Burn Injuries Among Migrants Crossing the Mediterranean Sea: A 10-Year Experience From a Single Center

Burn injuries among migrants crossing the Mediterranean increasingly represent a serious health issue, particularly in southern Europe. We retrospectively reviewed 91 migrant patients admitted to the Burn Center of ARNAS Civico Hospital in Palermo between 2015 and 2025: 65 (71.4%) had chemical burns from seawater-fuel mixtures, 25 (27.5%) had flame burns due to vessel explosions or torture, and 1 (1.1%) had a burn injury of other etiology. Mean age was 25 ± 9.84 years, and mean TBSA was 16.09% ± 11.06%. Chemical burns healed faster than flame burns (P = .0043). Split-thickness grafting was required in 40.0% of flame burns versus 3.07% of chemical burns (P = .000026). Inhalation pneumonia occurred in 20% of flame burns versus 3.07% of chemical burns (P = .0164), and sepsis developed in 28.0% of flame burns versus 0% of chemical burns (P = .000064). Among the 7 septic patients, mean burn surface area was 32.14% ± 16.54% TBSA, and 2 patients (28.57%) died. Predominant isolates included Acinetobacter baumannii and Klebsiella pneumoniae. These findings highlight the elevated risk of surgical, pulmonary, and infectious complications following flame burns in resource-limited maritime settings. Optimized burn care protocols, rapid microbiological diagnostics, and improved postrescue coordination are critical to reducing morbidity and mortality in this high-risk group.