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Evaluating an outreach service for paediatric burns follow up
Jonathan J Cubitt1, Amy Chesney1, Liz Brown1
1The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Morriston, Swansea SA6 6NL, United Kingdom.
Insights
Paediatric burns patients require appropriate follow-up care. A new burns outreach service reduces travel distances and costs, with optimum follow-up at 18 months for uncomplicated cases.
Area of Science:
- Paediatric surgery
- Burn management
- Healthcare service delivery
Background:
- Paediatric burns necessitate careful follow-up, historically extending into adulthood.
- Centralisation of UK burns services increases patient travel burdens.
- Burns outreach services aim to decentralise care, bringing treatment closer to patients.
Purpose of the Study:
- To evaluate the impact of a new burns outreach service.
- To determine the optimal follow-up duration for paediatric burn patients.
- To assess the feasibility and cost-effectiveness of burns outreach.
Main Methods:
- Retrospective analysis of 100 paediatric burn patients undergoing surgical management.
- Tracking of complications including scarring, delayed healing, and contractures.
- Comparison of outreach clinic costs and patient travel distances versus traditional physician-led clinics.
Main Results:
- 32% of patients experienced complications (adverse scarring, delayed healing, contractures).
- 59% of complications occurred within 6 months, all within 18 months.
- Burn size correlated with complication risk; outreach reduced travel by over 50% and clinic costs by 50%.
Conclusions:
- Burns outreach is a feasible and beneficial service for paediatric burn patients.
- The service offers significant cost savings for healthcare providers.
- Optimal follow-up for paediatric burns is 18 months, after which uncomplicated cases can be discharged.
Abstract:
Complications following paediatric burns are well documented and care needs to be taken to ensure the appropriate follow up of these patients. Historically this has meant follow up into adulthood however this is often not necessary. The centralisation of burns services in the UK means that patients and their parents may have to travel significant distances to receive this follow up care. To optimise our burns service we have introduced a burns outreach service to enable the patients to be treated closer to home. The aim of this study is to investigate the impact of the introduction of the burns outreach service and within this environment define the optimum length of time needed to follow up these patients. A retrospective analysis was carried out of 100 consecutive paediatric burns patients who underwent surgical management of their burn. During the follow up period there were 43 complications in 32 patients (32%). These included adverse scarring (either hypertrophic or keloid), delayed healing (taking >1 month to heal) and contractures (utilising either splinting or surgical correction). Fifty-nine percent of these complications occurred within 6 months of injury and all occurred within 18 months. Size of burn was directly correlated to the risk of developing a complication. The outreach service reduced the distance the patient needs to travel for follow up by more than 50%. There was also a significant financial benefit for the service as the follow up clinics were on average 50% cheaper with burns outreach than burns physician. Burns outreach is a feasible service that not only benefits the patients but also is cheaper for the burns service. The optimum length of follow up for paediatric burns in 18 months, after which if there have not been any complications they can be discharged.
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