Burn injuries range from the most minor, dealt with in the community, to the most severe and devastating. They are highly variable and individual injuries affecting all ages and social groups. In general terms the definition is based on the size and anatomical site of the injury, the depth of skin injury, and the presence of co-existing conditions.
The care for such patients may be provided on an in-patient or outpatient basis depending on progression and recovery. Individuals may require input from a range of services including surgical, nursing and physical therapy. In some cases the major need is for specialist psychological or social worker involvement. With a complex injury the whole burn care team are involved throughout the acute care period with continuing care and rehabilitation, plus reintegration of the individual into society. This post-acute period may continue with the same team for some years, especially for children, and involve multiple outpatient interventions and several admissions to hospital for reconstructive surgery.
The National Burn Care Review Committee (a sub-committee of the British Burn Association considered the provision of burn care services in the UK from September 1998 to March 2001. The resultant publication, Standards and Strategy for Burn Care recommends standards for service organisation, stratification of burn care and a process for implementing the recommendations plus burn injury referral guidelines. The guidelines are clinically based and do not readily translate into any existing coding system. The full Report can be found on the British Association of Plastic Surgeons' website
There is no clear way within current NHS information systems to identify injuries requiring the highest level of specialised care. This definition of specialised burn care is based on the above burn injury referral guidelines, and includes the whole process of care from injury to final discharge.