The Future of Burn Care From a Complexity Science Perspective

Abstract

Health care is undergoing a profound technological and digital transformation and has become increasingly complex. It is important for burns professionals and researchers to adapt to these developments which may require new ways of thinking and subsequent new strategies. As Einstein has put it: "We must learn to see the world anew." The relatively new scientific discipline "Complexity science" can give more direction to this and is the metaphorical open door that should not go unnoticed in view of the burn care of the future. Complexity science studies "why the whole is more than the sum of the parts." It studies how multiple separate components interact with each other and their environment and how these interactions lead to "behavior of the system." Biological systems are always part of smaller and larger systems and exhibit the behavior of adaptivity, hence the name complex adaptive systems. From the perspective of complexity science, a severe burn injury is an extreme disruption of the "human body system." But this disruption also applies to the systems at the organ and cellular levels. All these systems follow the principles of complex systems. Awareness of the scaling process at multilevel helps to understand and manage the complex situation when dealing with severe burn cases. This paper aims to create awareness of the concept of complexity and to demonstrate the value and possibilities of complexity science methods and tools for the future of burn care through examples from preclinical, clinical, and organizational perspectives in burn care.

Figure 1.

Multi-scaling in health care. The figure illustrates the range from microscopic to macroscopic level of interest to health care professionals which ranges from the smallest (molecular) level to human (patient) level even up to society and global level. All the processes at all these levels work as complex (adaptive) systems.

Figure 2.

Model of factors and interactions for recovery of a burn patient. Stock and flow diagram representing the system of outcome after burn injury in perspective of the patient. The diagram is based on a causal loop diagram.

Figure 3.

Model of factors and interactions for burn wound healing dynamics. Causal loop diagram displaying the complexity of burn wound healing by investigating the interactions between the cells and molecules within the burn wound.