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Lower extremity burns and Unna paste: can we decrease health care costs without compromising patient care?
N J Wells1, J C Boyle, C F Snelling
1Division of Plastic Surgery, University of British Columbia, Vancouver General Hospital. BC.
Objective:
To compare an alternative treatment for lower extremity burns with the standard in-hospital treatment, in an attempt to shorten hospital stay.
Design:
A case-control series.
Setting:
A university-affiliated hospital.
Patients:
All patients with a burn isolated to a lower extremity were treated over an 8-month period with split-thickness skin grafting (STSG), Unna paste dressing, immediate mobilization and early discharge. This group was compared with matched controls from the preceding 8 years treated with STSG, occlusive burn gauze dressing, bed rest and hospitalization.
Main Outcome Measures:
Duration of hospital stay and graft viability.
Results:
Thirteen patients with an average wound size of 131 cm2 were treated with Unna paste and had a graft viability of greater than 95% and a burn-scar rating equivalent to that of patients treated with the earlier regimen. The duration of hospital stay decreased from a mean of 12.9 days to 1.4 days, with no complications. This translated into a saving of $10,350 per patient.
Conclusions:
This alternative treatment is safe, inexpensive and effective and is recommended as the treatment of choice for uncomplicated, noncircumferential lower extremity burns.