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Management principles for burns resulting from mass disasters and war casualties

Steven E Wolf, MD
Section Editor
Marc G Jeschke, MD, PhD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS


The magnitude and impact of burns associated with wars, bombings, and mass disasters can be devastating as they can affect large numbers of individuals simultaneously [1-10]. In contrast, civilian fires and the resultant burns are generally due to structure and vehicular fires, impacting small numbers of individuals.

The management principles of war casualties and mass disasters are discussed here. The global epidemiology of burns is reviewed elsewhere. (See "Epidemiology of burn injuries globally".)


Severe burns occur in approximately 5 to 20 percent of survivors of conventional casualties of war and casualties from civilian mass disasters or terrorist events [11-17]. Burns are more common during wars at sea and during wars that involve armored vehicles; 80 percent of burns in survivors involve less than 20 percent total body surface area (TBSA) [17]. Most civilian disasters produce fewer than 25 to 50 patients receiving inpatient burn care [3]. The vast majority of severe burn patients die at the scene or within the first 24 hours following the burn [1,3,5].

The following contemporary civilian mass disasters and wars illustrate the frequency of burns in survivors:

There were 39 survivors with severe burns undergoing hospital admission following the World Trade Center bombing in New York City on September 11, 2001 [5-7,18,19]. The burn patients comprised 19 percent of all hospitalized patients and 4 percent of all patients (survivors and rescue workers) treated during the initial 48 hours following the attack [20].

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Literature review current through: Nov 2017. | This topic last updated: Jan 21, 2016.
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