Skip to main content

Epidemiology of Burn Injuries and Burn Care

  • Chapter
  • First Online:
Burn Care for General Surgeons and General Practitioners

Abstract

The science of epidemiology is of great importance, as the patterns of burn injury can lead to more concentrated efforts for both prevention and treatment. The goal of this chapter is not to attempt an exhaustive review of burn epidemiology, but rather to utilize some basic epidemiologic data to convey several important points that strengthen the premise and purpose of this book. These data will demonstrate the following:

  1. 1.

    Burns remain a significant mechanism of injury.

  2. 2.

    Most burns are nonfatal and are minor in terms of size (i.e., total body surface area).

  3. 3.

    Knowledge of the common causes and circumstances of burn injuries provides a greater understanding of the patterns sustained by each specific etiology, as well as providing targets for burn prevention in our local communities.

  4. 4.

    General surgeons have a role in the treatment of burn injuries, but they need to recognize those injuries that require referral to a burn center.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. American Burn Association. http://www.ameriburn.org/resources_factsheet.php. Accessed 17 June 2015.

  2. Centers for Disease Control and Prevention: Web-based Injury Statistics Query and Reporting System (WISQARS) [Online]. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (producer). http://www.cdc.gov/Injury. Accessed 17 June 2015.

  3. National Fire Protection Association. http://www.nfpa.org/research/reports-and-statistics/fires-in-the-us. Accessed 17 June 2015.

  4. Feck GA, Baptiste MS, Tate Jr CL. Burn injuries, epidemiology and prevention. Accid Anal Prev. 1979;11:129–36.

    Article  Google Scholar 

  5. Mlcak RP, Suman OE, Herndon DN. Respiratory management of inhalation injury. Burns. 2007;33(1):2–13.

    Article  PubMed  Google Scholar 

  6. Tsurumi A, Que YA, Yan S, Tompkins RG, Rahme LG, Ryan CM. Do standard burn mortality formulae work on a population of severely burned children and adults? Burns. 2015;41(5):935–45.

    Article  PubMed  Google Scholar 

  7. Ryan CM, Schoenfeld DA, Thorpe WP, Sheridan RL, Cassem EH, Tompkins RG. Objective estimates of the probability of death from burn injuries. N Engl J Med. 1998;338(6):362–6.

    Article  CAS  PubMed  Google Scholar 

  8. Baux S. Contribution a l’Etude du traitement local des brulures thermigues etendues These, Paris, France. 1961.

    Google Scholar 

  9. Baux S, Mimoun M, Saade H, Lioret N, Esteve M, Nolland XB, et al. Burns in the elderly. Burns. 1989;15(4):239–40.

    Article  CAS  PubMed  Google Scholar 

  10. Osler T, Glance LG, Hosmer DW. Simplified estimates of the probability of death after burn injuries: extending and updating the Baux score. J Trauma. 2010;68(3):690–7.

    Article  PubMed  Google Scholar 

  11. Royston P, Sauerbrei W. Multivariable model-building: a pragmatic approach to regression analysis based on fractional polynomials for modeling continuous variables. Hoboken, NJ: Wiley; 2008. p. 115–83.

    Book  Google Scholar 

  12. Tobiasen J, Hiebert JM, Edlich RF. The abbreviated burn severity index. Ann Emerg Med. 1982;11(5):260–2.

    Article  CAS  PubMed  Google Scholar 

  13. Forster NA, Zingg M, Haile SR, Kϋnzi W, Giovanoli P, Guggenheim M. 30 years later – does the ABSI need revision? Burns. 2011;37(6):958–63.

    Article  PubMed  Google Scholar 

  14. Germann G, Barthold U, Lefering R, Raff T, Hartmann B. The impact of risk factors and preexisting conditions on the mortality of burn patients and the precision of predictive admission-scoring systems. Burns. 1997;23(3):195–203.

    Article  CAS  PubMed  Google Scholar 

  15. Gravante G, Delogu D, Esposito G, Monton A. Analysis of prognostic indexes and other parameters to predict the length of hospitalization in thermally burned patients. Burns. 2007;33(3):312–5.

    Article  CAS  PubMed  Google Scholar 

  16. Seo DK, Kym D, Yim H, Yang HT, Cho YS, Kim JH, et al. Epidemiological trends and risk factors in major burns patients in South Korea: a 10-year experience. Burns. 2015;41(1):181–7.

    Article  PubMed  Google Scholar 

  17. Hussain A, Dunn KW. Accuracy of commercial reporting systems to monitor quality of care in burns. Burns. 2014;40(2):251–6.

    Article  PubMed  Google Scholar 

  18. Ahrens M. Home Fires involving cooking equipment. National Fire Protection Association. November 2013. http://www.nfpa.org/research/reports-and-statistics/fire-causes/appliances-and-equipment/cooking-equipment. Accessed 17 June 2015.

  19. Hall J. Home fires involving heating equipment. National Fire Protection Association. October 2013. http://www.nfpa.org/research/reports-and-statistics/fire-causes/appliances-and-equipment/heating-equipment. Accessed 17 June 2015.

  20. National Fire Data Center: fire in the United States, 1983 to 1990. 8th ed. National Fire Data Center Emmitsburg October 1993.

    Google Scholar 

  21. Hall J. The smoking-material fire problem. National Fire Protection Association. July 2013. http://www.nfpa.org/research/reports-and-statistics/fire-causes/smoking-materials. Accessed 17 June 2015.

  22. National Fire Protection Association. www.firesafecigarettes.org. Accessed 17 June 2015.

  23. Holmes W, Hold P, James M. The increasing trend in alcohol-related burns: its impact on a tertiary burn centre. Burns. 2010;36:938–43.

    Article  PubMed  Google Scholar 

  24. United States Department of Health and Human Services. Results from the 2011 National Survey on Drug Use and Health: summary of National Findings (2012). Rockville, MD: Substance Abuse and Mental Health Services Administration, Department of Health and Human Services; 2012.

    Google Scholar 

  25. Jehle Jr CC, Nazir N, Bhavsar D. The rapidly increasing trend of cannabis use in burn injury. J Burn Care Res. 2015;36(1):e12–7.

    Article  PubMed  Google Scholar 

  26. Anderson DM, Hansen B, Rees DI. Medical marijuana laws, traffic fatalities, and alcohol consumption. J Law Econ. 2013;56:333–69.

    Article  Google Scholar 

  27. Mierley MC, Baker SP. Fatal house fires in an urban population. JAMA. 1983;249:1466–8.

    Article  CAS  PubMed  Google Scholar 

  28. Fraga AM, Fraga GP, Noordenbos J, Tenenhaus M, Castle S, Bhavsar D, Lee JG, Coimbra R, Potenza BM. Beach and campfire burns: a site of pleasure and tragedy. J Burn Care Res. 2010;31(1):184–9.

    Article  PubMed  Google Scholar 

  29. Hultman CS, Tong WT, Surrusco M, Roden KS, Kiser M, Cairns BA. To everything there is a season: impact of seasonal change on admissions, acuity of injury, length of stay, throughput, and charges at an accredited, regional burn center. Ann Plast Surg. 2012;69(1):30–4.

    Article  CAS  PubMed  Google Scholar 

  30. National Fire Protection Association. http://www.nfpa.org/research/reports-and-statistics/fire-causes. Accessed 17 June 2015.

  31. Hall J. Fireworks. National Fire Protection Association. April 2013. http://www.nfpa.org/research/reports-and-statistics/fire-causes/electrical. Accessed 17 June 2015.

  32. Hoang DM, Reid D, Lentz CW. Statewide ban on recreational fires resulted in a significant decrease in campfire-related summer burn center admissions. J Burn Care Res. 2013;34(1):74–7.

    Article  PubMed  Google Scholar 

  33. Campbell, R. Intentional Fires. National Fire Protection Association. April 2014. http://www.nfpa.org/research/reports-and-statistics/fire-causes/arson-and-juvenile-firesetting/intentional-fires. Accessed 17 June 2015.

  34. Hall, J. Electrical Fires. National Fire Protection Association. April 2013. http://www.nfpa.org/research/reports-and-statistics/fire-causes/electrical. Accessed 17 June 2015.

  35. Spies C, Trohman RG. Narrative review: electrocution and life-threatening electrical injuries. Ann Intern Med. 2006;145:531–7.

    Article  PubMed  Google Scholar 

  36. Koumbourlis AC. Electrical injuries. Crit Care Med. 2002;30(Suppl):S424–30.

    Article  PubMed  Google Scholar 

  37. Curinga G, Pietramaggiori G, Scherer SS, Masellis A, Gherardini G, Brancato R, Conte F, Bistoni G. Electrical injuries due to theft of copper. J Burn Care Res. 2010;31(2):341–6

    Google Scholar 

  38. Report from the Italian Institute of Copper. http://www.ir.it/rame/statistiche/asp#Prezzi; http://www.iir.it/rame/caratteristiche_chimicofische. Accessed 17 June 2015.

  39. Taylor AJ, McGwin Jr G, Brissie RM, Rue 3rd LW, Davis GG. Death during theft from electric utilities. Am J Forensic Med Pathol. 2003;24(2):173–6.

    PubMed  Google Scholar 

  40. Adukauskiene D, Vizgirdaite V, Mazeikiene S. Electrical injuries. Medicina (Kaunas). 2007;43(3): 259–66.

    Google Scholar 

  41. Francis EC, Shelley OP. Copper wire theft and high voltage electrical burns. Int J Burns Trauma. 2014;4(2):59–61.

    PubMed  PubMed Central  Google Scholar 

  42. Hammond J. The status of statewide burn prevention legislation. J Burn Care Rehabil. 1993;14:473–5.

    Article  CAS  PubMed  Google Scholar 

  43. Herndon D. Total burn care. Elsevier 2012.

    Google Scholar 

  44. Klein MB, Kramer CB, Nelson J, Rivara FP, Gibran NS, Concannon T. Geographic access to burn center hospitals. JAMA. 2009;302(16):1774–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. 2015 NBR Report. http://www.ameriburn.org/2015NBRAnnualReport.pdf. Accessed 17 June 2015.

  46. Burton KR, Sharma VK, Harrop R, Lindsay R. A population-based study of the epidemiology of acute adult burn injuries in the Calgary Health Region and factors associated with mortality and hospital length of stay from 1995 to 2004. Burns. 2009;35(4):572–9.

    Article  PubMed  Google Scholar 

  47. Santaniello JM, Luchette FA, Esposito TJ, Gunawan H, Reed RL, Davis KA, Gamelli RL. Ten year experience of burn, trauma, and combined burn/trauma injuries comparing outcomes. J Trauma. 2004;57(4):696–700.

    Article  PubMed  Google Scholar 

  48. Lionelli GT, Pickus EJ, Beckum OK, Decoursey RL, Korentager RA. A three decade analysis of factors affecting burn mortality in the elderly. Burns. 2005;31(8):958–63.

    Article  CAS  PubMed  Google Scholar 

  49. Murray CK. Burns. In: Mandell, Douglas, and Bennett’s principles and practice of infectious diseases, vol. 2, Churchill Livingstone: Elsevier. p. 3905–9.

    Google Scholar 

  50. Cook N. Methicillin-resistant Staphylococcus aureus versus the burn patient. Burns. 1998;24:91–8.

    Article  CAS  PubMed  Google Scholar 

  51. DiMuzio EE, Healy DP, Durkee P, Neely AN, Kagan RJ. Trends in bacterial wound isolates and antimicrobial susceptibility in a Pediatric Burn Hospital. J Burn Care Res. 2014;35(5).

    Google Scholar 

  52. American Thoracic Society; Infectious Diseases Society of America. Guidelines on the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005;171:388–416. 10.1164/rccm.200405-644ST and http://www.atsjournals.org/doi/abs/10.1164/rccm.200405-644ST#.Vt0xW8ftVJo.

  53. Boggan JC, Navar-Boggan AM, Jhaveri R. Pediatric-specific antimicrobial susceptibility data and empiric antibiotic selection. Pediatrics. 2012;130:e615–22.

    Article  PubMed  Google Scholar 

  54. Girerd-Genessay I, Bénet T, Vanhems P. Multidrug-resistant bacterial outbreaks in burn units: a synthesis of the literature according to the ORION statement. J Burn Care Res. 2015;28.

    Google Scholar 

  55. McCampbell B, Wasif N, Rabbitts A, Staiano-Coico L, Yurt RW, Schwartz S. Diabetes and burns: retrospective cohort study. J Burn Care Rehabil. 2002; 23(3):157–66.

    Article  PubMed  Google Scholar 

  56. Kimball Z, Patil S, Mansour H, Marano MA, Petrone SJ, Chamberlain RS. Clinical outcomes of isolated lower extremity or foot burns in diabetic versus non-diabetic patients: a 10-year retrospective analysis. Burns. 2013;39(2):279–84.

    Article  PubMed  Google Scholar 

  57. Barsun A, Sen S, Palmieri TL, Greenhalgh DG. A ten-year review of lower extremity burns in diabetics: small burns that lead to major problems. J Burn Care Res. 2013;34(2):255–60.

    Article  PubMed  Google Scholar 

  58. Merchant N, Boudana D, Willoughby L, Lin J, Rehou S, Shahrokhi S, Jeschke MG. Management of adult patients with buttock and perineal burns: The Ross Tilley Burn Centre experience. J Trauma Acute Care Surg. 2014;77(4):640–8.

    Article  PubMed  Google Scholar 

  59. Price CE, Cox S, Rode H. The use of diverting colostomies in paediatric peri-anal burns: experience in 45 patients. S Afr J Surg. 2013;51(3):102–5.

    Article  CAS  PubMed  Google Scholar 

  60. Kement M, Acar HA, Barlas IS, Aksakal N, Gezen C, Düzci U, Oncel M. Clinical evaluation of a temporary fecal containment device for non-surgical fecal diversion in perineal burns. Ulus Travma Acil Cerrahi Derg. 2011;17(2):123–7.

    Article  PubMed  Google Scholar 

  61. Pruitt BA Jr, Wolf SE, Mason AD Jr. Epidemiological, demographic, and outcome characteristics of burn injury. Chapter 3. In: Herndon DN, editor. Total burn care. 3rd ed. Philadelphia: Saunders Elsevier; 2007. p. 14–32.

    Google Scholar 

  62. Mullins RF, Alarm B, Huq Mian MA, Samples JM, Friedman BC, Shaver JR, Brandigi C, Hassan Z. Burns in mobile home fires – descriptive study at a regional burn center. J Burn Care Res. 2009;30(4):694–9.

    Article  PubMed  Google Scholar 

  63. FEMA. Vacant Residential Building Fires (2010-2012). Topical fire report series. 15(11). http://www.usfa.fema.gov/downloads/pdf/statistics/v15i11.pdf. Accessed 17 June 2015.

  64. Greene, Michael and Craig Andres, “2004-2005 National Sample Survey of Unreported Residential Fires,” Division of Hazard Analysis, Directorate for Epidemiology, U.S. Consumer Product Safety Commission, July 2009.

    Google Scholar 

  65. Harms BA, Bodai BI, Kramer GC. Microvascular fluid and protein flux in pulmonary and systemic circulations after thermal injury. Microvasc Res. 1982;23(1):77–86.

    Article  CAS  PubMed  Google Scholar 

  66. Harms BA, Bodai BI, Kramer GC. Microvascular fluid and protein flux in pulmonary and systemic circulations after thermal injury. Microvasc Res. 1982;23(1):77–86. http://www.ameriburn.org/BurnCenterReferralCriteria.pdf. Accessed 17 June 2015.

    Google Scholar 

  67. Hankins CL, Tang XQ, Phipps A. Hot oil burns – a study of predisposing factors, clinical course and prevention strategies. Burns. 2006;32(1):92–6. Epub 2005 Dec.

    Article  PubMed  Google Scholar 

  68. Klein MB, Gibran NS, Emerson D, Sullivan SR, Honari S, Engrav LH, Heimbach DM. Patterns of grease burn injury: development of a classification system. Burns. 2005;31(6):765–7.

    Article  PubMed  Google Scholar 

  69. Desai MH, Rutan RL, Herndon DN. Conservative treatment of scald burns is superior to early excision. J Burn Care Rehabil. 1991;12(5):482–4.

    Article  CAS  PubMed  Google Scholar 

  70. Vloemans AF, Hermans MH, Van der Wal MB, Leibregts J, Middlekoop E. Optimal treatment of partial-thickness burns in children: a systematic review. Burns. 2014;40(2):177–90.

    Article  CAS  PubMed  Google Scholar 

  71. Thomson PD, Parks DH. Monitoring, banking and clinical use of amnion as a burn wound dressing. Ann Plast Srug. 1981;7(5):354–6.

    Article  CAS  Google Scholar 

  72. Wood F, Martin L, Lewis D, Rawlins J, McWilliams T, Burrows S, et al. A prospective randomised clinical pilot study to compare the effectiveness of Biobrane(®) synthetic wound dressing, with or without autologous cell suspension, to the local standard treatment regimen in paediatric scald injuries. Burns. 2012;38:830–9.

    Article  CAS  PubMed  Google Scholar 

  73. Kennedy JM, Goldie C, Nickerson D. Burn progression secondary to cardioversion. J Burn Care Res. 2011;32(4):e143–5.

    Article  PubMed  Google Scholar 

  74. Alconero Camarero AR, Casaus Pérez M, Gutiérrez Caloca N. Incidents of cutaneous alteration secondary to external electrical cardioversion. Enferm Intensiva. 2006;17(4):163–72.

    Article  PubMed  Google Scholar 

  75. Luce EA. Electrical burns. Clin Plast Surg. 2000;27:133–43.

    CAS  PubMed  Google Scholar 

  76. Curinga G, Pietramaggiori G, Scherer SS, Masellis A, Gherardini G, Brancato R, Conte F, Bistoni G. Electrical injuries due to theft of copper. J Burn Care Res. 2010;31(2):341–6.

    Article  PubMed  Google Scholar 

  77. Luz DP, Millan LS, Alessi MS, Uguetto WF, Paggairo A, Gomez DS, Ferreira MC. Electrical burns: a retrospective analysis across a 5 year period. Burns. 2009;35(7):1015–9.

    Article  CAS  PubMed  Google Scholar 

  78. Carlotto RC, Peters WJ, Neligan PC, Douglas LG, Beeston J. Chemical burns. Can J Surg. 1996;39:2.

    Google Scholar 

  79. Sheridan RL, Ryan CM, Quinby Jr WC, Blair J, Tompkins RG, Burke JF. Emergency management of major hydrofluoric acid exposures. Burns. 1995;21: 62–3.

    Article  CAS  PubMed  Google Scholar 

  80. Pruitt BA. Chemical injuries: epidemiology, classification and pathophysiology. Presented at the annual meeting of the American Burns Association, Las Vegas, 1990.

    Google Scholar 

  81. Palao R, Monge I, Ruiz M, Barret JP. Chemical burns: pathophysiology and treatment. Burns. 2010;36(3):295–304.

    Article  CAS  PubMed  Google Scholar 

  82. Reiland A, Hovater M, McGwin Jr G, Rue 3rd LW, Cross JM. The epidemiology of intentional burns. J Burn Care Res. 2006;27(3):276–80.

    Article  PubMed  Google Scholar 

  83. Varley J, Pilcher D, Butt W, Cameron P. Self harm is an independent predictor of mortality in trauma and burns patients admitted to ICU. Injury. 2012;43(9):1562–5.

    Article  PubMed  Google Scholar 

  84. Modjarrad K, McGwin Jr G, Cross JM, Rue 3rd LW. The descriptive epidemiology of intentional burns in the United States: an analysis of the National Burn Repository. Burns. 2007;33(7):828–32. Epub 2007 May 24.

    Article  PubMed  Google Scholar 

  85. Thombs BD, Bresnick MG. Mortality risk and length of stay associated with self-inflicted burn injury: evidence from a national sample of 30,382 adult patients. Crit Care Med. 2008;36(1):118–25.

    Article  PubMed  Google Scholar 

  86. Friedman T, Shalom A, Westreich M. Self-inflicted burns. Ann Plast Surg. 2007;58(6):622–4.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Victor C. Joe M.D., FA.C.S. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Maximus, S., Joe, V.C. (2016). Epidemiology of Burn Injuries and Burn Care. In: Greenhalgh, D. (eds) Burn Care for General Surgeons and General Practitioners . Springer, Cham. https://doi.org/10.1007/978-3-319-29161-1_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-29161-1_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29159-8

  • Online ISBN: 978-3-319-29161-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics