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Journal Article Research Support, Non-U.S. Gov't Ppublish 1 citation

PubMed: 42308702 DOI: 10.1016/j.burns.2026.108052

How the world manages acute burns: Insights from an international survey of 106 burn units across 50 countries.

Burns 52(8):108052

Authors: Roos F C Salemans, Myrthe H Simon, Margriet E van Baar, Kiran C Baran, Stefan Doornbos, Fiona M Wood, Dale W Edgar, Denise van Uden, Cornelis H van der Vlies

Affiliations

  • Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands; Alliance of Dutch Burn Care (ADBC), Burn Centre, Maasstad Hospital, Rotterdam, the Netherlands.
  • Department of Plastic and Reconstructive Surgery, University Medical Centre, Amsterdam, the Netherlands.
  • Alliance of Dutch Burn Care (ADBC), Burn Centre, Maasstad Hospital, Rotterdam, the Netherlands; Erasmus MC, University Medical Centre Rotterdam, Department of Public Health, Rotterdam, the Netherlands.
  • Alliance of Dutch Burn Care (ADBC), Burn Centre, Red Cross Hospital, Beverwijk, the Netherlands.
  • Alliance of Dutch Burn Care (ADBC), Burn Centre, Martini Hospital, Groningen, the Netherlands.
  • Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; State Adult Burn Unit, Fiona Stanley Hospital, South Metropolitan Health Service, Murdoch, Western Australia, Australia.
  • Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; State Adult Burn Unit, Fiona Stanley Hospital, South Metropolitan Health Service, Murdoch, Western Australia, Australia; Burn Injury Research Unit, Faculty of Medicine and Dentistry, University of Western Australia, Crawley, Western Australia, Australia; Institute for Health Research, Burn Injury Research Node, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
  • Alliance of Dutch Burn Care (ADBC), Burn Centre, Maasstad Hospital, Rotterdam, the Netherlands.
  • Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands; Alliance of Dutch Burn Care (ADBC), Burn Centre, Maasstad Hospital, Rotterdam, the Netherlands; Department of Trauma and Burn Surgery, Maasstad Hospital, Rotterdam, the Netherlands.

Abstract

BACKGROUND

There is considerable variability in the management of acute burns globally, including differences between low- and middle-income countries (LMICs) and high-income countries (HICs). This study aimed to describe global surgical burn care practices through an international survey, providing insight into diagnostic, debridement, and coverage techniques and their timing.

METHODS

An online survey was developed and distributed to burn surgeons worldwide, focusing on the management of four patient cases and standard practices. The survey was developed and tested in collaboration with burn care experts, and distributed via email. One respondent per hospital performing burn surgery was permitted to prevent duplication. Data were analysed using descriptive statistics, Fisher's exact tests and Chi-square tests, with responses categorised by country and regional economic status.

RESULTS

Burn surgeons from 106 burn units across 50 countries completed the survey, achieving a 44% response rate. Early surgical debridement (<48 h) was most commonly referred to as standard care, although definitions of early grafting differed. LMICs and HICs differed in the availability of diagnostic tools, enzymatic debridement, and wound coverage techniques. Further regional differences were observed among HICs in Europe, North America, and Oceania, highlighting diverse approaches to burn care worldwide.

CONCLUSION

This study offers a global overview of acute surgical burn management, showing both universally common practices and significant regional variations between LMICs, HICs, and continents. The broad heterogeneity in surgical timing and techniques highlights the need for further research.

MeSH

Income, Burn Units, Debridement, Burns, Surgeons