The LSEBN is one of four, Operational Delivery Networks for specialised burns within the UK. The LSEBN serves a population of around 21 million people, living in London, the East of England, Kent Surrey and Sussex, Thames Valley and Wessex.
The network consists of five hospitals providing specialised care for people with burn injuries, including those with complex burn injuries (requiring care in a burn centre or burn unit). We are making plans to develop new facilities, providing specialist care for patients with less severe injuries, closer to where they live.
The network team is hosted by Chelsea & Westminster Hospital NHSF Trust.
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Statement from the National Burns Network and the British Burns Association
The National Burns Network and the British Burn Association continue to support 20 minutes of cool running water as the gold standard first aid treatment for thermal burns, applied as soon as possible and ideally within three hours of injury.
This recommendation remains supported by the strongest available clinical evidence. A 2022 systematic review and meta-analysis involving more than 11,000 burn patients concluded that there is “considerable evidence” that 20 minutes of cool running water significantly improves burn outcomes, including reducing the need for skin grafting and operative intervention. Direct human experimental evidence further supports this position: Wright et al. developed an in vivo human burn model and found that cooling burns at 16°C for 20 minutes modified burn progression and salvaged, on average, 25.2% of dermal thickness, demonstrating a measurable protective effect of cooling as first aid.
Large cohort studies in both adult and paediatric burn populations have additionally demonstrated that burns cooled with 20 minutes of running water are associated with:
- reduced burn depth,
- faster wound healing,
- fewer hospital admissions,
- and reduced requirements for skin grafting surgery.
While some recent international first aid guidelines acknowledge that shorter durations of cooling may still provide benefit where 20 minutes cannot be achieved, there is currently no high-quality clinical evidence demonstrating that reducing burn first aid from 20 minutes to 15 minutes provides equivalent outcomes. Existing evidence continues to identify 20 minutes of cool running water as the intervention associated with the best patient outcomes.
The London and South East Burns Network, National Burns Network and the British Burns Association therefore continue to recommend:
- 20 minutes of cool running water,
- within 3 hours of injury where possible,
- avoiding ice, iced water, creams, butter, or gels,
- while taking care to prevent hypothermia, particularly in young children and patients with large burns.
This simple first aid intervention remains one of the most effective ways to reduce burn severity and improve recovery following thermal injury.
References
1. Singer YM. Effect of <20 minutes of cool running water within 3 hours on burn patient outcomes: a systematic review. Journal of Burn Care & Research. 2023;44(Supplement_2):S181. doi:10.1093/jbcr/irad045.259
2. Wright EH, Tyler M, Vojnovic B, Pleat J, Harris A, Furniss D. Human model of burn injury that quantifies the benefit of cooling as a first aid measure. BJS. 2019;106(11):1472–1479. doi:10.1002/bjs.11263
3. Griffin BR, Frear CC, Babl F, et al. Effect of cool running water for 20 minutes after thermal burns. AAP Grand Rounds. 2020;43(6):63. doi:10.1542/gr.43-6-63
4. Griffin BR, Cabilan CJ, Ayoub B, Xu HG, Palmieri T, Kimble RM, Singer Y. The effect of 20 minutes of cool running water first aid within three hours of thermal burn injury on patient outcomes: a systematic review and meta-analysis. Australasian Emergency Care. 2022;25(4):367–376.
5. Olawoye OA, Isamah CP, Ademola SA, Iyun AO, Michael AI, Aderibigbe RO, Oluwatosin OM. Effect of prehospital topical application of water and other agents on outcome in burn injured patients: a prospective study. Burns. 2025;51(2):107357.
