Daigeler A, Kapalschinski N, Lehnhardt M
Klinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgie-Zentrum, Operatives Referenzzentrum für Gliedmaßentumoren, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland,
Chirurg. 2015 Apr;86(4):389-401. doi: 10.1007/s00104-014-2919-3.
Burns are classified according to the depth of the burn wound and extent of affected burned body surface area. In deep second degree and higher grade burns the epidermis and skin appendages are destroyed so that healing can only take place with severe scarring. In these cases necrectomy and skin grafting are recommended. Extensive and deep burns should be treated at specialized centers and more precise criteria for this are laid down in the guidelines. Emergency room treatment protocols have improved the quality of admission and treatment. Concomitant injuries need to be diagnosed and treated early. In addition to the damage to the skin the subsequent burn disease with massive accumulation of interstitial fluid determines the prognosis. The circulation is stabilized and the risk of infection is controlled by intensive fluid management, early necrectomy and split thickness skin grafting. Modern sedation and ventilation management allows a more rapid convalescence.
烧伤根据烧伤创面的深度和受影响的烧伤体表面积进行分类。在深二度及更高等级的烧伤中,表皮和皮肤附属器被破坏,因此愈合只能伴随着严重的瘢痕形成。在这些情况下,建议进行坏死组织切除和皮肤移植。大面积深度烧伤应在专科中心进行治疗,指南中为此制定了更精确的标准。急诊室治疗方案提高了入院和治疗的质量。需要早期诊断和治疗伴随的损伤。除了皮肤损伤外,随后出现的伴有大量间质液积聚的烧伤疾病决定了预后。通过强化液体管理、早期坏死组织切除和中厚皮片移植来稳定循环并控制感染风险。现代镇静和通气管理有助于更快康复。