center with dedicated staff.
• A collaborative system between a regional burn center and a rural trauma center is effective in managing minor burns.
• This model improves access to specialized care for rural populations and alleviates the workload of regional burn centers.