Citation

Bache SE, Barnes D. BMJ Med. 2022; 1(1): e000273.

Copyright

(Copyright © 2022, BMJ Publishing Group)

DOI

10.1136/bmjmed-2022-000273

PMID

36936560

PMCID

PMC9978667

Abstract

Burn injuries contribute considerably to the global healthcare burden, with an estimated 11 million people annually affected worldwide.1 The impact of burn trauma can be destructive, lifelong, and indiscriminate. People of all ages, ethnic origins, and backgrounds are at risk. But it is the most vulnerable in society who are disproportionately affected: children, elderly people, individuals with poor mental or physical health, and those of low socioeconomic status. However, the past 50 years have seen substantial reductions in burn mortality, largely due to early excision and grafting, improved burn resuscitation, intensive care treatment, and better management of sepsis and wound care. Survival is now expected for the vast majority of people, even after severe burn injuries.2 The focus of the next 50 years will be on improving outcomes for survivors. Scarring, functionality, cosmesis, psychological, and long term physical impact are just a few examples of areas of research and focus for the worldwide burn community.

The evaluation and comparison of burn treatments presents a difficult challenge because they are a heterogenous group of injuries. Burn size, depth, anatomical location, cause, and patient factors are inconsistent. Additionally, the outcomes measured are also heterogenous, reliant on the preferences of researchers and not necessarily those most important to patients. Decreasing incidence of major burn in high income countries limits recruitment to trials, so evidence increasingly relies either on multicentre collaboration or systematic reviews. In the past, authors of systematic reviews have been prohibited from drawing firm conclusions by a lack of comparable outcomes in burn studies. The linked article by Young et al3 (doi:10.1136/bmjmed-2022-000183) is the first step towards reporting consistency through the development of a core outcome set for burn care research (COSB-i). The ultimate aim is for future burn research papers to include (but not be limited to) this common set of pertinent outcomes.

But what outcomes are considered most important--not only to those delivering burn care, but also to the patients and carers receiving it? Previous papers identified...

Language: en