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https://t.me/med1917
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Acknowledgements
We are most grateful to all our contributors who have helped bring this
project to fruition.
OUP has been a truly professional publisher that has worked tirelessly to
get the book over the line. Special thanks must go to Nick Marsden in his
role as editorial assistant.
Finally, a personal word of thanks to all authors whose work we were,
unfortunately, unable to include in the nal manuscript.
https://t.me/med1917
xi
Contents
Contributors xiv
1 Incidence and epidemiology 1
2 Bur n prevention 9
3 Pathophysiological response to burns 19
4 Hypermetabolic response to burns 29
5 The burns management pathway I:assessing and
transferring patients with an acute burn injury 35
6 The burns management pathway II:receiving
and initially managing a patient with burns 43
7 Predicting mortality and end of life care 53
8 Burns rst aid 59
9 Assessment of burn surface area 67
10 Burn depth assessment 77
11 Fluid resuscitation in burns 89
12 Escharotomies 95
13 Critical care of burns patients 109
14 Anaesthesia:preoperative management of
patients with acute burns 117
15 Anaesthesia:intraoperative management of
patients with acute burn injury 125
16 Burns surgery 131
17 Burn wound dressings 145
18 Management ofburn wound infection 151
19 Chemical burns 163
20 Electrical injuries 171
CONTENTS
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xii
21 Radiation burns 177
22 Ocular burns 183
23 Hand burns 191
24 Perineal and genital burns 199
25 Skin substitutes 203
26 Occupational and physiotherapy 213
27 Outcome measures for burns 225
28 Burns scar management 231
29 Principles of burn reconstruction 235
30 Burn contracture surgery 241
31 Outpatient management of minor burns 285
32 Remote assessment of burns 293
33 Cost of burn care 299
34 Paediatric burns 303
35 Non-accidental injury (NAI) in children 311
36 Burns itch 315
37 Nutritional requirements in the burn patients 321
38 Tetanus 327
39 Desquamating skin disorders 331
40 Military burns 339
41 Sunburn and articial tanning 347
42 Frostbite 353
43 Hair restoration 367
44 Laser management of scars 375
45 Face transplantation 379
46 Pain management 383
47 Burn care drug formulary 391
CONTENTS
https://t.me/med1917
Appendix 1 Transfer proforma 417
Appendix 2 Burn care referral criteria 425
Appendix 3 Admission proforma 429
Appendix 4 Burn links 435
xiii
Index 439
xiv
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xiv
Contributors
Ammar Allouni
Plastic Surgery Trainee,
University Hospitals Birmingham
NHS Foundation Trust,
Birmingham, UK
Incidence and epidemiology,
Costof burn care
Francis Andrews
Consultant in Critical
CareandEmergency
Medicine, Whiston Hospital,
Merseyside, UK
Critical care of burns patients
Ali Arham
Research Fellow, Shriners
Hospital for Children, University
of Texas Medical, USA
Chemical burns, Outcome
measures
Ernest Azzopardi
Senior Clinical Lecturer Swansea
University Medical School, UK;
Superspecialist Fellow in Laser
Cutaneous Reconstruction,
Laserplast SrL, Milan.
Infections in burns
Sarah Bache
Specialist Registrar in
PlasticSurgery, St Andrew’s
Centre for Plastic Surgery
andBurns, Chelmsford,
Essex, UK
Burns surgery
Christopher Henry
Barbara
Clinical Chairman, Pathology
Department, Mater Dei
Hospital, Malta
Infections in burns
Greg Barton
Specialist Pharmacist Critical
Care and Burns, St Helens and
Knowsley Teaching Hospitals
NHS Trust; Chair of the United
Kingdom Clinical Pharmacy
Association Critical Care Group
(UKCPA CCG), UK
Burn formulary
Kamal Bisarya
Resident, Burns and Plastic &
Reconstructive Surgery, Imperial
College Hospitals, London, UK
Military burns
David Bodansky
Plastic Surgery Trainee, Mersey
Regional Centre for Burns
and Plastic Surgery, Whiston
Hospital, Liverpool, UK
Radiation Burns
Peter Brooks
Consultant Plastic Surgeon, UK
Burns itch
Tania Cubison
Lieutenant Colonel and
Consultant Burns and Plastic
Surgeon, Queen
Victoria Hospital, East
Grinstead, UK
Military burns
Dallan Dargan
Plastic Surgery Trainee, Mersey
Regional Centre for Burns
and Plastic Surgery, Whiston
Hospital, Liverpool, UK
Nagham Darhouse
Specialist Registrar in Plastic
Surgery, Chelsea and Westminster
Hospital, London, UK
Hair restoration
CONTRIBUTORS
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xv
Baljit Dheansa
Consultant Burns and Plastic
Surgeon, McIndoe Burns Centre,
Queen Victoria Hospital, UK
Outpatient management of burns,
Dietary requirements
William Dickson
Consultant Plastic Surgeon and
Director of the Welsh Centre
for Burns and Plastic Surgery,
Morriston Hospital, Swansea,
Wales, UK
Remote burn assessment
Peter Drew
Consultant Burn and Plastic
Surgeon, The Welsh Centre
for Burns and Plastic Surgery,
Morriston Hospital, Swansea, UK
Perineal burns
Peter George Dziewulski
Consultant Plastic Surgeon,
St Andrews Centre for Plastic
Surgery and Burns, Mid Essex
NHS Trust, UK
Assessment of burn depth, Burns
surgery
Shawn Fagan
Medical Director, Division of
Burns, Massachusetts General
Hospital, Boston, MA, USA
Hand burns
Celeste C. Finnerty
Associate Professor, Department
of Surgery, Sealy Center for
Molecular Medicine, University
of Texas, Texas, USA
Hypermetabolic response to burns,
Chemical burns, Electrical burns,
Outcome measures
Quentin Frew
Plastic Surgeon, St Andrew’s
Centre for Plastic Surgery and
Burns, Chelmsford, UK
Assessment of burn depth
Parneet Gill
Plastic Surgery Registrar, Countess
of Chester Hospital NHS
Foundation Trust, Chester, UK
Ocular burns
Nicole Glassey
Clinical Specialist
Physiotherapist,Burns and
PlasticSurgery, Nottingham
University Hospitals
NHS Foundation Trust,
Nottingham, UK
Occupational and physiotherapy
Jeremy Goverman
Division of Burns, Massachusetts
General Hospital; and
Assistant Professor of Surgery,
Harvard Medical School,
Boston, MA USA
Hand burns
Joseph Hardwicke
Associate Clinical Professor,
University of Warwick and
Consultant Plastic Surgeon,
University Hospitals of Coventry
and Warwickshire NHS Trust,
Coventry, UK
Burn wound dressings
Emily Hedges
Advanced Practitioner
Occupational Therapist,
Nottingham University Hospitals
NHS Foundation Trust,
Nottingham, UK
Occupational and physiotherapy
Sarah Hemington- Gorse
Consultant Burns and
Plastic Surgeon, The Welsh
Centre for Burns and Plastic
Surgery, Morriston Hospital,
Swansea, UK
Predicting mortality and end of
life care, Sunburn and articial
tanning
CONTRIBUTORS
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xvi
David N. Herndon
Jesse H.Jones Distinguished
Chair in Burn Surgery, Professor
of Surgery and Pediatrics;
Chief of Sta and Director of
Research,
Shriners Hospitals for Children,
Houston, TX, USA
Hypermetabolic response to burns,
Chemical burns, Electrical burns,
Outcome measures
Sandip Hindocha
Consultant Plastic Surgeon,
Clinical Director, Plastic
Surgery & Laser Centre.
Bedford Hospital NHS Trust
Desquamating skin disorders
Ranjeet Jeevan
Consultant Plastic Surgeon,
Manchester Centre for Plastic
Surgery and Burns,
Manchester University
NHS Foundation Trust,
Manchester,UK
Jong Lee
Associate Director of Burn
Services, University of Texas
Medical Branch, Houston,
TX, USA
Electrical burns, Paediatric burns
Jorge Leon-Villapalos
Consultant in Plastic Surgery and
Burns, Lead Clinician, Chelsea
and Westminster Hospital;
Senior Honorary Clinical
Lecturer, Imperial School of
Medicine
First aid
Karen J. Lindsay
Plastic Surgery Registrar,
Aberdeen Royal Inrmary,
Aberdeen, UK
Tetanus, Laser management of
scars
Nigel Tapiwa Mabvuure
Plastic Surgery Registrar, East of
England Deanery, Broomeld
hospital, Chelmsford, UK
Pathophysiology, Chemical burns,
Outcome measures, Outpatient
management of burns, Dietary
requirements
Nick Marsden
Specialist Registrar, the Welsh
Centre for Burns and Plastic
Surgery, Morriston Hospital,
Swansea, UK
Predicting mortality and end of
life care, Sunburn and articial
tanning
Walter J. Meyer III
Professor, Department of
Psychiatry and Behavioural Sciences,
University of Texas Medical Branch,
Galveston, TX, USA
Pain management
Anuj Mishra
Consultant Plastic Surgeon,
Manchester Centre for Plastic
Surgery and Burns,
Manchester University
NHS Foundation Trust,
Manchester,UK
Naiem Moiemen
Consultant Plastic Surgeon
and Director of the Healing
Foundation UK Burns Research
Centre, Birmingham, UK
Incidence and epidemiology, Burn
wound dressings, Cost of burn care
Adeyinka Molajo
Specialty Registrar in Plastic
Surgery, Department of Burns
and Plastic Surgery, St Helen’s and
Knowsley NHS Trust, Whiston
Hospital, Merseyside, UK
Non-accidental injury (NAI) in
children
CONTRIBUTORS
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xvii
Christopher F. Munson
Clinical Research Fellow,
Canniesburn Plastic Surgery
Unit, Glasgow Royal Inrmary,
Glasgow, UK
Pathophysiology, Infections in
burns, Dietary requirements
William B. Norbury
Reconstructive Burns Fellow,
Shriners Hospital for Children,
University of Texas Medical
Branch, USA
Escharotomy and fasciotomy
Michael Peck
Associate Director, Arizona
Burns Centre, Phoenix,
AZ, USA
Burn prevention
Jonathon Pleat
Consultant Burns and Plastic
Surgeon, North Bristol NHS
Trust, Bristol, UK
Pathophysiology
Bohdan Pomahac
Associate Professor of Surgery,
Harvard Medical School, Boston,
MA, USA
Face transplant
Sophie Pope- Jones
Specialist Registrar, The Welsh
Centre for Burns and Plastic
Surgery, Morriston Hospital,
Swansea, UK
Remote burn assessment
Tom S. Potokar
Chair in Global Burn Injury &
Director NIHR Global Health
Research Group on Burn
Trauma, University of Swansea,
UK; Honorary Consultant Plastic
Surgeon, Welsh Centre for
Burns & Plastic Surgery, UK
Principles of burn reconstruction
Rowan Pritchard- Jones
Consultant Plastic Surgeon,
St Helen’s & Knowsley
Teaching Hospitals NHS Trust,
Liverpool, UK
Assessment of burn surface area,
Fluid resuscitation, Remote burn
assessment
Rene Przkora
Associate Professor of
Anesthesiology and Pain Medicine
Department of Anesthesiology
College of Medicine, University
of Florida, Gainesville, FL, USA
Hypermetabolic response to burns,
Pain management
Alison Reeves
Senior Physiotherapist, Burns
and Plastic Surgery, Nottingham
University Hospitals NHS
Foundation Trust, Nottingham, UK
Occupational and physiotherapy
Norbert Schrage
Department of Ophthalmology,
County Hospital Cologne,
Cologne, Germany
Ocular burns
Chris Seaton
Research Manager, Virtual
Machine Group, Oracle Labs, UK
Fluid resuscitation
Kayvan Shokrollahi
Consultant Burns and Plastic
Surgeon, Mersey Burns
Centre, Whiston Hospital,
Merseyside, UK
Burns management pathway 1,
Burns management pathway2,
Assessment of burn surface
area, Fluid resuscitation, Skin
Substitutes, Non-accidental injury
(NAI) in children Desquamating
skin disorders, Frostbite, Laser
management of scars, Appendix1,
Appendix 2, Appendix 3
xviii
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CONTRIBUTORS
Indranil Sinha
Fellow in Burn Surgery, Division
of Plastic Surgery, Brigham and
Women’s Hospital, Harvard
Medical School, Boston,
MA, USA
Face transplant
Sujatha Tadiparth
Consultant Plastic and
Reconstructive Surgeon,
Queen Elizabeth Hospital,
Birmingham, UK
Skin Substitutes, Frostbite
Raj M. Vyas
Plastic Surgeon, Division of Plastic
Surgery, Brigham and Women’s
Hospital, Harvard Medical School,
Boston, MA, USA
Face transplant
James Warbrick- Smith
Registrar, The Welsh
Centre for Burns and Plastic
Surgery, Morriston Hospital,
Swansea, UK
Perineal burns, Principles of burn
reconstruction
Stuart B. Watson
Consultant Plastic
Surgeon,Canniesburn Unit,
Glasgow Royal Inrmary,
Glasgow, UK
Burn contracture release
Greg Williams
Hair Transplant Surgeon, Farjo
Hair Institute, London, UK
Hair restoration
Lee C. Woodson
Chief of Anaesthesiology,
Shriners Hospital for Children,
University of Texas Medical
Branch, Galveston, TX, USA
Anaesthesia: Preoperative
management of patients with
acute burns, Anaesthesia:
Intraoperative management of
patients with acute burn injury,
Pain management
William L. Yancey
Department of Anaesthesiology,
University of Texas Medical
Branch, Galveston, TX, USA
Pain management
Susie Yao
Plastic Surgery Registrar,
Specialist Registrar,
MerseyBurnsCentre, Whiston
Hospital, Merseyside, UK
Burns management pathway 1,
Burns management pathway 2,
Transfer proforma, Admission
proforma
Christina Yip
Canniesburn Plastic Surgery
Unit, Glasgow Royal Inrmary,
Glasgow, UK
Outpatient management of burns
https://t.me/med1917
Chapter1
1
Incidence and
epidemiology
Introduction to incidence and epidemiology 2
Risk groups 4
Non- accidental burns 6
Mass casualties 8
Further reading 8
References 8
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