Outpatient Follow-Up and Reconstructive Surgery Rates in Massive Burn Survivors: Investigating the Social...

Area of Science:

• Trauma Surgery
• Burn Care
• Public Health

Background:

• Survival rates for large total body surface area (TBSA) burns are increasing, leading to a greater need for comprehensive post-discharge care.
• Socioeconomic factors, including housing insecurity, are known to impact follow-up care for burn survivors, but data on massively burned patients are limited.

Purpose of the Study:

• To evaluate socioeconomic factors associated with follow-up and reconstructive surgery rates in patients with massive burns (>50% TBSA).

Main Methods:

• Retrospective analysis of patients surviving >50% TBSA burns who planned return to the treating institution.
• Univariate and multivariate regression analyses were used to identify factors associated with follow-up and reconstructive surgery.
• Data collected included TBSA, insurance status, housing security, and reconstructive surgery utilization.

Main Results:

• Of 65 patients, 81.5% attended follow-up. Younger age, larger TBSA, private insurance, and housing security were associated with higher follow-up rates.
• Housing insecurity was independently associated with lack of follow-up (OR: 0.009).
• No patients experiencing housing insecurity underwent reconstructive surgery, while over half of all patients did.

Conclusions:

• Follow-up rates for massive burns exceed those for smaller TBSA burns, with over half receiving reconstructive surgery.
• Housing-insecure patients represent a critical group needing targeted interventions to improve access to essential follow-up care and reconstructive surgery.