Assessment of acute burn management in 32 low- and middle-income countries

Joseph, Krishan, Trehan, Abhishek, Cherian, Meena, Kelley, Edward and Watters, David A. 2016, Assessment of acute burn management in 32 low- and middle-income countries, World journal of surgery, vol. 40, no. 4, pp. 791-800, doi: 10.1007/s00268-015-3355-3.

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Title Assessment of acute burn management in 32 low- and middle-income countries
Author(s) Joseph, Krishan
Trehan, Abhishek
Cherian, Meena
Kelley, Edward
Watters, David A.ORCID iD for Watters, David A.
Journal name World journal of surgery
Volume number 40
Issue number 4
Start page 791
End page 800
Total pages 10
Publisher Springer
Place of publication Berlin, Germany
Publication date 2016-04
ISSN 1432-2323
Summary BACKGROUND: The purpose of this study is to ascertain whether acute burn management (ABM) is available at health facilities in low- and middle-income countries (LMICs). METHOD: The study used the World Health Organization situational analysis tool (SAT) which is designed to assess emergency and essential surgical care and includes data points relevant to the acute management of burns. The SAT was available for 1413 health facilities in 59 countries. RESULTS: A majority (1036, 77.5 %) of the health facilities are able to perform ABM. The main reasons for the referral of ABM are lack of skills (53.4 %) and non-functioning equipment (52.2 %). Considering health centres and district/rural/community hospitals that referred due to lack of supplies/drugs and/or non-functioning equipment, almost half of the facilities were not able to provide continuous and consistent access to the equipment required either for resuscitation or to perform burn wound debridement. Out of the facilities that performed ABM, 379 (36.6 %) are capable of carrying out skin grafts and contracture release, which is indicative of their ability to manage full thickness burns. However the magnitude of full thickness burns managed was limited in half of these facilities, as they did not have access to a blood bank. CONCLUSION: The initial management of acute burns is generally available in LMICs, however it is constrained by the inability to perform resuscitation (19 %) and/or burn wound debridement (10 %). For more severe burns, an inability to perform skin grafting or contracture release limits definitive management of full thickness burns, whilst lack of availability to blood further compromises the treatment of major burns.
Language eng
DOI 10.1007/s00268-015-3355-3
Field of Research 111799 Public Health and Health Services not elsewhere classified
1103 Clinical Sciences
Socio Economic Objective 920409 Injury Control
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Springer
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Document type: Journal Article
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School of Medicine
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