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Management of burn injuries – recent developments in resuscitation, infection control and outcomes research

INTRODUCTION: Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve remote organ function. Later complications of burn injury are dominated by infe...

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Autor principal: Dries, David J
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2666628/
https://www.ncbi.nlm.nih.gov/pubmed/19284591
http://dx.doi.org/10.1186/1757-7241-17-14
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author Dries, David J
author_facet Dries, David J
author_sort Dries, David J
collection PubMed
description INTRODUCTION: Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve remote organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage soft tissue problems outside thermal injury including soft tissue infection and Toxic Epidermal Necrolysis. METHODS: A selected review of recent reports published by the American Burn Association is provided. RESULTS: The burn-injured patient is easily and frequently over resuscitated with complications including delayed wound healing and respiratory compromise. A feedback protocol is designed to limit the occurrence of excessive resuscitation has been proposed but no new "gold standard" for resuscitation has replaced the Parkland formula. Significant additional work has been included in recent guidelines identifying specific infectious complications and criteria for these diagnoses in the burn-injured patient. While new medical therapies have been proposed for patients sustaining inhalation injury, a new standard of medical therapy has not emerged. Renal failure as a contributor to adverse outcome in burns has been reinforced by recent data generated in Scandinavia. Of special problems addressed in burn centers, soft tissue infections and Toxic Epidermal Necrolysis have been reviewed but new treatment strategies have not been identified. The value of burn centers in management of burns and other soft tissue problems is supported in several recent reports. CONCLUSION: Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury exists but new standards for description of burn-related infections have been presented. The value of the burn center in care of soft tissue problems including Toxic Epidermal Necrolysis and soft tissue infections is supported in recent papers.
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spelling pubmed-26666282009-04-08 Management of burn injuries – recent developments in resuscitation, infection control and outcomes research Dries, David J Scand J Trauma Resusc Emerg Med Commentary INTRODUCTION: Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve remote organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage soft tissue problems outside thermal injury including soft tissue infection and Toxic Epidermal Necrolysis. METHODS: A selected review of recent reports published by the American Burn Association is provided. RESULTS: The burn-injured patient is easily and frequently over resuscitated with complications including delayed wound healing and respiratory compromise. A feedback protocol is designed to limit the occurrence of excessive resuscitation has been proposed but no new "gold standard" for resuscitation has replaced the Parkland formula. Significant additional work has been included in recent guidelines identifying specific infectious complications and criteria for these diagnoses in the burn-injured patient. While new medical therapies have been proposed for patients sustaining inhalation injury, a new standard of medical therapy has not emerged. Renal failure as a contributor to adverse outcome in burns has been reinforced by recent data generated in Scandinavia. Of special problems addressed in burn centers, soft tissue infections and Toxic Epidermal Necrolysis have been reviewed but new treatment strategies have not been identified. The value of burn centers in management of burns and other soft tissue problems is supported in several recent reports. CONCLUSION: Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury exists but new standards for description of burn-related infections have been presented. The value of the burn center in care of soft tissue problems including Toxic Epidermal Necrolysis and soft tissue infections is supported in recent papers. BioMed Central 2009-03-11 /pmc/articles/PMC2666628/ /pubmed/19284591 http://dx.doi.org/10.1186/1757-7241-17-14 Text en Copyright © 2009 Dries; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Commentary
Dries, David J
Management of burn injuries – recent developments in resuscitation, infection control and outcomes research
title Management of burn injuries – recent developments in resuscitation, infection control and outcomes research
title_full Management of burn injuries – recent developments in resuscitation, infection control and outcomes research
title_fullStr Management of burn injuries – recent developments in resuscitation, infection control and outcomes research
title_full_unstemmed Management of burn injuries – recent developments in resuscitation, infection control and outcomes research
title_short Management of burn injuries – recent developments in resuscitation, infection control and outcomes research
title_sort management of burn injuries – recent developments in resuscitation, infection control and outcomes research
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2666628/
https://www.ncbi.nlm.nih.gov/pubmed/19284591
http://dx.doi.org/10.1186/1757-7241-17-14
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