Burns: Definition and Epidemiology

Sathish Manivel

Consultant Plastic and Aesthetic Surgeon, Kauvery Hospital, Alwarpet, Chennai

Definition

Burn is a coagulative necrosis of the tissues

Aetiology

  • Scald: is a type of superficial burn caused by hot liquids
  • Flame burns: Tissues come in direct contact with fire
  • Flash burns: Explosion causing burn to exposed areas of body • Contact burns – Contact with hot objects
  • Electrical burns: Passage of electricity through tissues
  • Chemical burns: Acids and Alkali

Magnitude of the Problem

Burn Injury is potentially a big Public Health Problem. More people die due to burn injury than Malaria and Tuberculosis. Burn injuries are on the rise in our country and are the second largest group of injuries after road accident.

On an average 7 million people receive burn injuries every year, out of which 7 lakh need hospital admission  1.5 lakhs die and 2.5 lakhs left crippled due to severity of burns. 4 out of 5 burnt are women and children in their most productive age group of 15-35 years. 80% of cases admitted are as a result of accident at home

Burn injury is mostly unrecognized in our country

Treatment facilities specific for burn injury are not available in most parts of India. Most of the burn victims belong to vulnerable group of the society.The misery of burn patients is further aggravated as the treatment requires prolonged hospitalization and multiple corrective plastic surgeries, leading to economic hardship.

A large number of burn injury patients require psychological counselling as well as physiotherapeutic rehabilitation for many years.

Death and disability due to burn injury is preventable to a great extent provided timely and appropriate treatment is given by trained personnel. The management of burns is a distinct branch of medical super specialty.

Data on Burn care centers

There are total 67 centers in the country providing burn care, of which 30 are Government and 37 are in the private sector .

Total number of 1339 beds are available for burns patients in our country but out of these there are only 297 ICU beds for burn care. Sadly there are only 8 Skin banks available in our country. So it is obvious that there is a wide gap between the number of patients sustaining burns every year (7 million) and requiring treatment (7 lakhs) and versus number of beds available for treatment (1339).

This proves that we still have a long way to go if we have to provide total burn care to all the victims of burns in our country. We also need more plastic surgeons to take interest in Burns and take the initiative of opening more state of the art burn units in the private sectors.

Types of care areas

  • Burn Facilities provide acute care for people with less complex burns. These services form part of a plastic surgery service. Burn Facilities refer patients to Burn Units and Centres for the treatment of more complex injuries.
  • Burn Units provide care for patients with a burn of moderate size and/or moderate severity. These services treat patients across a wider area than Burn Facilities and provide treatment for patients requiring critical care (such as care in a high dependency unit).
  • Burn Centres provide care for patients with the most severe injuries and for those requiring the highest level of critical care

Team Effort – Burn Unit

  • Plastic or Burn Surgeon
  • Intensivists / Physicians
  • Infectious diseases specialist
  • Anaesthesiologist
  • Wound care nurses
  • Nutritionists
  • Rehabilitation specialist
  • Psychologist
  • Social workers.

Dr Sathish Manivel

Dr. Sathish Manivel
Consultant Plastic and Aesthetic Surgeon

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