Surgical complications of thermal injury.

Aggressive control of intragastric pH in the burn patient has essentially eliminated upper gastrointestinal bleeding. The recent spectrum of complications in the thermally injured patient has shifted. Vascular occlusion and missed associated injury were the most frequent early complications in this review. Those complications occurring late in the course were attributed to sepsis originating in the burn wound. The common diagnostic error was to blame the burn injury for the patient's signs and symptoms. A high index of suspicion of an occult process must be exercised when caring for the burn patient who has burn shock with a decreasing hematocrit value or a compartment syndrome that does not respond to escharotomy or fasciotomy or the septic patient with a clean burn wound.