The special expertise and training necessary to treat burn injuries is not widely available. Completion of a one year fellowship training in this area, as the lead surgeon of Trinidad Institute of Plastic Surgery has done 2001-2002 at the Tampa Bay Regional Burn Center, University of South Florida, is certainly desirable before embarking on the treatment of these injuries. Some minor injuries in cosmetically and functionally insignificant areas may be treated adequately by almost any surgeon. Others, however, may fare better if referred.
The American Burn Association (ABA) specifies to following criteria justifying referral to a burn specialist (TBSA denotes the total body surface area).
Second and third degree burns of more than 10% TBSA in patients under 10 or over 50
Second and third degree burns of more than 20% TBSA in all other age groups
Second and third degree burns with serious threat of functional or cosmetic impairment that involve face, hands, feet, genitalia, perineum, and major joints
Third degree burns of more than 5% TBSA in any age group
Electrical burns (including injury from lightning)
Chemical burns with serious threat of functional or cosmetic impairment
Circumferential burns of an extremity and/or chest
Burned children should be transferred to a hospital with qualified personnel and equipment
Burns with patterns that are suspected results of abuse