Contempo Updates
August 13, 2003

Burn CareResults of Technical and Organizational Progress

Author Affiliations

Author Affiliations: Burn Surgery Service, Shriners Hospital for Children, Department of Surgery, Division of Burns and Trauma, Massachusetts General Hospital, Department of Surgery, Harvard Medical School, Boston.


Contempo Updates Section Editor: Sarah Pressman Lovinger, MD, Fishbein Fellow.

JAMA. 2003;290(6):719-722. doi:10.1001/jama.290.6.719

"The patients in the wards presented the usual clinical picture of large exposed burn wounds covered by broken-down eschars, with infected granulating areas on anemic, exhausted and frightened individuals."—Zora Janzekovic reflecting on burn care, 19701

Burn care has improved markedly in the decades that have passed since the sad description quoted above. Of the 1.25 million individuals who are treated for burns in the United States each year, about 51 000 require hospital admission.2 High-risk groups include infants and young children, elderly persons, and young people in industrial occupations. Care of serious burns progresses through 4 phases, which often overlap in time: (1) initial evaluation and resuscitation; (2) initial excision and biological closure; (3) definitive wound closure; and (4) rehabilitation, reconstruction, and reintegration (Table 1).

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