{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T17:45:42Z","timestamp":1776015942817,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Major Burns are life\u2010threatening injuries that cause approximately 2500 deaths per year in Brazil. The Brazilian healthcare system has 80 hospitals with Burn Care Units (BCUs). However, non specialized hospitals also manage major burn injuries. The aim of this study was to evaluate differences in burn management and outcomes between BCUs and hospitals without BCUs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with an ICD\u201010 code for a burn injury were identified in a Brazilian discharge database (DATASUS) from 2015 to 2023, were categorized by total body surface area (TBSA). Hospitalizations were compared based on whether they occurred in a BCU or not, adjusting for TBSA, age, and sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 2015 to 2023, there were 22,627 burn injury hospitalizations in Brazil. Of these, 14,187 (62.71%) were treated in Burn Care Units (BCUs), 6553 (28.96%) in non\u2010BCU hospitals with plastic surgery services, and 1887 (8.34%) in non\u2010BCU hospitals without plastic surgery. Mean TBSA was highest in non\u2010BCUs with plastic surgery (42.0%) compared to BCUs (35.2%) and non\u2010BCUs without plastic surgery (34.4%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Mortality occurred in 9.87% of hospitalizations at BCUs, 7.78% at non\u2010BCUs with plastic surgery, and 4.45% at non\u2010BCUs without plastic surgery. After adjusting for TBSA, age, and sex, non\u2010BCU facilities showed lower odds of mortality (non\u2010BCU with plastic surgery: aOR 0.49, 95% CI 0.44\u20130.56; non\u2010BCU without plastic surgery: aOR 0.36, 95% CI 0.28\u20130.47; both\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Transfers to other facilities occurred in 1.28% (182\/14,187) of BCUs, 16.26% of non\u2010BCUs with plastic surgery, and 29.61% (559\/1887) of non\u2010BCUs without plastic surgery. Surgical management rates were highest in BCUs, intermediate in non\u2010BCUs with plastic surgery, and lowest in non\u2010BCUs without plastic surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hospitalizations in BCUs were associated with lower transfer rates and higher rates of surgical intervention. However, BCUs also reported higher mortality rates, suggesting that they likely provided care to the most severely injured burn patients until their final outcomes, whether recovery or death. Despite non\u2010BCUs with plastic surgery treating burns with higher mean TBSA, BCUs had higher mortality, suggesting that BCUs receive patients with unmeasured risk factors beyond TBSA and serve as referral centers for the most complex cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70275","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T03:31:15Z","timestamp":1771817475000},"page":"811-817","source":"Crossref","is-referenced-by-count":0,"title":["Management of Burn Injuries in Brazil by Total Body Surface Area Affected"],"prefix":"10.1002","volume":"50","author":[{"given":"Paulo Henrique Moreira","family":"Melo","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Sciences Department of Surgery McGill University  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o Oliveira G\u00f3es","family":"Neno","sequence":"additional","affiliation":[{"name":"Est\u00e1cio de S\u00e1 University\/IDOMED Vista Carioca Campus  Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4146-2098","authenticated-orcid":false,"given":"Cynthia Florencio de","family":"Mesquita","sequence":"additional","affiliation":[{"name":"Federal University of Pernambuco (UFPE)  Recife Pernambuco Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Lopes","family":"Salom\u00e3o","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Rehabilitation Sciences Hospital for Rehabilitation of Craniofacial Anomalies University of S\u00e3o Paulo (HRAC\u2010USP)  Bauru S\u00e3o Paul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Kratky","sequence":"additional","affiliation":[{"name":"Program in Global Surgery and Social Change Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Surgery Dartmouth\u2010Hitchcock Medical Center  Lebanon New Hampshire USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4853-7002","authenticated-orcid":false,"given":"David P.","family":"Mooney","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina Pires","family":"Camargo","sequence":"additional","affiliation":[{"name":"Laboratory of Microsurgery and Plastic Surgery School of Medicine, Universidade de S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010020\u20100145\u20105"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2011.06.005"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/burnst\/tkab037"},{"key":"e_1_2_10_5_1","unstructured":"World Health Organization \u201cBurns \u201d [Internet] (2023) [Cited February 24 2025 ] https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/burns."},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/gox.0000000000003428"},{"key":"e_1_2_10_7_1","unstructured":"SchefferM. \u201cDemografia M\u00e9dica No Brasil 2023. Faculdade de Medicina da Universidade de S\u00e3o Paulo (FMUSP) \u201d editor. S\u00e3o Paulo: Associa\u00e7\u00e3o M\u00e9dica Brasileira (AMB) (2023)."},{"key":"e_1_2_10_8_1","unstructured":"\u201cSpecialist Surgical Workforce (Per 100 000 Population) \u201d [Internet] (2020) [Cited February 15 2025] https:\/\/data.worldbank.org\/indicator\/SH.MED.SAOP.P5."},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2017.11.023"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cps.2009.05.015"},{"key":"e_1_2_10_11_1","unstructured":"Unidades de Tratamentos de Queimados \u201cSociedade Brasileira de Queimaduras \u201d [Internet] [Cited February 15 2025] https:\/\/sbqueimaduras.org.br\/unidades\u2010tratamento\u2010queimados."},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2024.06.009"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1590\/0102\u2010311x00032419"},{"key":"e_1_2_10_14_1","unstructured":"\u201cResolu\u00e7\u00e3o No 510 de 07 de abril de 2016 \u201d [Internet] [Cited December 16 2025] https:\/\/www.gov.br\/conselho\u2010nacional\u2010de\u2010saude."},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010198905000\u201000006"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra1807442"},{"key":"e_1_2_10_17_1","unstructured":"Burn Incidence Fact Sheet American Burn Association[Internet] (2017): [Cited March 1 2025] https:\/\/ameriburn.org\/resources\/burn\u2010incidence\u2010fact\u2010sheet\/."},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-196806000-00008"},{"key":"e_1_2_10_19_1","article-title":"The Estimation of Areas of Burns","volume":"79","author":"Lund C. 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