Infection and the burn patient

Abstract : Burn patient survival has significantly increased during the past four decades as hypovolaemic shock, acute renal failure, invasive bacterial burn wound infection, Curling's ulcer, and metabolic wasting have been controlled by timely adequate resuscitation, topical chemotherapy, gastric acid control, and effective nutritional support. Even though infection of the burn wound is rare (only 8 per cent of infections in 1989), infection remains the major predator and most common cause of death in burn patients in whom the respiratory tract has now become the most frequent portal of infection. The success of current burn wound care is further indexed by the change in the predominant form of pneumonia, haematogenous pneumonia that commonly arose from an infected burn wound, having been supplanted by bronchopneumonia. Pneumonia and bronchitis comprised 53 per cent of all infections in burn patients treated at the US Army Institute of Surgical Research during 1989.