The Consensus of the Surgical Treatment of Burn Injuries in Belgium

Abstract

Abstract. On the occasion of the twentieth anniversary of the 'Belgian Association of Burn Injuries' an inventory was made of all surgical techniques used in the five largest Belgian burn centres in order to draw up a consensus document. A questionnaire covering the whole treatment of severely burned patients was sent to the surgeons of each burn unit, ranging from emergency treatment, through diagnostic techniques, burn surgery and post-healing treatment (scars, contractures). During the past decade, several (often expensive) new techniques have been commercialised, resulting in a wide variety of treatment modalities in the different centres. For the majority of burns, however, a similar protocol is followed : the superficial burns are treated conservatively and the deep burns surgically. Nevertheless, burns of indeterminate depth are susceptible to variations in their treatment. There are also different therapeutic options for the deepest burns, from the use of donor skin to dermal substitutes as well as cultured keratinocytes. The writing of this consensus required intense communication on the different therapeutic modalities, as well as an increased exchange of experiences, which could lead to an improvement in the quality of burn treatment in Belgium.

Burn Scar Assessment: A Systematic Review of Different Scar Scales

“…Due to the improvements in burn treatment as provided in highly specialized burn centers, more patients with deep and extended burn injuries do survive nowadays [1][2][3], resulting in a larger group of patients with more extensive scar formation [4]. Scar formation depends on several variables, including the wound treatment, the depth of the burn, the skin type and age of the patient, the healing process (inflammation, infection, etc.)…”

Severe burn injury in europe: a systematic review of the incidence, etiology, morbidity, and mortality

“…Whether inpatient treatment in a specialized burn unit is required depends principally on the severity of the burn, the concomitant trauma, and the general condition of the patient [4-7]. In the European Union, transport accidents (21.8%), accidental falls (19.4%), and suicide (24.7%) are the three most common "fatal injuries," with burns reported as "other unintentional fatal injuries," together with poisoning and drowning (34.1%) [8].…”

Morbidity and Mortality of Bloodstream Infections in Patients With Severe Burn Injury

“…In 28% of the BSI episodes, multiple bacteria were detected. Median time between admission and onset of BSI was 11 days (IQR, [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. A total of 39 episodes were primary BSIs (39/7651%); of these, 23 were due to contaminated catheters (23/76, 30%).…”

“…4 Early debridement and wound closure are advocated to decrease infection risk, but even then colonization of burns is difficult to avoid, potentially leading to systemic invasion of microbes. [6][7][8] Furthermore, burn patients are at risk for BSI because of the use of invasive devices, multiple surgical procedures, and prolonged hospitalization.…”