Thermal Injury

Thermal injury represents a serious threat to the geriatric patient population. Due to various age-related risk factors, morbidity and mortality are significantly increased in the elderly. The overall principles of treating geriatric burn patients are identical to those for younger patients, and less aggressive approaches should not be chosen by the burn physician owing to advanced age. Early excision and grafting of burn wounds, perioperative optimization and stabilization, as well as early and aggressive rehabilitation should be the cornerstones of interdisciplinary therapy. Special attention should be paid to the detrimental hypermetabolic and hypercatabolic systemic state that is induced by burn injury. It is characterized by an increase in energy expenditure, loss of muscle mass, increased lipolysis, inefficient cardiac work, reduced immune function, and hyperpyrexia. Various therapeutic agents have been shown to mitigate this systemic reaction and should be incorporated into burn care for the elderly.