Patient care for burn victims in Brazil: A national survey

Abstract

To analyze, through the responses of physicians who work in burn treatment units, their demographic profiles and academic backgrounds, the structure available for patient care, the adoption of care protocols, support from medical and multidisciplinary specialties, and the main challenges faced by these professionals. Cross-sectional study of the survey type carried out from March 2020 to April 2021 through a questionnaire constructed according to the Delphi method. The questionnaire was applied online to plastic surgeons and intensivists who work in burn units. A list was obtained of Brazilian centers, as well as the epidemiological and academic profile of the medical team, level of structure, treatment protocols, and restrictions and challenges encountered. The majority of the burn centers are located in the South and Southeast of the country, and are references for care for populations of over 1000,000 inhabitants. Professionals are between 30 and 60 years old, and have been concentrating on burn victims for between 5 and 15 years. For the most part, the professionals performed their skills training in the centers where they work, which, in turn, have a strong academic tendency, with medical residency programs and other specialties. Burn care protocols, together with related clinical conditions such as surgery, measurement of the burned area, use of antibiotics, thromboembolic prophylaxis, nutrition, physical therapy, and nursing care are widespread and the greatest difficulties pointed out are the serious nature of the burn and infections. The demand for procedures, and regulatory and reception flows seem to be coordinated and in line with regional needs. Burn treatment units are widespread throughout the country, at different levels of complexity. The most frequent organization is a regional reference center, with care for more than one million inhabitants, located within a tertiary hospital. Most professionals are between 30 and 60 years old, with more than 5 years of experience in burns. The majority of centers demonstrate well-established clinical, surgical, dressing, and global patient care protocols. The complexity of cases, patterns of resistance, and bacterial colonization are important challenges throughout Brazil.