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. 2023 Nov 18;15(11):e49012. doi: 10.7759/cureus.49012

Table 2. Management and outcomes of the included studies.

Author(s) Management Outcome
Rawlins et al., 2007 [6]   Initial Emergency Department (ED) Response: Based on burn severity, patients were either discharged with follow-up, admitted to local plastic surgery, or transferred to a regional burn center. Documentation: All patients had a burn registry form completed in the ED. Dressing: Most burns were treated with liquid paraffin dressings (Jelonet). Referrals: Minor burns were sent to GPs; larger burns were managed in the ED clinic or referred to plastic surgery. Guidelines: The British Burn Association (BBA) guidelines determined referrals, considering burn size, location, and type. Follow-up: Missed appointments led to outreach through letters or home visits by nurses for care and education.   Demographics: 208 children attended the ED, mostly infants and young children. Burn Types: 51% scalds, 36% contact burns. Pre-ED Care: One-third lacked first aid; 87% received no analgesia. Post-ED Directives: 5% discharged with no follow-up. 23% referred to general practitioners. 58% to ED clinic for review. 4% to plastic surgery dressing clinic. 7% admitted to plastic surgery. 3% transferred to a burn center. Surgical Care: 3% needed burn excision and skin grafting. Mortality: No deaths reported.
Ewings et al., 2008 [9]   Many minor injuries, however, are treated in EDs or outpatient settings. The study was a retrospective review conducted over a 5-year period in an urban children's hospital ED to evaluate the management of pediatric upper extremity burns. The aim was to determine the effectiveness of treatments and interventions, especially given the large number of burn patients managed by primary care providers. 75% of the burns were second-degree, 21% first-degree, and 2% third-degree. 15% (40 patients) had a consultation with plastic surgery, and 3% (7 patients) required skin grafting.  
Tourtier et al., 2010 [10]   The focus was also on pain management, with 65% of EDs having a written protocol for managing pain in children. For analgesia, 80% of EDs used oxygen/nitrous oxide. Concerning second-step analgesics, 67% used a combination of paracetamol/codeine, while only 22% used non-steroidal anti-inflammatory drugs (NSAIDs). For third-step analgesics, 67% of EDs used nalbuphine, while only 43% used morphine.   These EDs treated a total of 3,258 children with burns, representing 0.63% of pediatric pathologies in EDs.
Saritas et al., 2013 [13]   The patients were managed in accordance with the guidelines of the American Burn Association (1990). The study is retrospective and covers medical records of children (aged 18 years and below) with acute burn injuries admitted to the hospital from January 1, 2001, to December 31, 2008. They were categorized based on various factors like age, cause of the burn, anatomical areas affected, and depth of the burn, among others. The outcomes were classified as either survivor or died. A total of 2269 children with acute burn injuries were admitted. Out of these, 86 children (3.8%) died due to burn injuries. Deaths were seen 1.849 times more in males than in females. In terms of TBSA (Total Body Surface Area) burned, mortality occurred 121.116 times more in the >41% TBSA burned group. Most deaths (n = 77) were among patients referred to the hospital. The mortality rate was higher in rural areas (6.3%) compared to urban areas (2.8%). Deaths were most frequent in patients with scalding burns, but the mortality ratio was higher for tandir burns. Most of the deaths occurred within the first 10 days of hospitalization.
Glatstein et al., 2013 [14]   28 patients were treated conservatively with dressings and minor surgical interventions like debridement and primary repair. The remaining patients required more extensive treatments like excision and/or grafting. No patient needed amputation. 2 patients underwent fasciotomy and/or escharotomy.   13% of patients with electrical current burns required hospital admission. 60% of patients with lightning-associated burns needed hospitalization. Two patients required prolonged hospital stays after sustaining burns from household electrical incidents. One of these patients, a 7-year-old boy, had burns from electric transmission lines in an industrial area, resulting in third-degree burns to the shoulder, upper limb, trunk, hip, and lower limb, covering approximately 25% of his body surface area.  
Al-Hoqail et al., 2011 [18]   Not operated: 168 cases (71.8%) Selection: 71.8% of patients weren't operated due to reasons like minor burns (78.5%), patient refusal (1.8%), transfers (1.8%), or high anesthetic risk (0.6%). Wound Care: Clean and dress burns regularly. Pain Management: Administer pain relief as needed. Monitoring: Check for healing progress and signs of infection. Rehabilitation: Physical therapy for affected areas if necessary. Education: Advice on home care and potential complications.   Operated: 66 cases (28.2%) Most common first operation: Split-thickness skin grafting surgical interventions can range from debridement to skin grafting. The urgency of operations was categorized as: Elective (60.6%): These operations are scheduled in advance and aren't emergencies; Emergency (39.4%): Immediate surgical intervention is required.     Burns that were surgically excised and grafted between 12 and 18 days recovered more quickly than those managed conservatively until the eschar had sloughed off, followed by grafting. Burns managed by excision and grafting in less than 5 weeks post-injury healed 8.6 days faster than those grafted later. For more severe burns, those grafted within 5 weeks healed 13 days faster than the delayed group.  
McCormack et al., 2003 [21]   Immediate Cooling: Run cold tap water directly onto the burn for a minimum of 20 minutes. Be cautious to prevent hypothermia. Maintain Patient Warmth: Elevate the room's temperature to 25°C–30°C. Remove any wet clothing from the patient and cover unburnt areas with a blanket. Continuous Cooling During Transport: Use a fine mist spray or frequently changed soaked dressings to continue cooling the burn while transporting the patient. Avoid Ice: Never apply ice to a burn. Timeliness: Administering first aid within the first three hours post-burn is beneficial.   14 out of 14 (100%) had presented to their general practitioner (GP). 22 out of 31 (71%) had presented to their local hospital. 22 out of 38 (58%) had presented to CHW. 2 out of 2 (100%) had first contact with other health professionals.  
Yilmaz et al., 2015 [23]   Urine Output Monitoring: Patients had their urine output monitored. Electrocardiography (ECG): ECG findings were recorded for each patient. Serum Measurements: Serum values for alanine transaminase (ALT), aspartate transaminase (AST), creatine kinase (CK), and creatine kinase-myocardial isoenzyme (CK-MB) were recorded. Fluid Resuscitation: All patients underwent fluid resuscitation. Burn and Wound Care: Burn and wound dressings were applied to the patients. Tetanus Prophylaxis: Tetanus prophylaxis was provided as indicated.   Mortality: There were no reported deaths among the patients. Recovery: The specific recovery details or long-term outcomes for the patients were not provided in the paper