What research needs to be prioritised in global burns – results from a project spanning 88 countries

Each year, more than 11 million people worldwide suffer serious life-changing burns, affecting both adults and children.  The largest-ever project of its kind — the Priorities in Global Burns Research partnership, led by the University of Bristol — has identified the top 10 priorities in burns care research from 88 countries. The findings are published today [23 April] in The Lancet Global Health.  

Burn survivors often experience lifelong disabilities, post-traumatic stress disorder, depression, anxiety, and pain. This new project, funded by the National Institute of Health and Care Research (NIHR) and facilitated by the James Lind Alliance, aimed to identify knowledge gaps in burns care that are most important to survivors, carers and healthcare professionals in order to guide future research and treatment improvements worldwide.  

Researchers from Bristol Medical School surveyed over 1,600 people, spanning 6 continents, on their experiences of burns care and treatment. Participants in the study, comprising survivors, their families, carers and healthcare professionals, were asked to complete a survey and take part in workshops to agree the top 10 most important unanswered research questions in global burns care. 

The project revealed some differences between high- and low-income countries, particularly in the areas of stigma, cost-effective treatments, and long-term care. However, the survey found psychological effects were one of the most challenging aspects for all burns survivors, regardless of where they lived.  

Ian Easton, a singer-songwriter-guitarist from Hampshire, explained the “exponential amount of shock and trauma” he endured following his injury, sustained while repairing his guitars in his garage when his wall mounted electric heater exploded. The accident left him with third-degree burns, a collapsed lung and damaged vocal cords.  

Due to the extensive inhalation burns and the burns to his hands, Ian was concerned that he would never play guitar again. He also knew his singing voice was changed forever. Ian benefited from three years of treatment with an NHS clinical Psychologist. 

 Ian said:

“Having these burns means that I get a lot of looks and comments from people who don’t know me, which I have become used to over time.

“Ongoing breathing issues mean I have procedures booked to try to fix this, but I may be left with breathing and voice problems for the rest of my life. The adjustment is difficult; mentally, physically, emotionally and socially. But it has taught me how strong we can be in the most adverse situations, and that there is happiness and satisfaction in the peaceful, quiet life. I believe the whole experience has made me more humble, and I am glad of that. Taking part in this project was really important to me – to ensure as a burns survivor – our voices are heard.” 

The project is part of the late Professor Amber Young’s NIHR Advanced Fellowship. Professor Young,  was based at the Bristol Centre for Surgical Research, and NIHR Bristol Biomedical Research Centre (NIHR Bristol BRC) and was a Consultant Paediatric Anaesthetist at University Hospitals Bristol and Weston NHS Foundation Trust (UHBW), who dedicated her work to improving burns care for patients all over the world. Amber very sadly passed away in September 2022, after living with Stage 4 cancer for a number of years. 

Jane Blazeby, Amber’s friend, colleague and Professor of Surgery at Bristol Medical School: Population Health Sciences (PHS), who has continued the project, said:

“This project is very much Amber’s legacy, which has created a lasting impact of offering hope to improve treatment for burn patients and improved quality of life for burns survivors – a testament to Amber’s determination, kindness and tenacity.”  

Hollie Richards, a Senior Research Associate at NIHR Bristol BRC, who worked with Amber for a number of years and co-ordinated the Priorities in Global Burbs Research partnership, added: 

“It’s been a privilege to collaborate with this community of burns clinicians and survivors, and I’m honoured to have completed this work for Amber. The top ten priorities represent the experiences and views of hundreds of people all over the world, and demonstrate the extent to which research needs to address the disparities, inequities and gaps in care to improve outcomes for burn survivors.” 

Suzannah Kinsella at the James Lind Alliance, added:

“Despite the severity of burns, high-quality research in burn care is lacking, leading to disparities in treatment and care standards. The next step is for researchers and clinicians to translate these priorities into actionable studies to enhance global burn care.” 

The Priorities in Global Burns Research Partnership is a collaboration between the University of Bristol and James Lind Alliance, and funded by the National Institute for Health and Care Research (NIHR).  

For more information about the project, please visit: www.burnsresearch.bristol.ac.uk/