Browsing by Author "Jorge Villegas"

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    Changes Produce Changes: The Current Situation of Major Burns Treatment in Chile
    (Başkent Üniversitesi, 2021-03) Jorge Villegas
    ABSTRACT OBJECTIVES: Population, gross domestic product, life expectancy, and public spending on health in Chile have significantly changed over the past few decades. However, as of 2004, the fatality rate among major burn patients had remained constant at 76%. In this study, events that have affected the reduced fatality rates of patients with large burns in Chile over the recent decades were reviewed. MATERIALS AND METHODS: Publications on fatality rates, the new law that guarantees care for pathologies with the highest burden of disease (GES Law), and official documents on interventions for large burns from the National Reference Center were reviewed. In addition, immediate results, incorporation of large burns to the GES Law and its consequences, emergence of new needs, and creation of new burn units and outcomes were reviewed. Lethality rate was the primary endpoint. RESULTS: Reasons for persistent high fatality rates have included (1) conservative surgical index protocols designed to classify severity groups as a predictor of survival and (2) the late incorporation (in 2003) of intensive therapy to severe burn treatment. The promulgation of the 2004 Explicit Health Guarantee law, establishment of burn services at the Public Hospital of Urgent Care and National Reference Center in 2005, incorporation of major burns into the GES Law in 2007, and development of new burn units in 2012 have together generated a process that has allowed the fatality rate to be reduced to 6%. CONCLUSIONS: Changes from conservative treatment to proactive treatment have been of great value. Significant structural and financial support provided by the GES Law has made it possible to offer coverage to patients at major burn units in Chile and to continue to improve the quality of the care. Development of new units has been stimulated through practical learning and through the use of infrastructure and human resources already available.
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    Survival in Patients With Large Burns Treated With the Meek Technique
    (Başkent Üniversitesi, 2021-09) Sebastián Villegas; Jorge Villegas; Eduar Murcia
    OBJECTIVES: In this report, we evaluated the results of the use of the Meek micrografting technique in the treatment of extensive burns in which classic repair methods were insufficient, using percent mortality as an indicator of outcome. MATERIALS AND METHODS: Our study included 23 patients among a total of 282 patients with large burns who were treated between January 2015 and February 2021. Age, etiology, percentage of burned body surface, severity group, and percentage of survival were analyzed. RESULTS: Of 282 patients seen during the study period, 23 patients (8%) were treated with the Meek technique. The mean age was 47.2 years, with a range of 15 to 85 years; 13% were over 61 years of age; 91.3% had been burned by fire, and 47% also presented with inhalation injury. The burned body surface area was between 17% and 93% (mean of 58.14%), with 78% of patients treated with the Meek technique having the highest severity burns. The overall survival rate was 95.65%. Those with and without inhalation injury had similar results. CONCLUSIONS: The incorporation of the Meek technique provided us with an effective additional tool for treatment of burns. Use of the Meek technique also allowed us to reduce the need for additional donor area, thus allowing us to be less surgically aggressive.