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Burn Care
Results of Technical and Organizational Progress
Robert L. Sheridan, MD
JAMA. 2003;290:719-722.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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INTRODUCTION
"The patients in the wards presented the usual clinical picture of large exposed burn wounds covered by broken-down eschars, with infected granulating areas on anemic, exhausted and frightened individuals."—Zora Janzekovic reflecting on burn care, 19701
Burn care has improved markedly in the decades that have passed since the sad description quoted above. Of the 1.25 million individuals who are treated for burns in the United States each year, about 51 000 require hospital admission.2 High-risk groups include infants and young children, elderly persons, and young people in industrial occupations. Care of serious burns progresses through 4 phases, which often overlap in time: (1) initial evaluation and resuscitation; (2) initial excision and biological closure; (3) definitive wound closure; and (4) rehabilitation, reconstruction, and reintegration (Table 1).
Table appears in full text version.
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Table. Phases of Burn Care
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TECHNICAL PROGRESS
Fluid Resuscitation
The diffuse capillary leak syndrome that characterizes the early period following a burn . . . [Full Text of this Article] Treatment of Inhalation Injury Support of Hypermetabolism Surgical Treatment of the Wound Pain and Anxiety Control Reconstruction and Rehabilitation
ORGANIZATIONAL PROGRESS
Burn Center Paradigm Burn Center Aftercare Programs Disaster Preparedness
RESULTS OF PROGRESS
Survival Long-term Outcomes
RESEARCH DIRECTIONS AND CONCLUSIONS
Author Affiliations: Burn Surgery Service, Shriners Hospital for Children, Department of Surgery, Division of Burns and Trauma, Massachusetts General Hospital, Department of Surgery, Harvard Medical School, Boston.
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