Church Deirdre, Elsayed Sameer, Reid Owen, Winston Brent, Lindsay Robert
Calgary Laboratory Services, 9-3535 Research Rd. N.W., Calgary, Alberta, Canada T2L 2K8.
Clin Microbiol Rev. 2006 Apr;19(2):403-34. doi: 10.1128/CMR.19.2.403-434.2006.
Burns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. Significant thermal injuries induce a state of immunosuppression that predisposes burn patients to infectious complications. A current summary of the classifications of burn wound infections, including their diagnosis, treatment, and prevention, is given. Early excision of the eschar has substantially decreased the incidence of invasive burn wound infection and secondary sepsis, but most deaths in severely burn-injured patients are still due to burn wound sepsis or complications due to inhalation injury. Burn patients are also at risk for developing sepsis secondary to pneumonia, catheter-related infections, and suppurative thrombophlebitis. The introduction of silver-impregnated devices (e.g., central lines and Foley urinary catheters) may reduce the incidence of nosocomial infections due to prolonged placement of these devices. Improved outcomes for severely burned patients have been attributed to medical advances in fluid resuscitation, nutritional support, pulmonary and burn wound care, and infection control practices.
烧伤是最常见且极具破坏性的创伤形式之一。严重热损伤患者需要立即接受专业护理,以尽量降低发病率和死亡率。严重热损伤会引发免疫抑制状态,使烧伤患者易发生感染性并发症。本文给出了烧伤创面感染分类的当前概述,包括其诊断、治疗和预防。早期切除焦痂已大幅降低了侵袭性烧伤创面感染和继发性脓毒症的发生率,但严重烧伤患者的大多数死亡仍归因于烧伤创面脓毒症或吸入性损伤引起的并发症。烧伤患者还存在继发于肺炎、导管相关感染和化脓性血栓性静脉炎的脓毒症风险。引入含银装置(如中心静脉导管和弗利氏导尿管)可能会降低因这些装置长期留置导致的医院感染发生率。严重烧伤患者预后的改善归因于液体复苏、营养支持、肺部和烧伤创面护理以及感染控制措施等医学进展。