Goals for managing an acute burn wound are similar to those of other wounds such that infection and scar formation are minimized, a moist wound environment is provided, and the surrounding tissue is protected from trauma. A variety of cleansing techniques are used with burn wounds, including local wound care and nonsubmersion and immersion hydrotherapy. Topical agents have significantly decreased the development of burn wound sepsis since the 1960s, and now various experimental agents are being investigated to improve wound healing. The choice of dressings depends on many patient and wound-related factors, and synthetic, biologic, and biosynthetic dressings are used to treat the different depths of burn wounds. However, skin grafts and the newer cultured skin substitutes remain the mainstay for healing a full-thickness burn wound.
Burns are a prevalent and burdensome critical care problem. The priorities of specialized facilities focus on stabilizing the patient, preventing infection, and optimizing functional recovery. Research on burns has generated sustained interest over the past few decades, and several important advancements have resulted in more effective patient stabilization and decreased mortality, especially among young patients and those with burns of intermediate extent. However, for the intensivist, challenges often exist that complicate patient support and stabilization. Furthermore, burn wounds are complex and can present unique difficulties that require late intervention or life-long rehabilitation. In addition to improvements in patient stabilization and care, research in burn wound care has yielded advancements that will continue to improve functional recovery.
A burn is an injury to the skin caused by its exposure to extreme heat like steam, chemicals or fire. Burns can be minor, which heal without the need for treatment, severe, requiring hospitalisation, and some that can be life-threatening. Based on the severity, burns are classified into first-degree burns (affect the outer layer of skin), second-degree (involve the first two layers of skin), and third-degree burns (damage the deeper layers of the skin and tissues – fat, muscle and bone). Normally, burns heal and new skin grows to replace the damaged skin. However, when a large amount of tissue is damaged (second or third degree burns), the surrounding normal skin pulls together in an attempt to cover and heal the affected region. This tightening of the skin is called a contracture. Contractures are the most common post burn deformity, and when formed across or close to joints, can cause stiffness and restrict the motion and function around the injured area. if such contractures form in the childhood, they can cause serious growth disturbances and subsequent limb deformities.