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THE COMPLEXITIES OF MANAGING SEVERE BURNS WITH ASSOCIATED TRAUMA

1996; Elsevier BV; Volume: 76; Issue: 4 Linguagem: Inglês

10.1016/s0039-6109(05)70488-6

1558-3171

William Dougherty, Kenneth Waxman,

Trauma Management and Diagnosis

Major burn injury in association with polytrauma poses an unusual yet complex management problem. In the military environment it may account for as much as 24% of burn casualties, 78 whereas in civilian burn centers multiply injured patients represent less than 7% of burn admissions.81 It has been reported that of those involved in an automobile fire, 36% have associated major trauma.82 When a burn is associated with other trauma, mortality is directly related to whether there is single or multiple organ system involvement.81 Improvement in the outcome of non–thermal-injured trauma patients, associated with treatment in trauma centers, 4, 24 has moved public policy and practice toward the triage of such patients to specialized trauma center units. Similarly, isolated burn patients are usually managed in burn centers. As a result, few general/trauma surgeons care for major burns, and few individuals have substantial clinical experience in the management of the combined problems. These injuries require multidisciplinary care and may necessitate modification of preoperative, intraoperative, postoperative, and critical care management to effect optimal survival and functional potential.24, 95 The success of coordinated treatment is realized through an effective triage, accurate and timely diagnosis, and precision in assignment of the surgical priorities.