Burns

Boston Shriners Hospital for Children, Division of Burns, Massachusetts General Hospital, Department of Surgery, Harvard Medical School, Boston, MA, USA

BACKGROUND Recent history Epidemiology Organization of burn care Long-term outcomes Austere alternatives PHYSIOLOGY OF BURNS Local response to burn injury Systemic response to burn injury Pediatric considerations Geriatric considerations INITIAL CARE Prehospital and interhospital transport Primary survey Burn-specific secondary survey Initial wound care Escharotomies and fasciotomies FLUID RESUSCITATION Resuscitation physiology Resuscitation practice WOUND EXCISION AND CLOSURE Evaluation of the wound Determining the time and need for operation Techniques of burn wound excision Techniques to minimize blood loss Graft fixation and postoperative wound care Skin substitutes Donor site management RESPIRATORY ISSUES Inhalation injury Carbon monoxide and cyanide exposures Respiratory failure Chronic airway management Weaning and extubation BURN CRITICAL CARE Neurologic and pain control issues Hemodynamic and electrolyte issues Vascular access Nutritional support Complications and sepsis Burn wound infection DEFINITIVE WOUND CLOSURE Massive burns Facial burns Eyelid burns Ear burns Scalp burns Neck burns Hand burns Genital burns SPECIAL INJURIES AND ILLNESSES Electrical injuries Chemical burns Hot tar burns Cold injuries Toxic epidermal necrolysis Purpura fulminans Staphylococcal scalded skin syndrome Soft tissue trauma and infection Injuries of abuse Combined burns and trauma OUT-PATIENT MANAGEMENT Patient selection Techniques BURN REHABILITATION Early acute rehabilitation Late acute rehabilitation Long-term rehabilitation and scar management ACUTE BURN RECONSTRUCTION AND AFTERCARE Head and neck Hand Upper extremity Lower extremity Aftercare and emotional recovery