255 Outcomes of Eight Years of International Outreach to Improve Burn Care through Prevention, Education, and Clinical Intervention: A Model for Optimization in a Resource-Constrained Environment

A substantial portion of global disease burden is surgically treatable. There are over two billion people living without access to the most basic surgical care. Burn injury constitutes a significant portion of surgically treatable morbidity and mortality worldwide, particularly in children, with low- and middle-income countries accounting for the majority of burden. Through collaboration with domestic healthcare providers, we have developed and implemented an adaptable model for improving burn prevention and care in a resource-constrained environment. These efforts have led to the development of a national burn prevention program, burn registry, clinical outreach programs, and telemedicine-aided patient triage. We followed up on four years of burn data from a new database in Ukraine and compared this to two years of prior collected data. Additionally, a survey aimed at determining knowledge of burn prevention and first aid was distributed to the public and to health care professionals in Ukraine. These results were compared to data from the same survey distributed three years prior. Clinical data from our outreach clinic and telemedicine consultation was collected to analyze trends. A more robust national burn prevention policy has been implemented. Educational programs have led to statistically significant decreases in wound infection rates. Patient ventilation, blood transfusion, pneumonia, sepsis, UTI, and cellulitis rates all showed statistically significant increases, which may be attributed to the effect of penetration of educational programs to improve treatment of severe burns and a relative increase in numbers of patients being captured. Through carefully implemented principles of global surgery, we have developed a burn prevention and outreach model for a resource constrained environment. Favorable results have been seen within a relatively short period of implementation over the past eight years. Further study and data collection will allow for more robust analysis of results and improvement in optimizing this model. The authors provide description and results of interventions capable of being used as a model for the decrease of burn injury burden on a global scale.