The following statement was developed by the American College of Surgeons (ACS) Subcommittee
on Trauma Subcommittee on Injury Prevention and Control to educate surgeons and other medical
professionals about the significance of older adult burns and evidence-based prevention activities. The
ACS Board of Regents reviewed and approved the statement at its October 2015 meeting in Chicago, IL.
Statement on older adult burn prevention
The ACS recognizes the following facts:
•Changes occur to the skin of the elderly that increase
their risk for burns. These changes include the following:
Ȗ Intrinsic skin changes—those changes due solely
to aging and which include loss of hair follicles and
thinning and looseness of skin—increase the risk of
deep burn and difficulty healing
Ȗ Extrinsic skin changes, such as exposure to
ultraviolet light and smoking, which accelerate
•Metabolic changes in the elderly that increase mortality
after burns, including the following:
Ȗ The lethal dose 50 or LD50 (total body surface
area [TBSA] burn leading to 50 percent mortality)
decreases markedly with age (LD50 value for a
teenager is approximately 85 percent TBSA; for an
80 year old, it is approximately 10 percent TBSA).
Ȗ The elderly have slower reflexes, resulting in an
inability to react quickly in dangerous situations.
•Diseases associated with aging predispose the elderly to
higher risk for burns, including the following:
Ȗ Neurologic diseases:
Tremors, seizures, and syncope may lead to spills and
flame and hot liquid exposure can result in deep burns.
Dementia is associated with poor choices that
increase burn risk.
Ȗ Diabetes mellitus increases burn risk and poor burn
healing in three ways:
Higher risk for peripheral vascular disease, which
leads to poor healing
Neuropathy, which leads to an inability to sense heat
related to hot water, hot pavement, and heaters
Impaired resistance to infection, placing patients at
increased risk for amputation
Ȗ Pulmonary diseases:
Smoking while on oxygen may lead to face and inhalation burns.
Supported by the evidence, the ACS champions
efforts to promote, enact, and sustain policies and legislation that encourage the following:
•Health care provider and public education regarding
increased mortality of burns in geriatric patients compared with younger populations
•Public and health care provider education and preven-
tion programs targeted to specific burns that are unique
to the elderly population
Prevention programs to reduce burns in the elderly
should include the following: