• Pompermaier Laura, Adorno José, Allorto Nikki, Altarrah Khaled, Juan Barret, Carter Jeffery, Chamania Shobha, Chong Si Jack, Corlew Scott, Depetris Nadia, Elmasry Moustafa, Junlin Liao, Haik Josef, Horwath Briana, Keswani Sunil, Kiyozumi Tetsuro, Leon-Villapalos Jorge, Luo Gaoxing, Matsumura Hajime, Miranda-Altamirano Ariel, Moiemen Naiem, Nakarmi Kiran, Ahmed Nawar, Ntirenganya Faustin, Olekwu Anthony, Potokar Tom, Qiao Liang, Rai Shankar Man, Steinvall Ingrid, Tanveer Ahmed, Philipe Luiz Vana Molina, Wall Shelley, and Fisher Mark.
• Department of Hand Surgery, Plastic Surgery and Burns, Linköping University, Linköping, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Global Health and Social Medicine Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA. Electronic address: laura.pompermaier@liu.se.
• Burns. 2022 Sep 1; 48 (6): 130113101301-1310.

BackgroundWorldwide, different strategies have been chosen to face the COVID-19-patient surge, often affecting access to health care for other patients. This observational study aimed to investigate whether the standard of burn care changed globally during the pandemic, and whether country´s income, geographical location, COVID-19-transmission pattern, and levels of specialization of the burn units affected reallocation of resources and access to burn care.MethodsThe Burn Care Survey is a questionnaire developed to collect information on the capacity to provide burn care by burn units around the world, before and during the pandemic. The survey was distributed between September and October 2020. McNemar`s test analyzed differences between services provided before and during the pandemic, χ2 or Fisher's exact test differences between groups. Multivariable logistic regression analyzed the independent effect of different factors on keeping the burn units open during the pandemic.ResultsThe survey was completed by 234 burn units in 43 countries. During the pandemic, presence of burn surgeons did not change (p = 0.06), while that of anesthetists and dedicated nursing staff was reduced (<0.01), and so did the capacity to manage patients in all age groups (p = 0.04). Use of telemedicine was implemented (p < 0.01), collaboration between burn centers was not. Burn units in LMICs and LICs were more likely to be closed, after adjustment for other factors.ConclusionsDuring the pandemic, most burn units were open, although availability of standard resources diminished worldwide. The use of telemedicine increased, suggesting the implementation of new strategies to manage burns. Low income was independently associated with reduced access to burn care.Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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