Research

The vision for the Interburns is to ‘develop the burns teams of the future’. The importance of interdisciplinary work in all fields of health is becoming increasingly recognised, not just within medical and allied professionals, but also across other sectors such as education, human rights, industry etc.

This is especially so for burn injuries which on a global basis are directly linked to poverty, poor socioeconomic environments, poor or non existent health and safety measures and ignorance or ignoring of human rights, especially for children. In order to develop appropriate burn teams for the future therefore we should expand our concept of what we consider to be the burns team as a medical model, into a more inclusive biopsychosocial model. Without commitment from politicians, education of the general public, legal reforms etc the burns team will be facing insurmountable odds. A superb example of this approach is the Acid Survivors Trust of Bangladesh which could be considered as a biopsychosocial burns team and over the course of the last few years has not only provided excellent services for the treatment of acid assault victims (medical, psychological and social), but also addressed the underlying causes and managed to reduce the incidence of these injuries by 40%. This multifaceted approach which addresses the clinical problem as well as its underlying causes is surely the type of ‘burns team of the future’ which we should be promoting.

In the same time the organization of the burn services varies between developing countries and developed countries. With a widely dispersed population and an infrastructure not ideal for transfer of patients over long distances, it is important to work towards decentralisation of services rather than centralisation which is more appropriate in countries such as the UK where the incidence of burns is much lower and the transport system and hospital transfer are easier.

Some centres are necessary for managing the more severe cases and for acting as a hub for training, education and research and to provide the leadership and commitment to developing services. The onus though must be on disseminating training throughout the country, particularly with reference to the management of minor and moderate burns locally and stabilisation of major burns for transfer.

This is not an overnight solution and will take time and resources, but is the most equitable way of distributing burn care. On the contrary if services are centralised they will remain accessible to a minority of the population and will always be over capacity tending towards continual crisis management.