DEVELOPMENT OF A BURN REHABILITATION UNIT - IMPACT ON BURN CENTER LENGTH OF STAY AND FUNCTIONAL OUTCOME

In 1995 we initiated the development of a specialized burn rehabilitat ion unit within an acute rehabilitation hospital, geographically separ ated from our burn center. The purpose was to allow an earlier initiat ion of an intensive rehabilitation program while still maintaining opt imal burn wound care and nutritional support. The unit was directed by a burn center nurse coordinator who spent 50% of the time in the burn center and 50% in the rehabilitation unit training and supervising ca re. By 1996 the unit was able to manage open wounds, including skin su bstitutes of as much as 18% total body surface area, with 2- to 3-day returns to the center for around coverage (2.5 +/- 0.5 procedures/pati ent). Our length of stay in 1996 for burns requiring inpatient rehabil itation (mean size 54% +/- 7% total body surface area) decreased by 21 +/- 5 days with respect to those in 1994 and 1995, with no increased morbidity. This length of stay was also significantly shorter (24%) th an that predicted by the American Burn Association Registry formula. I n addition, the rehabilitation unit length of stay required to restore the same degree of function according to a standardized measurement w as significantly shorter (by 9 +/- 3 days) than for patients referred to other rehabilitation facilities in 1996. We conclude that the benef its of a burn rehabilitation unit include not only a decreased burn ce nter length of stay but also a more rapid restoration of function.