Factors Predicting Burn Surgery Operative Time in a Middle-Income Country Regional Burn Service.

Abstract

Access to theater is essential for the surgical management of deep burns. This is a scarce resource in low-middle-income countries. It underpins the importance of optimizing theater time. We sought to look at specific factors and their influence on operative time in minor to moderate burn surgery. This knowledge can assist teams where theater planning and optimization may be beneficial in resource-limited settings. Operative records between January and December 2018 at the Regional Hospital were analyzed. Data fields included age, gender, TBSA of burn, surface area burn operated on, intraoperative position change, seniority of surgeon, presence of an assistant, inclusion of special areas, predicted operative time, and actual operative time. Operative records for 265 patients were analyzed, with a median operative time of 40 minutes (interquartile range 25-64). Overall factors that predict longer operating time are larger total body surface area burn, larger surface area burn operated on, an operation involving at least one special area, number of special areas operated on, position change, presence of an assistant, and longer predicted operative time. Total percentage burn, operated percentage, special areas to be operated, and position change are overall factors to be considered when planning a burns list for the nonspecialist burn surgeon. This knowledge may be useful for an inexperienced surgeon to understand and aid in the effective utilization of limited operative time available for the surgical management of deep burns in resource-limited settings.