Shailvi Gupta1, Evan G Wong2, Umbareen Mahmood3, Anthony G Charles4, Benedict C Nwomeh5, Adam L Kushner6. 1. Department of Surgery, University of California, San Francisco East Bay, Oakland, CA, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Surgeons OverSeas (SOS), New York, NY, USA. Electronic address: shagupta@jhsph.edu. 2. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Surgeons OverSeas (SOS), New York, NY, USA; Centre for Global Surgery, McGill University Health Centre, Montreal, QC, Canada. Electronic address: evwong@jhsph.edu. 3. Department of Surgery, Division of Plastic Surgery, University of South Florida, Tampa, FL, USA. Electronic address: umbarm@gmail.com. 4. Department of Surgery, University of North Carolina, Chapel Hill, NC, USA. Electronic address: anthchar@med.unc.edu. 5. Surgeons OverSeas (SOS), New York, NY, USA; Department of Pediatric Surgery, Nationwide's Children Hospital, Columbus, OH, USA. Electronic address: benedict.nwomeh@nationwidechildrens.org. 6. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Surgeons OverSeas (SOS), New York, NY, USA; Department of Surgery, Columbia University, New York, NY, USA. Electronic address: adamkushner@yahoo.com.
Abstract
IMPORTANCE: More than 90% of thermal injury-related deaths occur in low-resource settings. While baseline assessment of burn management capabilities is necessary to guide capacity building strategies, limited data exist from low and middle-income countries (LMICs). OBJECTIVE: The objective of our review is to assess burn management capacity in LMICs. EVIDENCE REVIEW: A PubMed literature review was performed based on studies assessing baseline surgical capacity in individual LMICs. Seven criteria were used to assess burn management capabilities: presence of surgeon, presence of anesthesiologist, basic resuscitation capabilities, acute burn management, management of burn complications, endotracheal intubation and skin grafts. FINDINGS: Fourteen studies were reviewed using data from 458 hospitals in fourteen countries. Of these, 82.3% (284/345) of hospitals had the capacity to provide basic resuscitation and 84.9% (275/324) were capable of providing acute burn management. Endotracheal intubation was only available at 38.3% (51/133) of hospitals. Moreover, only 35.6% (111/312) and 37.9% (120/317) of hospitals were able to provide skin grafts and treat burn complications, respectively. CONCLUSION: Many hospitals in LMICs are capable of initial burn management and basic resuscitation. However, deficiencies still exist in the capacity to systematically provide advanced burn care. Efforts should be made to better document resources in order to guide burn management resource allocation.
IMPORTANCE: More than 90% of thermal injury-related deaths occur in low-resource settings. While baseline assessment of burn management capabilities is necessary to guide capacity building strategies, limited data exist from low and middle-income countries (LMICs). OBJECTIVE: The objective of our review is to assess burn management capacity in LMICs. EVIDENCE REVIEW: A PubMed literature review was performed based on studies assessing baseline surgical capacity in individual LMICs. Seven criteria were used to assess burn management capabilities: presence of surgeon, presence of anesthesiologist, basic resuscitation capabilities, acute burn management, management of burn complications, endotracheal intubation and skin grafts. FINDINGS: Fourteen studies were reviewed using data from 458 hospitals in fourteen countries. Of these, 82.3% (284/345) of hospitals had the capacity to provide basic resuscitation and 84.9% (275/324) were capable of providing acute burn management. Endotracheal intubation was only available at 38.3% (51/133) of hospitals. Moreover, only 35.6% (111/312) and 37.9% (120/317) of hospitals were able to provide skin grafts and treat burn complications, respectively. CONCLUSION: Many hospitals in LMICs are capable of initial burn management and basic resuscitation. However, deficiencies still exist in the capacity to systematically provide advanced burn care. Efforts should be made to better document resources in order to guide burn management resource allocation.
Authors: Barclay T Stewart; Robert Quansah; Adam Gyedu; James Ankomah; Peter Donkor; Charles Mock Journal: World J Surg Date: 2015-10 Impact factor: 3.352
Authors: James Ankomah; Barclay T Stewart; Victor Oppong-Nketia; Adofo Koranteng; Adam Gyedu; Robert Quansah; Peter Donkor; Francis Abantanga; Charles Mock Journal: J Pediatr Surg Date: 2015-03-26 Impact factor: 2.545
Authors: Janos Cambiaso-Daniel; Victoria G Rontoyanni; Guillermo Foncerrada; Anthony Nguyen; Karel D Capek; Paul Wurzer; Jong O Lee; Gabriel Hundeshagen; Charles D Voigt; Ludwik K Branski; Celeste C Finnerty; David N Herndon Journal: Burns Date: 2018-08-25 Impact factor: 2.744
Authors: Barclay T Stewart; Adam Gyedu; Pius Agbenorku; Richcane Amankwa; Adam L Kushner; Nicole Gibran Journal: Int J Surg Date: 2015-08-07 Impact factor: 6.071
Authors: Barclay T Stewart; Riyadh Lafta; Sahar A Esa Al Shatari; Megan Cherewick; Gilbert Burnham; Amy Hagopian; Lindsay P Galway; Adam L Kushner Journal: Burns Date: 2015-10-31 Impact factor: 2.744