Abstract
Burn injuries can be life-threatening, thus standardized procedures are essential to ensure the best medical care is provided after injury. Therefore, burn care guidelines were created throughout the world. There are many similarities within the different burn guidelines, especially in basic burn care procedures. Taking a closer look, it becomes clear that there are also a lot of disparities within the guidelines. In this review the guidelines of the German Society of Burn Treatment (DGV), British Burn Association (BBA), European Burns Association (EBA), American Burn Association (ABA), Australian and New Zealand Burn Association (ANZBA), and the International Society for Burn Injuries (ISBI) are compared. The DGV-guidelines focus on pre-hospital treatment measures, intensive care treatment and acute wound therapy, whereas the BBA puts emphasis on infrastructure and staff qualification. The EBA created guidelines for medical practitioners and non-medical staff to standardize burn care in European countries with special focus on clear treatment recommendations and best infrastructural facilities. The ABA underlines the need for best qualified medical staff and ABLS- (Advanced Burn Life Support) standards. The ANZBA focuses on best treatment options including novel wound healing biotechnologies and post-burn return-to-function rehabilitation. In contrast to all other guidelines, the ISBI does not only deal with burn care in developed countries but also in resource-limited settings. Special focus lies on the discussion of ethical issues and cost-effectiveness. In this review, advantages and disadvantages of each guideline are discussed. These findings are supposed to help improving burn care procedures worldwide.
Highlights
Clinical practice guidelines are based on highly qualified literature and offer systematic recommendations designed to help medical staff in decision-making about appropriate care and management for specific clinical circumstances
Whereas there are no great disparities in the basic steps in burn treatment worldwide, different burn associations focus on specific aspects concerning first aid procedures, transfer criteria to a burn center, treatment- and rehabilitation- recommendations
British Burn Association (BBA), European Burns Association (EBA), ANZBA, and International Society for Burn Injuries (ISBI)- guidelines recommend the cooling the burn with running water for approximately 20 min [8,12,34]
Summary
Clinical practice guidelines are based on highly qualified literature and offer systematic recommendations designed to help medical staff in decision-making about appropriate care and management for specific clinical circumstances. Patients need accurate treatment beginning with the initial injury and acute life-sustaining measures, clinical stabilization processes including best intensive care treatment and conservative and surgical wound management and reconstruction, followed by long-term rehabilitation. Infrastructural conditions and staff qualification are vital for burn care [1]. To optimize these processes, many countries have designed their own clinical practice guidelines to offer a standard for best medical care in all clinical phases. Whereas there are no great disparities in the basic steps in burn treatment worldwide, different burn associations focus on specific aspects concerning first aid procedures, transfer criteria to a burn center, treatment- and rehabilitation- recommendations
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