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Abstract
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A burn injury is the coagulative destruction of the skin and its structures by thermal, chemical, electrical or mechanical energy. A major burn is defined according to the percentage total body surface area (%TBSA) affected by the injury. A burn greater than 15% TBSA is considered major in an adult aged >16 yrs. A recent update on paediatric burns is available.
Epidemiology
Fire, heat and hot substance injuries caused 8,991,468 injuries and 120,632 deaths worldwide in 2017. Ninety percent of these were in low- or middle-income countries. Comprehensive up-to-date statistics for the UK are not available for reference, but there are approximately 10,000 hospital admissions and 300 major burns in adults requiring fluid resuscitation in England and Wales per year. In Scotland there is an incidence of 500 burn injury admissions per year, of which 5% are major burns.
The most common mechanism of injury requiring admission is scalds; however, the most common cause of major burns are flame injuries. Burn injuries have a wide aetiology including thermal (scald, flame, flash, contact, irradiation), electrical (including lightning strikes) and chemical (acid, alkali). Most are accidents in the home or work-related, but intentional injuries from deliberate self-harm, assaults or fires are more likely to result in major burns.
Risk factors
Risk factors worldwide for suffering a burn injury include: low socioeconomic status; overcrowding; households where young girls have domestic roles; cooking with kerosene; generalised poor health; and poor safety practices. Injuries are more common in patients with pre-existing psychiatric diagnoses, substance use problems and those at extremes of age. Children suffer accidental and non-accidental injury. As the population ages, the older and frail individuals with pre-existing medical conditions presenting as collapse, are increasingly represented. Burns are a preventable injury and strategies to decrease the incidence focus on awareness, education and health and safety legislation...
Language: en |