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Published on: November 6, 2018
Burns in Incarcerated Adults: A 10-Year Retrospective Review From an Australian Quaternary Burns Centre
Andrew Robertson1, Alexandra Boyling2,3, Miranda Pye1
1Department of Burns and Reconstructive Surgery, Concord Repatriation General Hospital, Concord, New South Wales, Australia.
Background:
Burn injuries sustained in custodial settings are poorly characterised within the Australian literature despite unique environmental and behavioural risk factors associated with incarceration. Scald burns related to interpersonal violence appear increasingly recognised within correctional facilities; however, their clinical characteristics, management requirements and outcomes remain inadequately described. This study aimed to characterise burns sustained by incarcerated adults treated at an Australian quaternary burns centre.
Methods:
A retrospective cohort study was conducted of incarcerated adults treated at the Concord Repatriation General Hospital Burns Unit between January 2016 and February 2026. Patients were identified through the NSW Statewide Burn Injury Service registry and cross-referenced with electronic medical records. Demographic characteristics, injury mechanism, burn severity, management and clinical outcomes were analysed. Patients were stratified by injury intent (assault vs. non-assault) for comparative analysis.
Results:
Forty-four patients met inclusion criteria. Median age was 32.5 years and 84.1% were male. Scald burns accounted for 81.8% of injuries, with assault responsible for 75.0% of all burns and 88.9% of scald injuries. Median TBSA was 4.8% (IQR 1.0-7.8), yet procedural intervention was required in 45.5% of patients. Burns most commonly involved the head and neck (56.8%), upper limbs (50.0%) and trunk (47.7%). Adequate burns first aid was provided in only 38.6% of cases. Assault-related injuries were associated with larger TBSA, increased burns unit admission, longer hospital stay and higher operative rates than non-assault injuries.
Conclusions:
Burn injuries in incarcerated adults represent a distinct and largely preventable injury subtype characterised predominantly by assault-related scald burns, inadequate first aid, frequent delays in presentation and high procedural requirements relative to burn size. Prevention initiatives, staff education and streamlined referral pathways within custodial healthcare systems may reduce preventable morbidity and improve outcomes in this high-risk population.
