Bridging the Evidence–Practice Gap in Early Burn Injury Care - A Comprehensive Evidence Synthesis of Global Guidelines, Consensus, and Systematic Reviews for Resource-Limited Settings

Sep 4, 2026

Background: Early management of adult burn injuries in resource-constrained environments—such as battlefields and primary care facilities—remains hindered by the absence of standardized, evidence-based protocols. This study aimed to systematically synthesize existing evidence and develop an integrated framework of actionable recommendations to optimize prehospital and early emergency care. Methods: A comprehensive evidence synthesis across 14 databases and authoritative repositories appraised source quality and extracted best-practice recommendations for thematic synthesis. Results: Fifty-nine high-quality studies produced 77 recommendations across 13 domains, forming a context-adaptive framework. Conclusions: The findings support frontline guidance and inform emergency care standards.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages22

Reading Time55 min

AccessFree to download

Highlights

What are the main findings?

What are the implications of the main findings?

Abstract

1. Introduction

Review Bridging the Evidence–Practice Gap in Early Burn Injury Care: A Comprehensive Evidence Synthesis of Global Guidelines, Consensus, and Systematic Reviews for Resource-Limited Settings Hongyu Tang 1, Shenjing Yu 1, Rui Zhang 2, Zheng Zhu 3, *,† and Li Gui 1, *,† Academic Editor: Naiem Moiemen Received: 13 April 2026 Revised: 25 May 2026 Accepted: 8 June 2026 Published: 10 June 2026 Copyright: © 2026 by the authors. Published by MDPI on behalf of the European Burns Association. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 School of Nursing, Naval Medical University, Shanghai 200433, China; [15211170016@fudan.edu.cn](15211170016@fudan.edu.cn) (H.T.); [emily19991027@163.com](emily19991027@163.com) (S.Y.) 2 Department of Military Health Management, Naval Medical University, Shanghai 200433, China; [zhangzz_2024@163.com](zhangzz_2024@163.com) 3 School of Nursing, Fudan University, Shanghai 200032, China * Correspondence: [zhengzhu@fudan.edu.cn](zhengzhu@fudan.edu.cn) (Z.Z.); [guili2026@126.com](guili2026@126.com) (L.G.)† These authors contributed equally to this work. Highlights What are the main findings? • 77 evidence-based recommendations across 13 domains establish an integrated burn emergency care framework. • Evidence reveals a protocol-resource disconnect, where underrepresented ABC and system-level enablers critically determine acute outcomes What are the implications of the main findings? • Early burn care is system-based, requiring adaptive scene control and resourcecalibrated interventions, not rigidity. • ABC saves lives, while suboptimal interventions sustain life until transfer, yet require greater resource capacity. Abstract Background: Early management of adult burn injuries in resource-constrained environments—such as battlefields and primary care facilities—remains hindered by the absence of standardized, evidence-based protocols. This study aimed to systematically synthesize existing evidence and develop an integrated framework of actionable recommendations to optimize prehospital and early emergency care. Methods: A comprehensive evidence synthesis was conducted across 14 international and domestic bibliographic databases and authoritative repositories. Eligible sources included clinical practice guidelines, expert consensus statements, evidence summaries, and systematic reviews. Literature quality was appraised using validated instruments, and best-practice recommendations were extracted and thematically synthesized across the continuum of early burn care. Results: Fifty-nine high-quality studies yielded 77 recommendations across 13 domains, spanning from scene safety and burn process cessation through airway, breathing, and circulatory management to wound care, infection control, and transfer preparation. An integrated, context-adaptive framework was established to guide resource-calibrated interventions rather than rigid protocol adherence. Conclusions: These findings provide tiered guidance for frontline healthcare providers and inform the development of emergency care standards in resource-limited settings. Future research should prioritize field validation and contextual implementation to address barriers to evidence translation and enhance real-world applicability. Keywords: evidence-based; burn injury; emergency care; summary report; nursing 1. Introduction Burn injuries represent one of the most devastating forms of trauma, causing extensive tissue damage and systemic complications through exposure to thermal, chemical, electrical, or radiation sources [1] . Globally, burns are a persistent public health burden, with an estimated 180,000 deaths annually and a disproportionate concentration in low-and middleincome countries (LMICs) [2–4] . According to the Global Burden of Disease 2019 study, approximately 9 million new b

FAQs

What is the study’s primary objective for early burn injury care?

To systematically synthesize existing evidence and develop an integrated framework of actionable recommendations that optimize prehospital and early emergency care in resource-limited settings.

How many recommendations and domains are included in the synthesized results?

The synthesis produced 77 evidence-based recommendations across 13 domains.

What key message is emphasized for early burn care implementation?

Early burn care should be system-based and context-adaptive, using resource-calibrated interventions and ABC-focused management rather than rigid protocol adherence.

Sep 4, 2026

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