A rationale for significant cost savings in patients suffering home oxygen burns: Despite many comorbid conditions, only modest care is necessary

Increasingly, patients are being evaluated for burns related to home oxygen use. Although the majority of burns are minor, referral to a burn unit regardless of depth or size is still common. The care of this population was reviewed to determine the feasibility and potential saving if such patients could be managed by nonburn-trained surgeons. Prospectively collected data on 5103 consecutive patients admitted to an urban tertiary burn center between April 1997 and September 2010 was reviewed. Data collected included age, TBSA burned, comorbidities, mode of admission, distance transported, mode of transport, number requiring surgery, length of stay, and outcome. Of 5103 admissions, 64 were for home oxygen burns. Patients had a mean age of 62.5 years and five comorbidities. They suffered a mean 4% TBSA burn, and all were mostly superficial, of partial thickness, and healed without surgery. Patients had a mean length of stay of 2 days and required one follow-up visit. Twenty-seven percent were transferred from another facility after initial care, and 28% arrived intubated. Twenty-two percent were transported by helicopter, and 61% arrived intubated. Eighty percent of ventilated patients were extubated within 8 hours of admission, and all within 24 hours. Average distance by helicopter transport was 57 miles, and cost $12,500.00. Large savings could be realized if patients cared for by local physicians were educated in basic burn care. This would be more palatable with good communication between the community hospital and burn center, with consultation on an as-needed basis.