Burn injuries are among diseases associated with poverty [1]. Be-tween 2009––2019 there were 9 million global burn cases and 111,000 deaths; 90 % of deaths occur in low- and middle-income countries (LMICs), 7 % in middle income countries and 3 % in high income countries (HIC) [2,3]. The risk of death is particularly high in children in LMICs [1]. Similarly, non-fatal burn injuries are an important cause of morbidity and disabilities; the global burden of Disability Adjusted Life
Years (DALY) of 7.5 million DALY disproportionally affects LMICs in terms of welfare loss as share of Gross Domestic Product (GDP) [3]. In Africa, the cause of the poor outcome is multifactorial; burn in- juries are part of many health challenges such malaria, tuberculosis and HIV/AIDS and in some settings, political instability plays a role [4]. However, delayed presentation is one of the commonest reasons for poor outcome in burn injuries in addition to shortage of doctors and nurses, and lack of equipment. Although burn centres have been established at the central level, people from rural areas often do not have access,
because of cost and lack of transport. This causes delay in wound debridement and dressing which is paramount in burn care to relieve infection, which is essential for burn healing [4,5] (https://www.afro.who.int/health-topics/traditional-medicine). The ISBI Guidelines aimed to create Practice Guidelines for burn care to improve the care in both Low Resource Settings (LRS) and resource-abundant settings [6,7]. If in deep partial thickness and full thickness wounds early excision and skin grafting are not possible, the open technique (exposure) may be applied until eschar separation has begun [6,7]. This means that after 4–5 days the wound may be infected with active invasion of unburned surrounding tissues with risk of sepsis and death. Keeping the wound dry may help in controlling bacterial infection for wound closure and sep-aration of the eschar; the latter is essential as below the eschar infection continues and there is no exposure to immune responses. The closed technique includes application of topical antimicrobial agents such as silver sulphadiazine (SSD), silver nitrate solution or silver releasing dressings (relatively expensive); cerium nitrate (relatively inexpensive) and antiseptic solutions such as Dakin’s solution, acetic acid..
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read full article: Increasing experience in the use of papaya for burn injuries in an African context, potential and limitations
