Abstract
Recently improved survival from thermal injuries has been demonstrated both in children and adults. This increase in burn injury survival rates is the result of multiple changes in treatment; probably the most important changes are, first, a more aggressive management of the wound with prompt excision of devitalized tissues and immediate closure of the wound, and, second, a better understanding and management of metabolic, immunologic, and nutritional aspects of the injuried patient. Artificial skin is a very important additional treatment modality that has more recently become available and promises to contribute significantly to improvements in wound management and survival rates by its ability to physiologically close a burn wound immediately after its excision.
Résumé
On a démontré récemment l'amélioration du taux de survie après lésions thermiques à la fois chez les enfants et chez les adultes. Cette augmentation des taux de survie dans les lésions par brûlures est due aux nombreuses améliorations du traitement. Les changements les plus importants sont probablement d'abord une attitude plus agressive de la lésion avec excision immédiate du tissu dévitalisé et fermeture rapide de la lésion, puis compréhension et traitement meilleurs des aspects métaboliques, immunologiques et nutritionnels du patient. La greffe de peau est un adjuvant très important qui s'est améliorée depuis peu de temps. Elle laisse entrevoir des progrès significatifs dans le traitement de la lésion et le taux de survie grâce à ses possibilités de fermeture physiologique d'une brûlure juste après l'excision.
Resumen
Recientemente se ha registrado una mayor supervivencia en pacientes con quemaduras, tanto en adultos como en niños. Tal incremento en las tasas de sobrevida es el resultado de mÚltiples modificaciones en el tratamiento de las quemaduras. Probablemente las modificaciones más importantes son, en primer lugar, un tratamiento más agresivo de la herida, con remoción precoz del tejido desvitalizado y la cobertura inmediata, y, en segundo lugar, una mejor comprensión y manejo de los aspectos metabólicos, inmunológicos, y nutricionales del paciente quemado. La piel artificial representa una muy importante modalidad terapéutica adicional que recientemente ha llegado a estar disponible y que promete ser un avance significativo en el manejo de la quemadura para el logro de mejores tasas de sobrevida, gracias a su capacidad de lograr el cierre fisiológico de la herida por quemadura inmediatamente después de realizada la resección.
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Supported in part by the National Institutes of Health grants GM 21700 and GM T32-07035.
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Tompkins, R.G., Burke, J.F. Progress in burn treatment and the use of artificial skin. World J. Surg. 14, 819–824 (1990). https://doi.org/10.1007/BF01670529
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DOI: https://doi.org/10.1007/BF01670529