Background & Scope

Burn medicine and surgery is a specialized field that focuses on the diagnosis, treatment, and management of burn injuries. The scope of burn medicine and surgery includes the assessment, resuscitation, and acute management of burn patients, as well as the management and repair of chronic burn-related conditions such as scarring, contractures, as well as the psychological sequelae.

Burns are a common and often devastating type of injury that can result from thermal, chemical, electrical, or radiant sources of energy. They range in severity from minor to life-threatening, and can affect the skin, underlying tissues, and organs. The severity of a burn is determined by its depth, size, location, and the presence of other injuries.

The initial management of burn injuries involves several key steps, including: assessment of the patient's airway, breathing, and circulation; management of pain and shock; and removal of the patient from the source of the burn. In cases of severe burns, the patient may require resuscitation with fluids and electrolytes, oxygen therapy, and medications to support blood pressure and organ function.

The acute management of burn injuries also involves wound care and management of infection, as burn wounds are at high risk for infection due to the destruction of the skin's protective barrier. This may involve debridement (removal of dead tissue) and wound dressings to promote healing and prevent infection.

Once the acute phase of burn injury has been managed, the focus shifts to rehabilitation and reconstruction. This may involve surgeries to repair and reconstruct damaged tissues, as well as physical therapy and occupational therapy to help the patient regain function and mobility.

Burns can also result in long-term consequences such as scarring, contractures (limited movement of joints due to scarring), and psychological sequelae such as post-traumatic stress disorder (PTSD). Burn medicine and surgery specialists work with patients to address these ongoing issues and help them achieve the best possible quality of life.

Qualifications, Training, and Certifications

The most common pathways for a burn physicians are plastic surgery, surgical critical care, and critical care. The required qualifications for burn medicine and surgery vary depending on the pathway taken but indicia of qualifications include having completed a fellowship in burn surgery or being in charge of a burn unit.

In addition to meeting certain qualifications and completing specialized training, medical professionals may choose to pursue additional certifications in burn medicine and surgery in order to demonstrate their expertise in this field.

Conditions, Diseases, Treatments, and Procedures

Burn medicine and surgery is a specialized field of healthcare that focuses on the diagnosis, treatment, and management of burn injuries and related conditions. Burn doctors, also known as burn surgeons or burn specialists, are medical professionals who are trained to diagnose and treat burns, as well as manage the acute and chronic consequences of burn injuries.

Diagnoses

Burn doctors use a variety of diagnostic methods to assess burn injuries, including physical examination, imaging tests (such as X-rays, CT scans, and MRIs), and laboratory tests (such as blood tests and wound cultures). They also consider factors such as the depth, size, location, and number of burns, as well as the presence of other injuries or underlying medical conditions.

Treatments

The treatment of burn injuries varies depending on the severity of the burn, as well as the patient's age, overall health, and other factors. Burn doctors use a range of medical and surgical interventions to manage burn injuries, including

• Wound care: This may involve cleaning and debriding the burn wound (removing dead tissue), applying dressings to promote healing and prevent infection, and using medications to manage pain and prevent scarring.

• Resuscitation: In cases of severe burns, the patient may require resuscitation with fluids and electrolytes, oxygen therapy, and medications to support blood pressure and organ function.

• Reconstructive surgery: This may involve surgeries to repair and reconstruct damaged tissues, such as skin grafts or flap surgery.

• Physical therapy and occupational therapy: These therapies may be used to help the patient regain function and mobility after a burn injury.

Diseases, Conditions, and Injuries

Burn medicine and surgery specialists diagnose and treat a variety of diseases, conditions, and injuries related to burn injuries, including:

• Thermal burns: These are the most common type of burn and result from contact with heat sources such as flames, hot liquids, or hot surfaces.

• Chemical burns: These result from contact with corrosive chemicals, such as acids or bases.

• Electrical burns: These result from contact with electrical currents or lightning.

• Radiative burns: These result from exposure to radiant energy sources, such as the sun or radiation therapy.

• Scarring: Burns can result in scarring, which can cause functional limitations and aesthetic concerns. Burn doctors use a range of treatments to minimize scarring and improve the appearance of scars.

• Contractures: These are limited movements of joints due to scarring, which can cause functional limitations. Burn doctors use a range of treatments, including surgery and physical therapy, to improve joint mobility and function.

• Psychological sequelae: Burn injuries can also have psychological consequences, such as post-traumatic stress disorder (PTSD), depression, and anxiety. Burn doctors may refer patients to mental health professionals for treatment of these conditions.

Procedures Performed

Burn doctors perform a range of medical and surgical procedures in the management of burn injuries and related conditions, including

• Wound care: This may involve cleaning and debriding the burn wound, applying dressings, and administering medications to manage pain and prevent scarring.

• Resuscitation: In cases of severe burns, burn doctors may perform procedures to support blood pressure and organ function, such as intubation (insertion of a breathing tube) and placement of intravenous lines.

• Reconstructive surgery: This may involve procedures such as skin grafts (using skin from another part of the body to cover the burn wound) or flap surgery (using tissue from one part of the body to cover the burn wound) or using artificial products to heal or replaced damaged skin and other tissue.

Related Medical Specialties

Burn patients often require pain management and other supportive care during their treatment.

Anesthesiology

Anesthesiologists work with surgeons in the operating room and are critically important in managing the acutely burned patient as they can be some of the most challenging to safely anesthetize.

Pain Medicine

Pain medicine specialists work closely with burn doctors to manage the pain and other supportive care needs of burn patients.

Critical Care Medicine

Severe burn injuries can result in life-threatening complications, such as sepsis (a severe infection) and organ failure. Critical care medicine specialists, who are medical doctors trained in the management of critically ill patients, work closely with burn doctors to provide specialized care for burn patients with severe injuries.

Physical Medicine and Rehabilitation

Physical medicine and rehabilitation specialists, also known as physiatrists, are medical doctors who specialize in the management of physical impairments and disabilities. They may work closely with burn doctors to help burn patients regain function and mobility through physical therapy and other rehabilitation modalities.

Psychiatry and Psychology

Burn injuries can have psychological consequences, such as post-traumatic stress disorder (PTSD), depression, and anxiety. Psychiatrists, who are medical doctors specializing in the treatment of mental health conditions, and psychologists, who are trained in the evaluation and treatment of mental health conditions, may work closely with burn doctors to address the psychological needs of burn patients.

Medical-Legal Cases Involving Burn Medicine & Surgery

Medical-legal cases involving burn medicine and surgery can arise in a variety of contexts, including medical malpractice, personal injury, and product liability. These cases may involve allegations of negligence or wrongdoing on the part of medical professionals, such as burn doctors, or other parties, such as manufacturers of defective products. Regardless of the kind of case, below, the burn specialist is typically needed to explain how a burn occurred, what the patient endured, and the prognosis.

Medical Malpractice

Medical malpractice cases involving burn medicine and surgery may arise when a patient alleges that a burn doctor failed to provide appropriate care.

Examples of medical malpractice in burn medicine and surgery may include failure to properly diagnose and treat a burn injury, failure to provide appropriate wound care, or failure to properly manage complications such as infection or scarring.

Personal Injury

Personal injury cases involving burn medicine and surgery are more common. The may arise when a person suffers a burn injury due to the negligence or wrongdoing of another party. For example, a person may bring a personal injury claim against a property owner if they suffer a burn injury due to a defective heating system, or against a manufacturer if they suffer a burn injury due to a defective product.

Child Abuse

Burn specialists are often needed to explain the etiology of burns in child abuse and/or criminal proceedings.

Product Liability

Product liability cases involving burn medicine and surgery may arise when a person suffers a burn injury due to a defect in a product.