Proposed practice guidelines for burn centres in the context of the SARS-CoV-2 pandemic

Dear Editor,
Considering the emergence of numerous cases of SARS-CoV-2 infection and the global pandemic of the disease it causes – COVID-19, healthcare in all the fields of medicine had to adapt to new challenges. Despite the protective measures and management protocols applied, SARS-CoV-2 caused over 3 million infections and 200 thousand deaths worldwide (data of May 2020) [1]. Infection control seems to be essential considering asymptomatic carriers and the latency period from the time of infection to the first symptoms of this viral infection [1, 2]. A special approach is needed in burn centres that manage acute patients, who may potentially require prompt interventions before the initial diagnostic procedures to exclude SARS-Cov-2 infection have been completed prior to initiating burn wound therapy. The first attempt to compile the experience gathered and formulate the management protocols was made by the group from the Zhejiang University School of Medicine in the Handbook of COVID-19 Prevention and Treatment. Thanks to the efforts of the students of the Poznań University of Medical Sciences, the handbook has been translated into Polish (Podręcznik prewencji i leczenia COVID-19). Both language versions, containing several suggestions based on the Chinese experience, are widely available on the Internet.
Concurrently, some other groups of researchers have published their findings and the resultant recommendations developed specifically for burn care provision centres. The recommendations can be divided into those regarding the changes in the centre infrastructure, procedures related to admission and classification of epidemiological risks in newly admitted patients, minor procedures (changes of dressings, fluid therapy) as well as surgical procedures, preparation for surgery and anaesthesia, post-procedure management and rehabilitation, if required.

Infrastructure of the centre

Due to the potential risk of transmission of the infection among patients, many suggestions concern the organization of a given burn care centre. First of all, it is suggested to divide all the activity areas (emergency rooms, clinics, wards and departments, intensive care units) into 3 zones: clean, transiently dirty (potentially dirty) and dirty, according to the epidemiological status of patients managed in the zones. The SARS-CoV-2-infected patients or patients whose infection has not been excluded are hospitalized in the dirty and...


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