Burn Wound Management

Burn etiology, patient age, and burn size predict patient prognosis. The initial burn wound assessment determines the type of burn, burn extent and depth, and additional injuries. These factors play a significant role determining burn treatment strategy. This chapter outlines some of the initial steps of burn wound management that emergency physicians, medical teams, and burn specialists might follow when treating burn wounds to guide best burn care management. Once percent total body surface area (% TBSA) burned is determined, triage may begin. Burn patients with less than 20% TBSA are generally treated as short-term inpatients or outpatients, whereas those with burns covering more than 20% TBSA are considered major with long inpatient stays expected such patients are best treated in dedicated burn centers when possible. Patients with major burns may experience sepsis and undergo many operations for wound closure. Before transfer to a burn center, an assessment for escharotomy to assure safe transport should be conducted to prevent circulatory and pulmonary complications. Many excision and grafting techniques are available to treat patients properly according to their specific injuries, prevent complications, and improve outcomes.