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Surgery
Management of Critical Burn Injuries: Recent Developments
David J. Dries, John J. Marini
Korean J Crit Care Med. 2017;32(1):9-21.   Published online February 17, 2017
DOI: https://doi.org/10.4266/kjccm.2016.00969
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  • 8 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
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 vital organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage problems related to thermal injury, including lightning and electrical injuries.
Methods
A selected review is provided of key management concepts as well as of recent reports published by the American Burn Association.
Results
The burn-injured patient is easily and frequently over resuscitated, with ensuing complications that include delayed wound healing and respiratory compromise. A feedback protocol designed to limit the occurrence of excessive resuscitation has been proposed, but no new “gold standard” for resuscitation has replaced the venerated Parkland formula. While new medical therapies have been proposed for patients sustaining inhalation injury, a paradigm-shifting standard of medical therapy has not emerged. Renal failure as a specific contributor to adverse outcome in burns has been reinforced by recent data. Of special problems addressed in burn centers, electrical injuries pose multisystem physiologic challenges and do not fit typical scoring systems.
Conclusion
Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury has been generally adopted, but new standards for description of burn-related infections have been presented. The value of the burn center in care of the problems of electrical exposure, both manmade and natural, is demonstrated in recent reports.

Citations

Citations to this article as recorded by  
  • Prevalence and Trend of Depression in Burn Survivors: A Single Center Cohort Study
    V S Ranganath, Smitha Segu, B S Girish, Joel M Johns, C S Meghana
    Journal of Burn Care & Research.2024;[Epub]     CrossRef
  • SUBMICROSCOPIC CHANGES IN THE HEMOCAPILLARIES OF THE CEREBRAL HEMISCLE CAUSES CAUSED BY THERMAL BURN
    H. V. Lukyantseva, V. A. Pastukhova, O. I. Kovalchuk
    Bulletin of Problems Biology and Medicine.2021; 3(1): 268.     CrossRef
  • Kefir Accelerates Burn Wound Healing Through Inducing Fibroblast Cell Migration In Vitro and Modulating the Expression of IL-1ß, TGF-ß1, and bFGF Genes In Vivo
    Ahmad Oryan, Esmat Alemzadeh, Mohammad Hadi Eskandari
    Probiotics and Antimicrobial Proteins.2019; 11(3): 874.     CrossRef
  • Viable placental allograft as a biological dressing in the clinical management of full-thickness thermal occupational burns
    Eric L. Johnson, Elisabet K. Tassis, Georgina M. Michael, Susan G. Whittinghill
    Medicine.2017; 96(49): e9045.     CrossRef

ACC : Acute and Critical Care