Pallua N, von Bülow S
Klinik für Plastische Chirurgie, Hand- und Verbrennungschirurgie, Universitätsklinikum Aachen.
Chirurg. 2006 Jan;77(1):81-92; quiz 93-4. doi: 10.1007/s00104-005-1121-z.
Burns and scalds are common injuries that present with a wide range of severity. Correct evaluation of a burn's depth and extent is essential for adequate treatment, not only initially but also for late results. The depth of a burn is classified as first-to-third degree, and its extent can be deducted from specific tables. As a generalised haemodynamic reaction, a capillary leak allows fluid and colloidal substances to leave the intravasal system. This can lead to hypovolemic shock. In the first 24 h, only cristalloid fluid according to Baxter's formula should be administered. Transfer to a burn centre is indicated in accordance with well-defined guidelines. Concomitant injuries, especially inhalation traumata, need to be diagnosed and treated early. By activation of the immune response, a sepsis-like immune response syndrome can occur,resulting in bacterial translocation and colonisation with high mortality rates.
烧伤和烫伤是常见的损伤,严重程度范围广泛。正确评估烧伤的深度和范围对于充分治疗至关重要,不仅在初始阶段如此,对后期结果亦是如此。烧伤深度分为一度至三度,其范围可从特定表格中推算得出。作为一种全身性血流动力学反应,毛细血管渗漏会使液体和胶体物质离开血管内系统。这可能导致低血容量性休克。在最初的24小时内,应仅根据巴克斯特公式给予晶体液。应按照明确的指南将患者转至烧伤中心。需要尽早诊断和治疗合并伤,尤其是吸入性创伤。通过激活免疫反应,可能会发生类似脓毒症的免疫反应综合征,导致细菌移位和定植,死亡率很高。