A National Evaluation of Time to Surgery Following Burn Center Admission Utilizing the Burn Care Quality Platform Data

Burn injuries are a major cause of morbidity in the United States, affecting 600 000 individuals annually. Early surgical intervention improves outcomes and reduces complications; however, access to specialized burn care is limited, with only 135 burn centers nationwide. Timely surgery, particularly for large burns, is critical for preventing complications such as hypertrophic scarring and infection while optimizing recovery. This study evaluates surgical timing across pediatric and adult burn patients to inform evidence-based practices. We analyzed data from the American Burn Association's Burn Care Quality Platform (2020-2023), including 99 195 patients (23 284 pediatric, 75 911 adult) admitted to 112 burn centers. Days from admission to first burn surgery were assessed, excluding cases with trauma or non-burn diagnoses. Surgical timing was compared by total body surface area (TBSA) burned and age group. Amongst pediatric patients, 34.6% (7247) underwent surgery, with a median time to surgery of 1 (interquartile range [IQR]: 1-3) day; for adults, 49.3% (32 052) underwent surgery, with a median of 2 (IQR: 1-4) days. Larger burns (≥20% TBSA) were treated slightly earlier, with median times of 1-3 days across groups. However, no statistically significant differences in surgical timing were observed by burn size in adults, whereas significant differences were found in the pediatric 20%-29% TBSA group (P = .035). Timely surgical intervention improves outcomes, yet delays in treating smaller burns highlight gaps in care. Future research should address referral guidelines, logistical barriers, and optimize surgical timing to improve outcomes and resource allocation in burn care.