Immunology and sepsis syndrome in burn trauma

被引:0
|
作者
Ipaktchi, K. [1 ]
Vogt, P. M. [2 ]
机构
[1] Univ Colorado, Sch Med, Denver Hlth Med Ctr, Dept Orthopaed Surg, Denver, CO 80204 USA
[2] Hannover Med Sch, Zentrum Schwerbrandverletzte, Klin & Poliklin Plast Hand & Wiederherstellungsch, Hannover, Germany
来源
UNFALLCHIRURG | 2009年 / 112卷 / 05期
关键词
Severe burn trauma; Sepsis; Systemic inflammation; Burn shock; Inflammatory mediators; RESUSCITATION; MANAGEMENT;
D O I
10.1007/s00113-009-1652-8
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Despite significant advances in burn surgery and critical care, severe burn trauma defined as injuries covering more than 25% of the total body surface area, is still associated with high mortality and morbidity. Burn trauma is a whole body injury where peripheral dermal injury rapidly results in systemic inflammation and inflammatory core organ damage. The severe disturbance of internal homeostasis involves all vital organ systems and obligates early referral to specialized burn centers. Treatment of severely burned patients is a multifaceted challenge directed by pathophysiologic events which progress from local skin destruction, disruption of physicochemical and microvascular barriers to breakdown of peripheral and central circulation, organ failure and ultimately death. While early intensive care focuses on maintenance of tissue oxygenation and perfusion, surgical treatment deals with management of the burn wounds as a source of inflammation and infection. Here wound debridement and coverage is essential to abrogate systemic effects of inflammation and limit pathogen invasion. While control of early burn stages minimizes mortality due to burn shock, subsequent burn sepsis continues to be a formidable challenge for physicians and the main cause of burn mortality.
引用
收藏
页码:472 / +
页数:6
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