Lower extremity burns and Unna paste: can we decrease health care costs without compromising patient care?

Abstract

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.

• Authors: N J Wells, J C Boyle, C F Snelling, N J Carr, D J Courtemanche
• Journal: Canadian journal of surgery. Journal canadien de chirurgie (Can J Surg) Vol. 38 Issue 6 Pg. 533-6 (Dec 1995) ISSN: 0008-428X [Print] Canada
• PMID: 7497369 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Drug Combinations
• Zinc Compounds
• gelatin, glycerin, zinc oxide drug combination
• Gelatin
• Glycerol

Topics

• Adolescent
• Adult
• Burns (therapy)
• Case-Control Studies
• Child
• Cost Control
• Drug Combinations
• Early Ambulation
• Gelatin (therapeutic use)
• Glycerol (therapeutic use)
• Humans
• Leg Injuries (therapy)
• Length of Stay
• Middle Aged
• Occlusive Dressings
• Skin Transplantation
• Tissue Survival
• Zinc Compounds (therapeutic use)