1. "Sequelae of burns,
traditional and emerging issues
in a developing country”
Dr. Jorge Villegas
Servicio de Quemados
Hospital de Urgencia Asistencia Pública
Instituto Traumatológico
Clínica INDISA
Santiago. CHILE
www.cirugiaplasticayquemados.cl
2. Burn injuries and their sequelae are, in our countries,
a major health problem
a major social medical problem
a challenge for plastic surgery
3. The incidence of burns is related to
►Life conditions
►Lifestyle
The treatment of burned patiens is
►Difficult
►Long
►Expensive
Burn frequency and severity are greater
Resources are minor
4. Resources are required to
Funding
Facilities
Human resourses
►Prevention,
►Acute phase treatment
►Rehabilitation
►Sequelae surgical treatment
18. When the repair is planned at the acute phase results are better
19. What are, for us, the issues in the treatment of sequelae today?
The problem is not only surgical technique
indication
performance
The problems are
►access,
►timeliness
►financing
►quality of care
20. A challenge for Plastic Surgery
A challenge for Health Service
Resources
Chile
Health System Public - Private
National Health expenditure per capita U.S. $ 670
Distribution Fifty- Fifty
Public System must attend 75% of the population.
The per capita expenditures in Public Service is
about 450 $ US Dollars
22. In Public Health System was necessary
to prioritize and
to optimize the use of resources
Focusing on pathologies of greater health impact,
guaranteeing by law :
access,
timeliness,
quality of care
funding
23. 2003. Intensive Care in the Burns Unit
2005. Changed treatment protocols
Surgical
Intensive Care
24. 2007.
►Serious burns patients were included in the group
of by law Guaranteed Pathologies
►The treatment of severe burns was concentrated
in our service as National Reference Center*
*130 Severe burns a year
25. The survival of our serious burns patients is increasing
% SURVIVAL
37. In many cases
,
These new survivors are now patients with larger
and deeper burned body surface, older, and also
have concomitant diseases
They are alive but
with severe sequelae
a large burden of disease
These patients need plastic surgery techniques, already
within the acute phase
38. This new situation generates a new scenario for
both:
►rehabilitation and social reintegration.
►treatment of sequelae
.
Our Public Health System is not prepared to face that
There are few plastic surgeons in the public system
39. .
In summary ,
►the increased survival of serious burns generates a
new scenario
►That scenario demands amongst other measures:
integration of plastic surgeons in the medical team
from the acute stage
40. That means
For The Public Health System
►To generate conditions to get necessary
infrastructure and equipment
►To develop incentives for incorporating plastic
surgeons to the Public Hospital network
For plastic Surgeons
►To strength their training in these areas.
►To take the challenge