Diagnosis and Treatment of Infection in the Burn Patient

摘要

Treatment of burn patients by the exposure method permitted daily monitoring of the status of the burn wound in the individual patient, and made possible the surveillance programmes which documented the changing microbial ecology in individual burn units. Clinical insights derived from exposure treatment permitted definition of the clinical syndrome of burn wound sepsis and led to the development of clinically relevant animal models in which the pathogenesis of invasive burn wound infection was defined. Most importantly, the exposure method enables one to correlate the status of the burn wound with changes in other physiological variables, to facilitate the early diagnosis of infection and permit the timely institution of the treatment necessary to control the local wound problem and minimize the systemic consequences of uncontrolled sepsis. There are both patient and microbial factors which determine the risk of wound and other infections in the burn patient. Not only mortality but the severity and duration of organ system dysfunction occur in proportion to the extent of burn. (Reprints)