Definitive care is defined as surgical excision and grafting with healing of burns. For U.S. Service Members it is provided at the USAISR Burn Center at Brooke Army Medical Center, Fort Sam Houston, TX. Partner and/or ally forces progress along the evacuation chain to return to their home nation healthcare facilities. Depending on the theater of operations, the care available to local national patients may not compare to that available for U.S. and partner/ally forces.

For U.S. and partner/ally service members who cannot be evacuated to a higher role of care for days to weeks:

1. Call the Burn Center for consultation
2. Debride burns within 24 hours postburn as described above.
3. Perform daily wound care as described above based on available resources.
4. For patients with a less than 50% TBSA burn, proceed with resuscitation and wound debridement as described above if resources allow.
5. Burns in excess of 20% TBSA general require early excision and grafting within a week to maximize chance of survival.
6. If performing excision and grafting (refer to Appendix F), contact the USAISR Burn center prior to the procedure if possible.