 The first hospital to treat burns opened in 1843 in London , England and the development of modern burn care began in the late 1800s and early 1900s . During World War I , Henry D. <unk> and Alexis <unk> developed standards for the cleaning and <unk> of burns and wounds using sodium <unk> solutions , which significantly reduced mortality . In the 1940s , the importance of early excision and skin <unk> was acknowledged , and around the same time , fluid resuscitation and formulas to guide it were developed . In the 1970s , researchers demonstrated the significance of the hypermetabolic state that follows large burns . 
