Burn Injuries Among Migrants Crossing the Mediterranean Sea: A Ten-Year Experience from a Single Center.

Abstract

Burn injuries among migrants crossing the Mediterranean are increasingly representing 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%) were chemical burns from seawater-fuel mixtures, 25 (27.5%) flame burns due to vessel explosions or torture and 1 (1.1%) other etiology of burn injury. 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 two 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 post-rescue coordination are critical to reducing morbidity and mortality in this high-risk group.