Damage Control Surgery after Burn Injury: A Narrative Review

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2022-04-01 DOI:10.3390/ebj3020024

H. Rennekampff, M. Tenenhaus

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引用次数: 2

Abstract

Burn injuries with cutaneous loss result in a severe systemic response when profound injuries exceed 20% of the total body surface area. The management of severely burned patients is a complex and dynamic process. Timely and safe operative interventions are critical components of multidisciplinary care. Effective management of severely burned patients, their cutaneous injuries, and the associated systemic disease requires a comprehensive understanding of the pathophysiologic response to trauma, objective indicators of patient status, and an appreciation for the dynamic nature of these parameters. Progress in both clinical and basic science research has advanced our understanding of these concepts and our approach to the management of burn patients. Incorporating concepts such as early total care, damage control surgery (DCS), and safe definitive surgery (SDS) in the polytraumatized patient may further aid in optimizing outcomes and quality of care for burn patients. This article connects current knowledge of the lethal triad, inflammation, immunosuppression, and eschar-derived toxins, with surgical burn care, especially burn wound debridement. The concepts of DCS and SDS for the care and management of burn patients are strongly advocated. Experimental and clinical studies are encouraged to validate these concepts in an effort to optimize patient outcomes.

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烧伤后的损伤控制手术:叙述回顾

当深度损伤超过体表总面积的20%时，伴有皮肤损失的烧伤会导致严重的全身反应。严重烧伤患者的管理是一个复杂而动态的过程。及时和安全的手术干预是多学科护理的关键组成部分。对严重烧伤患者及其皮肤损伤和相关全身性疾病的有效管理需要对创伤的病理生理反应、患者状态的客观指标以及这些参数的动态特性有全面的了解。临床和基础科学研究的进展促进了我们对这些概念的理解和我们对烧伤患者管理的方法。在多发创伤患者中纳入早期全面护理、损伤控制手术(DCS)和安全最终手术(SDS)等概念，可能进一步有助于优化烧伤患者的预后和护理质量。这篇文章将目前关于致死性三合一的知识——炎症、免疫抑制和痂源性毒素——与外科烧伤护理，特别是烧伤创面清创联系起来。在烧伤患者的护理和管理中大力提倡DCS和SDS的概念。鼓励实验和临床研究来验证这些概念，以努力优化患者的结果。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.