Burns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. Significant thermal injuries induce a state of immunosuppression that predisposes burn patients to infectious complications. A current summary of the classifications of burn wound infections, including their diagnosis, treatment, and prevention, is given. Early excision of the eschar has substantially decreased the incidence of invasive burn wound infection and secondary sepsis, but most deaths in severely burn-injured patients are still due to burn wound sepsis or complications due to inhalation injury. Burn patients are also at risk for developing sepsis secondary to pneumonia, catheter-related infections, and suppurative thrombophlebitis. The introduction of silver-impregnated devices (e.g., central lines and Foley urinary catheters) may reduce the incidence of nosocomial infections due to prolonged placement of these devices. Improved outcomes for severely burned patients have been attributed to medical advances in fluid resuscitation, nutritional support, pulmonary and burn wound care, and infection control practices.

Burn Wound Infections

Purpose.To review the changing epidemiology of herpes simplex disease and correlate it with the epidemiology of ocular herpes simplex disease.Method.A review of pertinent reports in the world literature about the epidemiology of herpes simplex and specifically about ocular herpes simplex.Results.In

Herpes simplex virus epidemiology and ocular importance.

Introduction: Burn injury is a serious pathology, potentially leading to severe morbidity and significant mortality, but it also has a considerable health-economic impact The aim of this study was to describe the European hospitalized population with severe burn injury, including the incidence, etiology, risk factors, mortality, and causes of death Methods: The systematic literature search (1985 to 2009) involved PubMed, the Web of Science, and the search engine Google The reference lists and the Science Citation Index were used for hand searching (snowballing) Only studies dealing with epidemiologic issues (for example, incidence and outcome) as their major topic, on hospitalized populations with severe burn injury (in secondary and tertiary care) in Europe were included Language restrictions were set on English, French, and Dutch Results: The search led to 76 eligible studies, including more than 186,500 patients in total The annual incidence of severe burns was 02 to 29/10,000 inhabitants with a decreasing trend in time Almost 50% of patients were younger than 16 years, and ~60% were male patients Flames, scalds, and contact burns were the most prevalent causes in the total population, but in children, scalds clearly dominated Mortality was usually between 14% and 18% and is decreasing in time Major risk factors for death were older age and a higher total percentage of burned surface area, as well as chronic diseases (Multi) organ failure and sepsis were the most frequently reported causes of death The main causes of early death (<48 hours) were burn shock and inhalation injury Conclusions: Despite the lack of a large-scale European registration of burn injury, more epidemiologic information is available about the hospitalized population with severe burn injury than is generally presumed National and international registration systems nevertheless remain necessary to allow better targeting of prevention campaigns and further improvement of cost-effectiveness in total burn care

https://link.springer.com/content/pdf/10.1186%2Fcc9300.pdf

Severe burn injury in europe: a systematic review of the incidence, etiology, morbidity, and mortality

A three decade analysis of factors affecting burn mortality in the elderly.

The pharmacokinetics and pharmacodynamics of drugs are significantly altered in the burn patient, and the burn patient population shows wide inter- and intraindividual variation in drug handling. Burn injury evolves in two phases. The first phase corresponds to the burn shock, which occurs during the first 48 hours after thermal injury. In this phase, hypovolaemia, oedema, hypoalbuminaemia and a low glomerular filtration rate are observed, which result in a slower rate of drug distribution and lower renal clearance. The second phase (beyond 48 hours after injury) is a hyperdynamic state with high blood flow in the kidneys and liver, an increased alpha1-acid-glycoprotein level and loss of the drug with exudate leakage. As a result, protein binding, drug distribution and clearance may be altered. Because of the alteration in these variables, wide intraindividual variation of pharmacokinetic parameters occurs depending upon the time since thermal injury and fluid resuscitation. Interindividual variations may be correlated with the percentage of the body surface area that is burnt, creatinine clearance, albuminaemia or the alpha1-acid-glycoprotein level. A number of important variations in pharmacodynamic parameters have been described, but their mechanisms are poorly understood. From a practical point of view, for the subpopulation of burn patients who eliminate drugs extremely rapidly, higher doses and/or shorter dosing intervals are required to avoid treatment inefficacy. Drug concentration measurements help to take into account interindividual variability. However, adaptation of doses based on Bayesian methods is frequently not possible because the distribution of pharmacokinetic parameters is poorly characterized in this population. Methods based only on individual data or on a surrogate marker for efficacy may be used to optimize the dosing regimen in this population.

Influence of burns on pharmacokinetics and pharmacodynamics of drugs used in the care of burn patients.

Epidemiology of elderly patients' burns in the South West of France

Herpes simplex virus infection in burned patients: Epidemiology of 11 cases

Assessment of vitamin and trace elementsupplementation in severely burned patients undergoing long-term parenteral and enteral nutrition

Pharmacocinétique de l'amikacine chez le brûlé de gravité moyenne.

Influence of chlorhexidine on the flora of burns

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