• T C C Hendriks, M Botman, J J Binnerts, G S Mtui, E Q Nuwass, A Meij-de Vries, H A H Winters, M K Nieuwenhuis, and van ZuijlenP P MPPMDepartment of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC (location VUmc), Amsterdam, The Netherlands; Global Surgery Amsterdam, The Netherlands; Burn Center, Red Cross Hospital, Beverwijk, The Netherlands; Pediatric Surgica.
• Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC (location VUmc), Amsterdam, The Netherlands; Global Surgery Amsterdam, The Netherlands; Department of Surgery, Haydom Lutheran Hospital, Haydom, Tanzania; Amsterdam Public Health Research Institute, The Netherlands; Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands. Electronic address: t.hendriks@globalsurgeryamsterdam.com.
• Burns. 2022 Dec 1; 48 (8): 196619791966-1979.

BackgroundOnly a few papers are published on the safety and effectiveness of acute burn care in low-income countries. A cohort study was therefore carried out to determine such outcomes.MethodsThe study was conducted in a rural Tanzanian hospital in 2017-2018. All patients admitted with burns were eligible. Complications were scored during admission as an indication for safety. Survivors of severe burn injuries were evaluated for time of reepithelialization, graft take, disability (WHODAS2.0) and quality of life (EQ5D-3L) up to 3 months post-injury, as an indication of effectiveness.ResultsPatients presented on average at 5 days after injury (SD 11, median 1, IQR 0-4). Three patients died at admission. The remaining 79 were included in the cohort. Their median age was 3 years (IQR 2-9, range 0.5-49), mean TBSA burned 12% (SD10%) and mortality rate 11.4%. No surgery-related mortality or life-threatening complications were observed. Skin grafting was performed on 29 patients at a delayed stage (median 23 days, IQR 15-47). Complications of skin grafts included partial (25% of procedures) and complete graft necrosis (8% of procedures). The mean time to reepithelialization was 52 (SD 42) days after admission. Disability and quality of life improved from admission to 3 months after injury (p<0.001, p<0.001, respectively).ConclusionIn this resource-limited setting patients presented after a delay and with multiple complications. The mortality during the first two weeks after admission was high. Surgery was found to be safe and effective. A significant improvement in disability and quality of life was observed.Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.

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