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CLINICAL PROBLEMS
Burn is one of other complex wound, manage a burn wound is such a complicated wound management. In Indonesia when there is a burn wound mostly need to be hospitalized, my clinic provides outpatient burn management with some criteria. These criteria are our modification from some criteria as references. There are four main problems: how to makes patient no need to hospitalize to minimizes cost, how to makes the wound healed faster, how to minimize pain and how to increase patient quality of life.
PAST MANAGEMENT
The past Indonesian concept for burn wound are hospitalize for; older burn patient grade 2 > 15 % and youngest burn patient > 10 %; Grade 2 in face, arm and leg, perineum and ankle; grade 3 for older burn patient and for all size grade 3 in youngest; Electric burn with trauma inhalation and other problems. The burn wound healed more than 1 month at the hospital (sometimes longer) and mostly no minimize pain at dressing time (skin remove for grade 2). And patient still with sickness model they unable to dress and limited activities (only in bed).
CURRENT CLINICAL APPROACH
In clinic we try to manage those four problems easily for 5 patients with burn 3 younger patients (less than 1 yod) and 2 older patients. TBSA range from 10% - 30% with no trauma inhalation grade 1-3. Burn etiologies are hot water & fire, all of them was advised for hospitalized and they refused to have they choose to come to the clinic for outpatient management. They came to clinic 2 hours – 3 days after burn accident. The wound management we provided minimizes pain (minimal wound contact) and optimize patients activities (no limited).
PATIENT OUTCOMES
After 4 times meeting (treatment) and not more than 4 weeks the wound became heal with no complication. Patients satisfied with the unlimited activities, minimize pain, no complication, no need to hospitalized and minimize cost for the treatment.