UF Health Shands Burn Reconstruction Program pioneers a new kind of longitudinal care

First, they save a life. Then, they do their best to make it a good one.

For physicians and providers at the UF Health Shands Burn Center, ensuring a patient survives the incident that led to their admission is only the first step. Increasingly, they’re setting the goal posts further — and looking at what patients need beyond survival.

“There has been a concerted effort over the last few years for the burn center to offer more comprehensive longitudinal care,” said Ian R. Driscoll, M.D., associate professor and director of the UF Health Shands Burn Center. “That includes burn reconstruction after patient’s initial hospitalization and doing things that help them reintegrate into society, jobs, and anything that constitutes a full life to them.”

The Center’s Burn Reconstruction Program provides patients with options to reconstruct burn scars — helping patients contend with the cosmetic after effects of their initial injuries, as well as the effects of procedures like grafting, that change a patient’s physical appearance. Burn survivors must contend with this, Driscoll pointed out, and it can change how they feel about themselves and how they interact with others.

As of 2023, Driscoll’s team is the only burn center for all of North Florida, all of South Georgia and even parts of Alabama. To better streamline their care, the burn center decided to offer their patients a centralized format of care — one location, several subspecialties and forms of support. Now, their volume of patients continues to climb.

“Many of our patients are very sick,” Driscoll said. “And once you get ‘em through the acute period, the initial hospital stay, of course everybody’s high fiving. But surviving terrible injuries is only the first step in what is typically a lifelong change, and we wanted to do better by them.”

Currently, most burn center accreditations or verifications are still largely dependent on the patient’s initial hospital stay and the commensurate outcome; whether or not they experienced complications, their length of stay, and other factors. More and more, however, physicians are recognizing the value of longitudinal care for burn survivors, Driscoll said. Patients that are critically ill can experience a variety of life-altering side effects as survivors, including changes in behavioral health to mental health difficulties like body dysmorphia following aesthetic changes to their physical appearance.

Thus, Driscoll and his team have increased their involvement in the Phoenix Society, which is a support network for burn survivors that offers support to those who are struggling with the aftermath of surviving burns. For example, the Soar Program, a subgroup of the Society, facilitates peer support for burn survivors. Burn center staff help host meetings, encouraging patients to speak with burn survivor peers who have learned to not only cope, but thrive — and provide a kind of emotional support unique between survivors.

“We want to ensure that we’re not only focusing on the physical changes, but also acknowledging how much these patients’ lives have changed since we first treated them,” Driscoll said.

Seeing patient success bolsters burn center staff, too. During their monthly meeting — titled “Reconstruction Rounds”— Driscoll and his team, which includes faculty, clinic staff and trainees, sit down and discuss current cases and revisit old ones. They go through every name on their list, looking at photos and debating treatment plans to ensure each patient is getting the best possible course of action for their individual burn presentation, discuss alternatives if something isn’t working and consider what the patient’s life will look like outside the hospital doors.

“At the end of the day, we realize our patients are coming to us at one of the most difficult moments of their lives,” Driscoll said. “The goal of offering something like the reconstruction program is to honor that by considering what happens once they are discharged, and by doing our best to ensure a good life by each patient’s own standards.”