Infection: Cause or Effect of Pathophysiologic Change in Burn and Trauma patients

Abstract

The survival of burn patients has increased significantly over the past 40 years as a result of improvements in both general care and burn specific treatment.¹The use of effective topical chemotherapy to control microbial proliferation within injured tissue has significantly reduced the incidence of invasive burn wound sepsis, even in patients with extensive burn injury, and has altered the characteristics of the burn wound flora and hence the causative organisms of the invasive infections that do occur, i.e., Pseudomonas burn wound infections have become relatively rare and yeast and fungal infections relatively common.² Even though present day management has reduced the occurrence of burn wound infections, infection in other sites remains the most frequent cause of morbidity and mortality in successfully resuscitated patients with burns and other injuries (Table I). The incidence of infection appears to be proportional to the severity of injury, e.g.,burn size, and to reflect both systemic and local effects of injury which predispose such patients to infection, confound its diagnosis and make it difficult to differentiate the cause and effect relationships of injury and infection.³