Surgical burn care in sub-Saharan Africa: A systematic review

  • Botman M
  • Beijneveld J
  • Negenborn V
  • et al.
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Abstract

Burn injuries are still one of the most common and devastating global health problems worldwide. The vast majority of burns occur in low- and middle-income countries, particularly in sub-Saharan Africa (SSA). A certain standard of surgical and anesthesia care is essential to minimize morbidity and mortality. The aim of this study is to obtain baseline information on surgical burn care in SSA and to determine how this can be improved. A systematic review (PRISMA) was conducted. Data were extracted regarding patient characteristics, surgical care, dressing techniques and outcome. Forty-seven articles from 12 different countries were included. The mean TBSA was 18.2%. Overall mortality was 12.6%. Of the included patients, 47% underwent an operation. Seventeen studies (36% of included studies) reported on the number of patients with deep burn wounds in their population. In this group, 90% was grafted (reported in 17 studies), 25% was done early (<10 days), and 75% late. In this group, the escharotomy rate was 11% (only shown in 3 studies), the amputation rate was 3% (in 6 studies), and development of contractures 8% (reported in 6 studies). Research on surgical burn care in SSA is scarce and a wide range of surgical treatment strategies was found. We were unable to conclude which treatment protocol, early or delayed excision, was most effective. Future studies should ensure uniform data collection to enable comparison between treatment strategies. To improve burn care, the recently published ISBI guidelines for burns provide a practical tool and national and regional treatment protocols, including training in burn surgery, should be developed. We recommend a new review of surgical care in 5 years to evaluate the effects of the ISBI guidelines.

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Botman, M., Beijneveld, J. A., Negenborn, V. L., Hendriks, T. C. C., Schoonmade, L. J., Mackie, D. P., & van Zuijlen, P. P. M. (2019). Surgical burn care in sub-Saharan Africa: A systematic review. Burns Open, 3(4), 129–134. https://doi.org/10.1016/j.burnso.2019.07.001

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