Secondary Burn Reconstruction: A Longitudinal Descriptive Study of a Prospective Registry to Optimize Reconstructive Practice Development in a Regional Burn Center.

Abstract

Burn reconstruction restores function and appearance after initial burn treatment, yet these interventions may remain underutilized due to fragmented care systems and inadequate follow-up. National datasets and procedural coding systems often fail to capture the scope of secondary reconstruction, limiting insights into long-term care needs. Therefore, this prospective analysis employs a prospective registry to track the volume, procedural patterns, and care settings of secondary burn reconstruction to create a basis of practice development of reconstructive burn surgery within a burn unit practice. A prospective registry was implemented from January 2023 to December 2024 to track secondary burn reconstruction procedures. Data collected included procedural type, timing from initial injury, original total body surface area burned, and the types of healthcare systems in which the procedures were performed. Registry data were compared to institutional acute burn care data from 2023 and 2024 to contextualize reconstructive volume and demographics. From 2023 to 2024, 353 reconstructive cases were identified. Laser scar revision was the most common procedure (50.4% in 2023; 44.7% in 2024). Most patients had initially minor injuries (<10% total body surface area). Average time to reconstruction was 319 days (2023) and 425 days (2024). Cases were performed across diverse settings, including rural hospitals (12-18%) and outpatient clinics (0.5-5%). The registry provided detailed procedural data not available in administrative datasets. This prospective burn reconstruction registry identified a number of reconstructive burn cases performed in the initial years of focus on the burn patient population. The characteristics of these patients create a basis for concentration on increased patient recruitment, faster time to reconstruction, and better analysis of indications and outcomes.