Nutritional interventions and barriers for patients early after burn injury: A retrospective evaluation of medical records

Background & aims

Inadequate intake and barriers to nutritional therapy are challenges in burn care. Post-burn injury nutritional care practices are rarely reported, particularly after minor injuries. The aim of this study was to describe nutritional interventions, identify barriers to nutritional intervention, and compare the documentation of nutrition for patients after minor and major burn injuries.

Methods

A retrospective single-centre medical record review was conducted on patients aged 18 and older who were admitted for more than 72 h between 2017 and 2019 at one of Sweden's two national burn centres. A content analysis and descriptive statistics were used to analyse the data, and differences were explored between patients with minor and major burn injuries.

Results

A total of 134 patients were included in the study: 90 patients had minor burn injuries (mean total burn surface area (TBSA) 8.1 % ± 5.0), and 44 patients had major burn injuries (mean TBSA 37.8 % ± 17.2). Nutritional supplement therapy (93 %) and nutrition prescription (91 %) were the most common interventions. Interventions targeting meals and snacks (43 %) and meal support (40 %), were documented less frequently. Fasting (93 %) and gastrointestinal symptoms (49 %) were the most common barriers.

Significantly more interventions (including enteral/parenteral nutrition, and vitamin/mineral supplementation) and barriers (primarily related to enteral nutrition and fasting) were documented for patients with major burn injuries.

Conclusion

This study concludes that while most patients have oral intake, vitamin and mineral supplementation and medical nutritional therapy were more frequently documented than meal/snack interventions and meal support. The lack of dietary interventions, whether unperformed or undocumented, needs further investigation. Frequent documentation of barriers to nutritional interventions suggests that patients post-burn injury are at risk of inadequate energy and protein intake. Therefore, emphasising nutritional therapy and its documentation in post-burn care is crucial, regardless of burn severity.