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Management of Burn Care and Pathways to a Career in Burn Surgery: A Qualitative Survey Study of Burn Units in the United States
Francesco M. Egro MD, MSc, MRCS; Erica Johnson BS; Elizabeth M. Kenny BS; Aaron M. Foglio BS; Alain A. Corcos MD, FACS; Jenny A. Ziembicki MD, FACS
University
2018-02-14
Presenter: Elizabeth Kenny
Affidavit:
Vu. T. Nguyen
Director Name: Vu. T. Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background: Leadership and management of burn care varies greatly by hospital and country. It is important for a general surgery (GS) or plastic surgery (PRS) resident interested in pursuing a burn surgery career to understand the changing training requirements. We aimed to evaluate the current state of leadership and care in US burn centers and the training requirements to secure a burn surgery position.
Methods: A cross-sectional study was conducted between August and September 2017. A 12-question survey was sent to all Burn Unit Directors in the US regarding their training and management of burn care (immediate assessment, airway/ventilation, cardiovascular support, fluid resuscitation, antibiotics, daily critical care, surgical care, wound care) at their respective hospitals.
Results: A total of 55 responses (47% response rate) were received. Burn Units Directors most commonly received GS training (69%), but interestingly the majority either did not undergo fellowship training (31%) or completed a burn surgery fellowship (29%). While surgical care and wound care were predominantly managed by GS- or PRS-trained teams, management of all other aspects of burn care and desired training characteristics varied greatly across institutions.
Conclusion: Leadership in burn surgery is dominated by general surgeons, while surgical and wound care responsibilities are shared among plastic and general surgeons. Other aspects of burn care have become increasingly multidisciplinary in nature and are often managed by critical care. Although 31% of current Burn Unit Directors did not undergo fellowship training, aspiring surgeons are advised to obtain a burn surgery and/or critical care fellowship.
