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Global Perspectives on Burn Prevention, Management, Collaboration, and Disparities
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Global Perspectives on Burn Prevention, Management, Collaboration, and Disparities

A special issue of European Burn Journal (ISSN 2673-1991).

Deadline for manuscript submissions: closed (31 December 2025) | Viewed by 10263

Special Issue Editor

Dr. Laura Pompermaier

E-Mail Website
Guest Editor
Division of Surgery, Orthopedics and Oncology (KOO), Department of Biomedical and Clinical Sciences (BKV), Linköping University (LIU), SE-581 83 Linköping, Sweden
Interests: global surgery; global burden of burns; burn care in low resource settings; implementation research; genital mutilation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Burns can lead to dramatic consequences in terms of morbidity and mortality. Where preventive strategies have been adopted and adequate care is guaranteed, incidence and outcomes after burns have progressively improved, while in limited resource settings they have not. Research can contribute to reducing the burden of burns, identifying risk groups, analyzing management and outcomes, and promoting systematic data collection. Collaboration among burn care experts and researchers around the world may contribute to providing one standard of care, reducing differences

Dr. Laura Pompermaier
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. European Burn Journal is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 971 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • burn injury
  • low-resource settings
  • low- and middle-income countries
  • burn care capacity
  • traditional medicine
  • delay in care
  • surgery
  • reconstruction
  • contractures
  • socio-economic factors
  • equality
  • burn registry
  • equity

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Published Papers (7 papers)

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Research

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12 pages, 601 KB  
Article
Association Between Rehabilitation Frequency and Functional Outcomes After Burn Injury: A Single-Center Retrospective Analysis of Confounding by Indication
by Yazeed Temraz, Theeb Al Salem, Shaimaa Khan, Raghad Alshehri, Lina Alosaimi, Mariam Hantoul, Rahaf Alrajhi, Rayya Alabdali, Amal Bahumayim, Ibtihal Al Jafin, Fai Al Qazlan and Abdulmajeed Al Ehaideb
Eur. Burn J. 2026, 7(1), 6; https://doi.org/10.3390/ebj7010006 - 19 Jan 2026
Viewed by 482
Abstract
Objective: To identify key predictors of clinical outcomes in burn survivors and clarify the role of mixed-depth burns and confounding by indication in observational rehabilitation research. Design: Retrospective cohort study using data from a burn rehabilitation registry (January 2024 to July 2025). Setting: [...] Read more.
Objective: To identify key predictors of clinical outcomes in burn survivors and clarify the role of mixed-depth burns and confounding by indication in observational rehabilitation research. Design: Retrospective cohort study using data from a burn rehabilitation registry (January 2024 to July 2025). Setting: Burn rehabilitation center. Participants: 120 adult patients (age ≥ 18 years) with burns affecting ≥1% total body surface area (TBSA) and complete baseline data. Interventions: Not applicable. Main Outcome Measures: Primary outcome was functional improvement (ΔFIM). Secondary outcomes included pain reduction (ΔPain), scar severity (Vancouver Scar Scale; VSS), Activities of Daily Living (ADL) improvement, and Range of Motion (ROM) recovery. Multivariable linear and logistic regression models were used to identify predictors. Results: Patients achieved significant improvements in function (mean ΔFIM = 11.3 ± 8.9 points) and pain (mean ΔPain = 1.28 ± 0.81). Having a mixed-depth burn was the strongest predictor of worse scar outcomes (β = 2.52, 95% CI: 0.93 to 4.12, p = 0.002) and failure to achieve full ROM (OR = 0.089, 95% CI: 0.008 to 0.930, p = 0.043). An apparent association between inpatient ward care and better scar outcomes (β = −1.30, p = 0.020) was determined to be an artifact of confounding by indication, as the outpatient group had a higher proportion of high-risk mixed-depth burns (6.2% vs. 3.5%). Longer therapy duration was the only significant predictor of achieving ADL goals (OR = 1.014, 95% CI: 1.002 to 1.026, p = 0.025). Conclusions: Injury characteristics, particularly the presence of a mixed-depth burn, emerged as the dominant predictors of long-term scar and functional outcomes. This study identifies mixed-depth burns as a potentially high-risk clinical phenotype requiring targeted therapeutic strategies and demonstrates the critical importance of accounting for confounding by indication when evaluating rehabilitation outcomes in observational burn research. Full article
(This article belongs to the Special Issue Global Perspectives on Burn Prevention, Management, Collaboration, and Disparities)
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12 pages, 1177 KB  
Article
Provider Survey on Burn Care in India
by Dorothy Bbaale, Priyansh Nathani, Shlok Patel, Anshul Mahajan, Bhavna Chavla, Christoph Mohr, Julia Elrod, Shobha Chamania and Judith Lindert
Eur. Burn J. 2026, 7(1), 3; https://doi.org/10.3390/ebj7010003 - 22 Dec 2025
Viewed by 634
Abstract
Background: Burns result in approximately 180,000 deaths annually, with the majority occurring in rural regions of Africa and Southeast Asia. This study aimed to assess the available resources, key challenges, and potential solutions in burn care from the perspective of healthcare providers in [...] Read more.
Background: Burns result in approximately 180,000 deaths annually, with the majority occurring in rural regions of Africa and Southeast Asia. This study aimed to assess the available resources, key challenges, and potential solutions in burn care from the perspective of healthcare providers in India. Methods: An online survey was conducted among burn care professionals across India. The survey was disseminated via social media platforms, burn care networks, and hospital representatives. Results: A total of 105 respondents, primarily from tertiary care centers, participated in the survey. Of these, 64.2% were affiliated with government hospitals, and 40.1% served catchment areas extending beyond 300 km. Dedicated burn units were present in 88.0% of government hospitals, compared to 66.9% in non-government facilities. Treatment costs were significantly lower in government hospitals, with 88.8% offering care either free of charge or at minimal cost (p ≤ 0.00001). Conclusions: The findings reveal significant gaps in staff training, intensive care monitoring, and infection prevention. Many patients initially seek help from traditional healers, often delaying appropriate treatment and worsening outcomes. Enhancing education, implementing standard monitoring practices, and ensuring adherence to clinical protocols are critical steps toward improving burn care outcomes in India. Full article
(This article belongs to the Special Issue Global Perspectives on Burn Prevention, Management, Collaboration, and Disparities)
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12 pages, 296 KB  
Article
A Prospective Observational Study to Determine the Efficacy of a Theatre Prioritisation Tool in Optimal Utilisation of Limited Theatre Time for Deep Burn Injury in a Resource-Restricted Setting
by Nikki Leigh Allorto, Reitze Rodseth and David Gray Bishop
Eur. Burn J. 2025, 6(4), 55; https://doi.org/10.3390/ebj6040055 - 17 Oct 2025
Cited by 1 | Viewed by 732
Abstract
Background: Routine early surgery for all deep burns in low-resource settings is not currently achievable. We designed and implemented a simple triage strategy that selected patients to be prioritised for early surgery based on a more urgent need and greater potential benefit. The [...] Read more.
Background: Routine early surgery for all deep burns in low-resource settings is not currently achievable. We designed and implemented a simple triage strategy that selected patients to be prioritised for early surgery based on a more urgent need and greater potential benefit. The primary outcome was the ability to perform surgery in the priority group within three days of the decision. Methods: This was a prospective, descriptive study undertaken at a tertiary hospital in Pietermaritzburg, South Africa. All patients referred to the Grey’s Hospital Burn Service were triaged into either priority or non-priority groups. Priority designation was based on total burn surface area (TBSA) > 15%, the presence of sepsis, or limb-threatening injury. Data related to demographic information, injury, and outcomes were collected and managed using REDCap electronic data capture tools. Results: There were 191 admissions with 42 (22%) meeting priority criteria. The priority group had larger burns (TBSA 25 [Interquartile range 15–30] vs. 8 [3–15]%) and included all septic injuries. We provided early surgery within a median of 1.4 (interquartile range 0.5–3.3) days of the decision for surgery being made. A total of 75% of patients were operated within 72 h of the decision, and 43% within 10 days of injury. The system identified a sicker cohort, as evidenced by high mortality, ICU admission, and acute kidney injury rates. In the non-priority group, reported outcomes were more positive, but with a high injury-to-discharge days per percentage TBSA. Conclusions: This simple triage strategy represents a novel approach for prioritising access to burn surgery in a setting where global surgery standards are desirable but not always possible. We were able to identify the high-risk groups and provide surgery within acceptable time frames. Future research should be aimed at refining this triage system and improving outcomes in the priority group. Full article
(This article belongs to the Special Issue Global Perspectives on Burn Prevention, Management, Collaboration, and Disparities)
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11 pages, 775 KB  
Article
Exploring Disparities in Pavement Burns: A Comparative Analysis of Housed and Unhoused Burn Patients
by Henry Krasner, Emma Chevalier, Samantha Chang, David Slattery and Syed Saquib
Eur. Burn J. 2025, 6(3), 38; https://doi.org/10.3390/ebj6030038 - 1 Jul 2025
Cited by 1 | Viewed by 857
Abstract
In some regions, extreme heat can result in pavement temperatures that are high enough to cause severe burn injuries within seconds of skin contact. This risk is elevated for unhoused individuals who may lack adequate clothing and shelter and have susceptibility to other [...] Read more.
In some regions, extreme heat can result in pavement temperatures that are high enough to cause severe burn injuries within seconds of skin contact. This risk is elevated for unhoused individuals who may lack adequate clothing and shelter and have susceptibility to other risk factors, including substance use and in turn loss of consciousness. While prior studies have shown worse outcomes for unhoused individuals due to delays in care and higher susceptibility, there is a lack of data on the impact of pavement burns specifically within this population. This single-institution retrospective cohort study aims to explore burn severity and hospital outcomes in housed vs. unhoused patients with pavement burns. The data were analyzed using independent samples t-tests and logistic regression when appropriate, with p < 0.05 considered statistically significant. A total of 305 individuals met the inclusion/exclusion criteria and comprised the final study cohort, 17.7% of which were unhoused. There was no significant difference in TBSA, survival to discharge, or hospital length of stay between housed and unhoused patients. While unhoused individuals may still be at heightened risk for pavement burns due to exposure to extreme heat and a lack of protective measures, these results may additionally suggest consistent emergency care for patients regardless of housing status. Furthermore, these results highlight the importance of developing targeted outreach and prevention programs and equitable emergency care protocols for vulnerable populations. Full article
(This article belongs to the Special Issue Global Perspectives on Burn Prevention, Management, Collaboration, and Disparities)
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14 pages, 234 KB  
Article
Improving Nutrition and Nutrition Education in the Burn Unit of a Developing Country: A Qualitative Study
by Jonathan Bayuo, Joyce Pwavra, Jephtah Davids, Anita Eseenam Agbeko, Paa Ekow Hoyte-Williams, Frank Bediako Agyei and Pius Agbenorku
Eur. Burn J. 2025, 6(1), 15; https://doi.org/10.3390/ebj6010015 - 10 Mar 2025
Viewed by 1223
Abstract
Burn injuries can trigger a series of metabolic and catabolic responses that exert significant impacts on an individual’s nutritional status, necessitating continuous nutritional support and education to aid recovery. However, burn units in developing countries often face resource limitations that can negatively affect [...] Read more.
Burn injuries can trigger a series of metabolic and catabolic responses that exert significant impacts on an individual’s nutritional status, necessitating continuous nutritional support and education to aid recovery. However, burn units in developing countries often face resource limitations that can negatively affect these needs. This study aimed to explore the challenges related to post-burn nutrition and nutrition education in our burn unit and identify ways to improve the situation. An interpretive description approach was used, and convenience sampling recruited fifty-three participants, including 18 adult burn survivors and their primary caregivers (each as a single dyad), 10 informal caregivers of paediatric burn survivors, and 25 burn care staff. The data were analysed through thematic analysis, revealing three main themes and seven subthemes. The findings highlight an unstructured approach to nutrition and education, along with financial constraints affecting adherence. To address these issues, strategies such as using educational materials like videos and booklets/leaflets in the local language are suggested to develop relevant interventions. In conclusion, while there are concerns about nutrition and education, there are also opportunities to improve the situation. Full article
(This article belongs to the Special Issue Global Perspectives on Burn Prevention, Management, Collaboration, and Disparities)

Review

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8 pages, 826 KB  
Review
Recreational Use of Nitrous Oxide as a Source of Frostbite Injuries to the Skin: A Review of the Literature and a Case Report
by Sebastian Holm, Reza Tabrisi and Johann Zdolsek
Eur. Burn J. 2025, 6(1), 14; https://doi.org/10.3390/ebj6010014 - 7 Mar 2025
Cited by 1 | Viewed by 3170
Abstract
Nitrous oxide has a wide range of medical applications, such as being used as an analgesic in general anesthesia, dental procedures, childbirth and sedation. Lately, it has also been employed as an inhalant recreational drug to induce brief euphoria. Recent studies indicate a [...] Read more.
Nitrous oxide has a wide range of medical applications, such as being used as an analgesic in general anesthesia, dental procedures, childbirth and sedation. Lately, it has also been employed as an inhalant recreational drug to induce brief euphoria. Recent studies indicate a worldwide rise in the incidence of skin frostbites associated with nitrous oxide use. A scoping review was conducted to synthesize and summarize the existing literature published in English regarding frostbite injuries associated with the recreational use of nitrous oxide. The literature search was carried out in July 2024 using databases such as Embase, Web of Science and PubMed®. From an initial pool of 83 publications, 8 studies were ultimately selected for full-text review as they met our inclusion criteria for analysis. Additionally, we provide a representative clinical case involving a 21-year-old male who experienced frostbite following skin exposure to nitrous oxide. Most publications on nitrous oxide induced frostbites are from recent years, primarily between 2022 and 2024, with the first case documented in 1996. These injuries are mostly observed in young adults, with a female dominance, and are typically localized to the inner thighs. According to the existing literature, the predominant treatment approach is conservative management, with excision and split-thickness skin grafting (STSG) in the second place. This study represents the first literature review summarizing frostbite injuries to the skin from nitrous oxide misuse. There is a need for enhanced preventive measures to raise public awareness and reduce the incidence of frostbite injuries associated with the recreational use of nitrous oxide. Full article
(This article belongs to the Special Issue Global Perspectives on Burn Prevention, Management, Collaboration, and Disparities)
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Other

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19 pages, 2063 KB  
Systematic Review
Exploring Ethnic Disparities in Burn Injury Outcomes in the UK: A Systematic Review
by Uashar Badakhshan, Reza Zamani and Tanimola Martins
Eur. Burn J. 2025, 6(3), 48; https://doi.org/10.3390/ebj6030048 - 22 Aug 2025
Viewed by 1605
Abstract
Background: Burn injuries are among the most distressing injuries, affecting approximately 250,000 people annually in the UK. While extensive research has explored how gender, health, and socioeconomic factors influence burn injury rates, ethnic disparities in burns have received less attention. Methods: The review [...] Read more.
Background: Burn injuries are among the most distressing injuries, affecting approximately 250,000 people annually in the UK. While extensive research has explored how gender, health, and socioeconomic factors influence burn injury rates, ethnic disparities in burns have received less attention. Methods: The review followed the PRISMA framework for database searches. Search terms included concepts of ethnicity and burn injuries in the UK. Results: From the initial 3339 search results, 11 studies were selected following the eligibility screening. White ethnic groups made up 52.4% of admissions, whereas Asians and Black groups made up 24.9% and 5.9%, respectively. Trends showed a decline in admissions among White patients and a rise in admissions among Black patients. Children aged 1 to 5 years were most affected, particularly in the Asian and Black groups. Males constituted 58.0% of admissions, while females accounted for 42.0%. Most burns occurred at home, with scalds, particularly among children. Ethnic minorities were more likely to apply unsuitable topical treatments and had higher rates of psychological referrals. Conclusions: The review underscores important ethnic disparities in burn injuries and outcomes. Targeting policies to address them could result in a more equitable healthcare system and improved outcomes for burn patients in the UK. Full article
(This article belongs to the Special Issue Global Perspectives on Burn Prevention, Management, Collaboration, and Disparities)
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