Conclusion and References


Fortunately, the vast majority of burn injuries can be managed with simple outpatient wound care and ambulatory clinic follow-up to ensure that all involved areas heal and do so without debilitating scarring. Selected patients require burn unit admission and surgical management, and this course requires a centralized infrastructure supported by a range of multi-professional experts.

Key Takeaways

  • Severe burn patients and those that meet specific criteria should be referred to regional burn units
  • For major burns, intravenous access should be obtained and a urinary catheter inserted
  • All burns should be immersed in cool running water (not ice water) for 20 minutes and then covered
  • Decompressive escharotomies are emergency procedures for constricting circumferential deep burns of the arms, legs, abdomen, and chest
  • Adequate fluid resuscitation is the most critically important aspect of early major burn care, and aims to maintain tissue and organ perfusion and minimize systemic sequelae, especially renal failure
  • Burn patients and their families/circle of care require emotional support from the healthcare team members



Allorto NL, Rogers AD, Rode H.  ‘Getting under our skin’:  Introducing allograft skin to burn surgery in South Africa.  S Afr Med J 2016; 106(9): 865-866

Brown DA, Gibbons J, Honari S, Klein MB, Pham TN, Gibran NS. Propranolol Dosing Practices in Adult Burn Patients: Implications for Safety and Efficacy. J Burn Care Res. 2016 May-Jun;37(3):e218-26. doi: 10.1097/BCR.0000000000000240. PMID: 25882517.

Cartotto R, Cicuto BJ, Kiwanuka HN, Bueno EM, Pomahac B. Common postburn deformities and their management. Surg Clin North Am. 2014 Aug;94(4):817-37. doi: 10.1016/j.suc.2014.05.006. Epub 2014 Jun 16. PMID: 25085090.

Friedstat JS, Hultman CS. Hypertrophic burn scar management: What does the evidence show? A systematic review of randomized controlled trials. Ann Plast Surg. 2014;72:S198–S201.

Hansen JK, Voss J, Ganatra H, et al. Sedation and Analgesia During Pediatric Burn Dressing Change: A Survey of American Burn Association Centers. J Burn Care Res. 2019;40(3):287-293. doi:10.1093/jbcr/irz023

Hettiaratchy S, Dziewulski P. ABC of burns: pathophysiology and types of burns [published correction appears in BMJ. 2004 Jul 17;329(7458):148]. BMJ. 2004;328(7453):1427-1429. doi:10.1136/bmj.328.7453.1427

Hultman CS, Friedstat JS, Edkins RE, Cairns BA, Meyer AA. Laser resurfacing and remodeling of hypertrophic burn scars: The results of a large, prospective, before-after cohort study, with long-term follow-up. Ann Surg. 2014;260:519– 529; discussion 529–532.

Mason SA, Nathens AB, Finnerty CCet al  Inflammation and the Host Response to Injury Collaborative Research Program. Hold the Pendulum: Rates of Acute Kidney Injury are Increased in Patients Who Receive Resuscitation Volumes Less than Predicted by the Parkland Equation. Ann Surg. 2016 Dec;264(6):1142-1147.PMID: 27828823

Nieuwendijk SMP, de Korte IJ, Pursad MM, van Dijk M, Rode H. Post burn pruritus in pediatric burn patients. Burns. 2018;44(5):1151-1158. doi:10.1016/j.burns.2018.02.022

Palmieri TL, Taylor S, Lawless M, Curri T, Sen S, Greenhalgh DG. Burn center volume makes a difference for burned children. Pediatr Crit Care Med. 2015;16(4):319-324. doi:10.1097/PCC.0000000000000366

Pardesi O, Fuzaylov G. Pain Management in Pediatric Burn Patients: Review of Recent Literature and Future Directions. J Burn Care Res. 2017;38(6):335-347. doi:10.1097/BCR.000000000000047

Rogers AD, Adams S, Rode H.  The Introduction of a protocol for the use of Biobrane for facial burns in children.  Plast Surg Int. 2011; 2011: 858093

Rogers AD, Deal C, Argent AC, Hudson DA, Rode H.  Ventilator associated pneumonia in major paediatric burns. Burns. 2014 Sep; 40 (6): 1141-8

Rousseau AF, Losser MR, Ichai C, Berger MM. ESPEN endorsed recommendations: nutritional therapy in major burns [published correction appears in Clin Nutr. 2013 Dec;32(6):1083]. Clin Nutr. 2013;32(4):497-502. doi:10.1016/j.clnu.2013.02.012

Saffle JI. The phenomenon of “fluid creep” in acute burn resuscitation. J Burn Care Res. 2007;28:382–395.

Schmitt YS, Hoffman HG, Blough DK, et al. A randomized, controlled trial of immersive virtual reality analgesia, during physical therapy for pediatric burns. Burns. 2011;37(1):61-68. doi:10.1016/j.burns.2010.07.007

Shah AR, Liao LF. Pediatric Burn Care: Unique Considerations in Management. Clin Plast Surg. 2017;44(3):603-610. doi:10.1016/j.cps.2017.02.017

Snell JA, Loh NH, Mahambrey T, Shokrollahi K. Clinical review: the critical care management of the burn patient.Crit Care. 2013 Oct 7;17(5):241. doi: 10.1186/cc12706. Review. PMID: 24093225

Strobel AM, Fey R. Emergency Care of Pediatric Burns. Emerg Med Clin North Am. 2018;36(2):441-458. doi:10.1016/j.emc.2017.12.011

Sudenis T, Hall K, Cartotto R. Enteral nutrition: what the dietitian prescribes is not what the burn patient gets! J Burn Care Res. 2015 Mar-Apr;36(2):297-305. doi: 10.1097/BCR.0000000000000069. PMID: 24722665.

Tredget EE, Levi B, Donelan MB. Biology and principles of scar management and burn reconstruction. Surg Clin North Am. 2014;94:793–815.

Wasiak J, Cleland H, Campbell F, Spinks A. Dressings for superficial and partial thickness burns. Cochrane Database of Systematic Reviews 2013, Issue 3. Art. No.: CD002106. DOI: 10.1002/14651858.CD002106.pub4. Accessed 15 December 2021.

Zuccaro J, Muser I, Singh M, Yu J, Kelly C, Fish J. Laser Therapy for Pediatric Burn Scars: Focusing on a Combined Treatment Approach. J Burn Care Res. 2018 Apr 20;39(3):457-462. doi: 10.1093/jbcr/irx008. PMID: 29897540.


Share This Book