Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN:
1312-773X (Online)
Issue:
2025, vol. 31, issue2
Subject Area:
Medicine
-
DOI:
10.5272/jimab.2025312.6243
Published online: 02 June 2025
Original article
J of IMAB. 2025 Apr-Jun;31(2):6243-6250
THERAPEUTIC APPROACH IN EXTENSIVE BURN INJURIES
Vania Anastasova1
, Elean Zanzov1
, Karina Ivanova1


, Petar Kiskinov1
, Elena Krasteva1
, Biser Ivanov2
,
1)Department of Plastic, Reconstructive, Aesthetic Surgery and Thermal Trauma, Medical Faculty, Medical University of Plovdiv, St George University Hospital, Plovdiv, Bulgaria.
2)Department of Pediatric Surgery, Medical Faculty, Medical University of Plovdiv, St George University Hospital, Plovdiv, Bulgaria.
ABSTRACT:
Introduction: burns are the fourth most common trauma. Regardless of the percentage, all burns require specialised treatment. Burns over 20% of total body surface area/ТBSA/ in adults and over 10% in children are called extensive. They require fluid resuscitation and surgical treatment. It is believed that tissue destruction, combined with capillary dysfunction and a pronounced inflammatory response, lead to the development of hypovolemia and thermal shock.
The goal: to validate a protocol for the treatment of extensive burns, including first aid, fluid resuscitation treatment, surgical interventions, rehabilitation, and care for the consequences of burns.
Material and methods: we tracked and compared the extensive burns of two random years, demographics, treatment types and outcome of it.
Discussion: treatment of thermal shock includes proper initial assessment, timely infusion therapy, early surgical treatment and wound covering, rehabilitation and active surveillance. For the outcome of the treatment, the general condition of the patient, the type and depth of the burn, as well as the time of starting the surgical treatment are important. These factors determine the outcome of the treatment, the development of cicatricial tissue and the preservation of the physiological capacity of motion.
Conclusion: extensive burns are a challenge for both plastic surgeons and anesthesiologists. The therapeutic approach follows a certain algorithm depending on many factors.
Keywords: extensive burns, thermal shock, surgical treatment, conservative treatment,
- Download FULL TEXT /PDF 3061 KB/
Please cite this article as: Anastasova V, Zanzov E, Ivanova K, Kiskinov P, Krasteva E, Ivanov B. Therapeutic approach in extensive burn injuries. J of IMAB. 2025 Apr-Jun;31(2):6243-6250. [Crossref - 10.5272/jimab.2025312.6243]
Correspondence to: Karina Ivanova, Department of Plastic, Reconstructive, Aesthetic Surgery and Thermal Trauma, Medical Faculty, Medical University of Plovdiv; 66, Peshtersko shose Str., Plovdiv, Bulgaria; E-mail: karina.ivanova@mu-plovdiv.bg
REFERENCES:
1. Herndon DN. Total Burn Care. Fifth Edition. Elsevier. 2018. [Crossref].
2. Barrow RE, Spies M, Barrow LN, Herndon DN. Influence of demographics and inhalation injury on burn mortality in children. Burns. 2004 Feb;30(1):72-7. [PubMed]
3. Kim H, Shin S, Han D. Review of History of Basic Principles of Burn Wound Management. Medicina (Kaunas). 2022 Mar 7;58(3):400. [PubMed]
4. Lineaweaver W, McMorris S, Soucy D, Howard R. Cellular and bacterial toxicities of topical antimicrobials. Plast Reconstr Surg. 1985 Mar;75(3):394-6. [PubMed]
5. Jones I, Currie L, Martin R. A guide to biological skin substitutes. Br J Plast Surg. 2002 Apr;55(3):185-93. [PubMed]
6. Wasiak J, Cleland H, Campbell F, Spinks A. Dressings for superficial and partial thickness burns. Cochrane Database Syst Rev. 2013 Mar 28;2013(3):CD002106. [PubMed]
7. Khundkar R, Malic C, Burge T. Use of Acticoat dressings in burns: what is the evidence?. Burns. 2010 Sep;36(6):751-8. [PubMed]
8. Alsarra IA. Chitosan topical gel formulation in the management of burn wounds. Int J Biol Macromol. 2009 Jul 1;45(1):16-21. [PubMed]
9. Maitz J, Merlino J, Rizzo S, McKew G, Maitz P. Burn wound infections microbiome and novel approaches using therapeutic microorganisms in burn wound infection control. Adv Drug Deliv Rev. 2023 May;196:114769. [PubMed]
10. Branski LK, Al-Mousawi A, Rivero H, Jeschke MG, Sanford AP, Herndon DN. Emerging infections in burns. Surg Infect (Larchmt). 2009 Oct;10(5):389-97. [PubMed]
11. Cope O, Moore FD. The Redistribution of Body Water and the Fluid Therapy of the Burned Patient. Ann Surg. 1947 Dec;126(6):1010-1045. [PubMed]
12. Baxter CR, Shires T. Physiological response to crystalloid resuscitation of severe burns. Ann N Y Acad Sci. 1968 Aug 14;150(3):874-94. [PubMed]
13. Żwierełło W, Piorun K, Skórka-Majewicz M, Maruszewska A, Antoniewski J, Gutowska I. Burns: Classification, Pathophysiology, and Treatment: A Review. Int J Mol Sci. 2023;24(4):3749. [PubMed]
14. Dries DJ. Management of burn injuries--recent developments in resuscitation, infection control and outcomes research. Scand J Trauma Resusc Emerg Med. 2009;17:14. [PubMed]
15. Radzikowska-Büchner E, Lopuszyńska I, Flieger W, Tobiasz M, Maciejewski R, Flieger J. An Overview of Recent Developments in the Management of Burn Injuries. Int J Mol Sci. 2023 Nov 15;24(22):16357. [PubMed]
16. Tannr JC Jr, Vandeput J, Olley JF. The Mesh Skin Graft. Plast Reconstr Surg. 1964 Sep;34:287-92. [PubMed]
17. Herndon DN, Parks DH. Comparison of serial debridement and autografting and early massive excision with cadaver skin overlay in the treatment of large burns in children. J Trauma. 1986 Feb;26(2):149-52. [PubMed]
18. Ozhathil DK, Tay MW, Wolf SE, Branski LK. A Narrative Review of the History of Skin Grafting in Burn Care. Medicina (Kaunas). 2021 Apr 15;57(4):380. [PubMed]
19. Heimbach D, Luterman A, Burke J, Cram A, Herndon D, Hunt J, et al. Artificial dermis for major burns. A multi-center randomised clinical trial. Ann Surg. 1988 Sep;208(3):313-20. [PubMed ]
20. van Zuijlen PP, van Trier AJ, Vloemans JF, Groenevelt F, Kreis RW, Middelkoop E. Graft survival and effectiveness of dermal substitution in burns and reconstructive surgery in a one-stage grafting model. Plast Reconstr Surg. 2000 Sep;106(3):615-23. [PubMed]
Received: 16 August 2024
Published online: 02 June 2025
back to Online Journal