Schlottmann Frederik, Lorbeer Lisa
Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany.
Innov Surg Sci. 2024 Aug 23;9(4):181-190. doi: 10.1515/iss-2024-0020. eCollection 2024 Dec.
The treatment of severe burn injuries is an essential part of plastic-reconstructive surgery. Severe burned patients are treated in burn centers, which have highly specialized technical and personnel equipment. In addition to clear recommendations for prehospital management, intensive care therapy is usually required for extensive burn wounds. Shock therapy in burns primarily involves balanced fluid resuscitation according to hemodynamic monitoring, vasopressor support, pain management, temperature regulation, oxygen therapy, and comprehensive supportive care to stabilize the patient's condition. Surgical treatment is still based on wound debridement and the gold standard of autologous split-thickness skin grafting. Besides skin transplantation, surgical management of burns may also involve the application of various topical therapies to promote wound healing, reduce pain, and prevent infection. These therapies may include antimicrobial dressings, skin substitutes, growth factors, or specialized wound care products. Once the acute treatment has been completed, multidisciplinary rehabilitation treatment takes place, which begins in the acute hospital and continues in the outpatient and inpatient rehabilitation areas. Surgical treatment of the secondary complications of burns and scars is also an important component of burn care. Comprehensive knowledge of the various components and players involved in the care of severely burned patients is, therefore, required in order to achieve the best possible outcome for the patient.
严重烧伤的治疗是整形重建外科的重要组成部分。严重烧伤患者在烧伤中心接受治疗,这些中心拥有高度专业化的技术和人员配备。除了对院前管理有明确建议外,大面积烧伤创面通常还需要重症监护治疗。烧伤的休克治疗主要包括根据血流动力学监测进行平衡的液体复苏、血管活性药物支持、疼痛管理、体温调节、氧疗以及全面的支持治疗,以稳定患者病情。手术治疗仍然基于伤口清创和自体中厚皮片移植的金标准。除了皮肤移植外,烧伤的手术管理还可能涉及应用各种局部治疗方法,以促进伤口愈合、减轻疼痛和预防感染。这些治疗方法可能包括抗菌敷料、皮肤替代物、生长因子或专门的伤口护理产品。一旦急性期治疗完成,就会进行多学科康复治疗,该治疗从急性医院开始,在门诊和住院康复区域继续进行。烧伤和瘢痕继发性并发症的手术治疗也是烧伤护理的重要组成部分。因此,为了使患者获得尽可能好的治疗效果,需要全面了解严重烧伤患者护理中涉及的各个组成部分和相关人员。