Oral Presentation ANZBA Annual Scientific Meeting 2025

Investigating the Impact of Acute Surgery Timing on Short-Term Post-Burn Outcomes in Adult Burn Patients (22868)

Andrew D McAuliffe 1 2 , Dale W Edgar 3 4 5 6 , Inge Spronk 3 , Shibi Doss 7 , Suzanne Rea 4 5 6 , Mark Fear 4 6 , Lisa Martin 4 6 , Edward Raby 5 6 , Fiona M Wood 3 4 5 6
  1. School of Medicine, The University of Western Australia, Nedlands, WESTERN AUSTRALIA, Australia
  2. The University of Notre Dame Australia, Fremantle, WESTERN AUSTRALIA, Australia
  3. Burn Injury Research Node, Institute for Health Research, Fremantle, WESTERN AUSTRALIA, Australia
  4. The Fiona Wood Foundation, Murdoch, WESTERN AUSTRALIA, Australia
  5. State Adult Burns Unit, Murdoch, WESTERN AUSTRALIA, Australia
  6. Burn Injury Research Unit, The University of Western Australia, Crawley, WESTERN AUSTRALIA, Australia
  7. St John of God Hospital, Midland, WESTERN AUSTRALIA, Australia

Background:

Acute burn surgical management has evolved over decades, but there is ongoing debate on ideal timing of these treatments. Previous studies with large TBSA cohorts (>20%) considered severe in our region have shown earlier surgery has better mortality outcomes, but smaller area burns are more representative of Australian burn service admissions and requires further investigation.

 

Methods:

This retrospective cohort study used adult patient data collected by the Burns Clinical Data Registry of Western Australia between 2004-2024. Length of hospital stay (LOS) and length of care (LOC; defined by the frequency of outpatient visits after discharge) were used as primary outcome measures. Multivariable modelling of the two variables was conducted, adjusting for known confounders.

 

Results:

A total of 3655 patients underwent acute burn surgery, with a median time to surgery of 5 days. TBSA ranged from 0.1-97.5%, with a median of 2.0 and IQR of 0.75-5.26. Both LOS and LOC demonstrated significant relationships with timing to surgery (p<0.05). LOS was shorter with delayed surgery, however LOC demonstrated the opposite trend. Multivariable analyses are ongoing to determine further explanations for these relationships.

 

Discussion:

Preliminary analysis of post-burn surgery outcomes suggests that timing to surgery plays an important role. LOS and LOC demonstrated conflicting results, and further adjusted analyses are required to elucidate if LOC is a more accurate reflection of post-operative outcomes, and provide clarity on the ideal timing to acute burn surgery.