Current treatment of severely burned patients

Thuan T. Nguyen, David A. Gilpin, Nicholas A. Meyer, David Herndon

Research output: Contribution to journalArticle

166 Citations (Scopus)

Abstract

Objective: The authors provide an update on a multidisciplinary approach to the treatment of severely burned patients. A review of studies and clinical trials from the past to the present include fluid resuscitation, sepsis, immune function, hypermetabolism, early excision, wound healing, scar formation, and inhalation injury. Summary Background Data: Advances in treating initial burn shock, infection control, early wound closure, and modulation of the hypermetabolic response have decreased morbidity and mortality in the last two decades. Specialized burn care centers, using a multidisciplinary approach, not only successfully treat large burns and their complications, but provide the necessary rehabilitation and psychological support required for readjustment back into society. Conclusions: Thermal injury results in a number of physiologic alterations that can be minimized by adequate fluid resuscitation to maintain tissue perfusion, early excision of burn wounds, and rapid wound coverage. These measures, in combination with antibiotic coverage and nutritional support in the form of early enteral tube feedings, will decrease the hypermetabolic response and the incidence of sepsis that can lead to hemodynamic instability and organ failure. Ongoing clinical trials using anabolic agents (eg., recombinant human growth hormone) and pharmacologic agents that modulate inflammatory and endocrine mediators (e.g., ibuprofen and propranolol) show promise in the treatment of severe burn injuries.

Original languageEnglish (US)
Pages (from-to)14-25
Number of pages12
JournalAnnals of Surgery
Volume223
Issue number1
DOIs
StatePublished - 1996

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Wounds and Injuries
Enteral Nutrition
Resuscitation
Sepsis
Therapeutics
Clinical Trials
Anabolic Agents
Burn Units
Nutritional Support
Human Growth Hormone
Ibuprofen
Infection Control
Burns
Propranolol
Wound Healing
Inhalation
Growth Hormone
Cicatrix
Shock
Rehabilitation

ASJC Scopus subject areas

  • Surgery

Cite this

Nguyen, T. T., Gilpin, D. A., Meyer, N. A., & Herndon, D. (1996). Current treatment of severely burned patients. Annals of Surgery, 223(1), 14-25. https://doi.org/10.1097/00000658-199601000-00004

Current treatment of severely burned patients. / Nguyen, Thuan T.; Gilpin, David A.; Meyer, Nicholas A.; Herndon, David.

In: Annals of Surgery, Vol. 223, No. 1, 1996, p. 14-25.

Research output: Contribution to journalArticle

Nguyen, TT, Gilpin, DA, Meyer, NA & Herndon, D 1996, 'Current treatment of severely burned patients', Annals of Surgery, vol. 223, no. 1, pp. 14-25. https://doi.org/10.1097/00000658-199601000-00004
Nguyen, Thuan T. ; Gilpin, David A. ; Meyer, Nicholas A. ; Herndon, David. / Current treatment of severely burned patients. In: Annals of Surgery. 1996 ; Vol. 223, No. 1. pp. 14-25.
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