C Surgical-and Trauma-Related Infections 319 Burns (original) (raw)

The biology of burn injury: Biology of burn injury

Experimental Dermatology, 2010

Please cite this paper as: The biology of burn injury. Experimental Dermatology 2010; 19: 777–783.Abstract: Burn injury is a complex traumatic event with various local and systemic effects, affecting several organ systems beyond the skin. The pathophysiology of the burn patient shows the full spectrum of the complexity of inflammatory response reactions. In the acute phase, inflammation mechanism may have negative effects because of capillary leak, the propagation of inhalation injury and the development of multiple organ failure. Attempts to mediate these processes remain a central subject of burn care research. Conversely, inflammation is a necessary prologue and component in the later-stage processes of wound healing. In this review, we are attempting to present the current science of burn wound pathophysiology and wound healing. We also describe the evolution of innovative strategies for burn management.

Plasma Cytokines Following Thermal Injury and Their Relationship with Patient Mortality, Burn Size, and Time Postburn

The Journal of Trauma: Injury, Infection, and Critical Care, 1993

We measured plasma levels of interieukin-1l6 (IL-1j5), tumor necrosis factor a (TNFa), and interdeukin-6 (IL-6) following thermal injury. Cytokine levels In the plasma of 27 burned patients were serially screened by ELISA and compared with cytokine levels > in 16 healthy laboratory employees. The relationships between cytokine_ (.0 concentrations and patient mortality, bum size, and time postbum were examined. Plasma samples with detectable amounts of IL-1ft and IL-6 were significantly more frequent in burned patients than In controls, whereas TNFa was undetectable in most plasma samples. All nonsurviving burned patients had detectable -6 levels; theseSt were significantly higher than those of surviving patients. The IL-1# and IL-6 concentrations were highest during the first week after injury and declined over time. The IL-18 concentrations were positively correlated with bum size. These findings ___ suggest that IL-16 and IL-6 may influence metabolic and Immunologic responses in the first few weeks following thermal Injury. Tumor necrosis factor a was transiently Q elevated in a small subpopulation of burned patients with no obvious relationship to MM bum size or time posthum.r S From the U.S. Army Institute of Surgical Research, Fort Sam Houston,

Immunological approaches and therapy in burns (Review)

Experimental and Therapeutic Medicine, 2020

Burns have become an important public health problem in the last two decades, with just over a quarter of a million deaths annually. Major burns are accompanied by a strong inflammatory response, which will most often lead to systemic response inflammatory syndrome, followed by sepsis and finally induce multiple organ failure. The main mechanism involved in wound healing after burns is the inflammatory process, characterized by the recruitment of myeloid and T cells and by the involvement of numerous cytokines, chemokines, complement fractions, as well as various growth factors. Inflammasomes, protein-based cytosolic complexes, activated during metabolic stress or infection, play a role in modulating and improving the defense capacity of the innate immune system. Nucleotide-binding domain and leucine-rich repeat protein 3 (NLRP3) inflammasome has been studied predominantly and several hypotheses have been issued. Restoring the balance between the pro-inflammatory response and the anti-inflammatory activity is the key element to effective therapy in burns. Severe burns require nutritional support and pharmacotherapy not only for burn area but for different pathological complications of burn injury. In-depth research is required to find new ways to modulate the defense capacity, to prevent the complications of abnormal immune response and to treat burn injuries efficiently. Contents 1. Introduction 2. Burns and host immune response 3. The involvement of inflammasomes in burn and host immune response 4. Burns and the therapy 5. Conclusions

Burn and scald injuries

2005

Burns are one of the most harmful physical and psychological traumas. Infection is the major cause of morbidity and mortality in burns. Infections acquired from hospital or from the patient's own endogenous flora have a significant prevalence after burns. Pseudomonas aeruginosa and Staphylococcus aureus are the most frequent colonizing agents whereas group A beta-haemolytic streptococci are the most virulent bacteria. Anaerobic bacteria and fungi are also prevalent. Viral infection is less frequent. Aggressive resuscitation, nutritional support, thorough surgical excision of infected wounds, early wound closure, grafting and the development of effective topical and systemic chemotherapy have largely improved morbidity and mortality rates of burn patients.

Burn injury: review of pathophysiology and therapeutic modalities in major burns

Annals of burns and fire disasters, 2017

Despite a considerable decrease in their incidence worldwide, burn injuries remain one of the commonest forms of trauma and account for a weighty proportion of trauma cases in health-care emergencies around the globe. Although the latest data reveal a substantial decline in burn-related mortality and hospital admissions in the US over the past three decades, severe thermal injuries continue to trigger devastating morbidity and significant mortality while their management remains a dynamic challenge for the entire medical and paramedical community. Concrete evidence continues to be established regarding burn-associated pathophysiologic responses, and their destructive sequelae and deleterious effects in survivors at cellular, systemic as well as socio-economic level. Better understanding of these responses have contributed to advances in therapeutic strategies, improved long-term outcomes and catalyzed the reintegration of victims back into society. This paper describes the current u...

The time-course of the inflammatory response to major burn injury and its relation to organ failure and outcome

Burns, 2019

Burn injury causes major inflammatory activation and cytokine release, however, the temporal resolution of the acute and sub-acute inflammatory response has not yet been fully delineated. To this end, we have quantified 20 inflammatory mediators in plasma from 44 adult patients 0-21 days after burn injury and related the time course of these mediators to % total body surface area (TBSA) burned, clinical parameters, organ failure and outcome. Of the cytokines analyzed in these patients, interleukin 6 (IL-6), IL-8, IL-10 and monocyte chemoattractant protein 1 (MCP-1) correlated to the size of the injury at 24-48h after burn injury. In our study, the concentration of IL-10 had prognostic value in patients with burn injury both measured at admission and at 24-48h after injury. However, simple demographic data such as age, % burned TBSA, inhalation injury and their combination, the Baux score and modified Baux score, outperform most of the cytokines, with the exception of IL-8 and MCP-1 levels on admission, in predicting death.

Innate Immune System Response to Burn Damage—Focus on Cytokine Alteration

International Journal of Molecular Sciences, 2022

In the literature, burns are understood as traumatic events accompanied by increased morbidity and mortality among affected patients. Their characteristic feature is the formation of swelling and redness at the site of the burn, which indicates the development of inflammation. This reaction is not only important in the healing process of wounds but is also responsible for stimulating the patient’s innate immune system. As a result of the loss of the protective ability of the epidermis, microbes which include bacteria, fungi, and viruses have easier access to the system, which can result in infections. However, the patient is still able to overcome the infections that occur through a cascade of cytokines and growth factors stimulated by inflammation. Long-term inflammation also has negative consequences for the body, which may result in multi-organ failure or lead to fibrosis and scarring of the skin. The innate immune response to burns is not only immediate, but also severe and prol...