Secondary sclerosing cholangitis following major burn injury—An underestimated issue in burn care?

Burns ◽  
2011 ◽  
Vol 37 (2) ◽  
pp. 355-356 ◽  
Author(s):  
R. Ipaktchi ◽  
K. Knobloch ◽  
P.M. Vogt
Burns ◽  
2010 ◽  
Vol 36 (6) ◽  
pp. e106-e110 ◽  
Author(s):  
Sammy Al-Benna ◽  
Jörg Willert ◽  
Hans-Ulrich Steinau ◽  
Lars Steinstraesser

2015 ◽  
Vol 14 (5) ◽  
pp. 695-701 ◽  
Author(s):  
Ziv Ben-Ari ◽  
David Levingston ◽  
Ella Weitzman ◽  
Yael Haviv-Yadid ◽  
Oranit Cohen-Ezra ◽  
...  

2021 ◽  
Vol 2 (4) ◽  
pp. 293-300
Author(s):  
Stephen Frost ◽  
Liz Davies ◽  
Claire Porter ◽  
Avinash Deodhar ◽  
Reena Agarwal

Respiratory compromise is a recognised sequelae of major burn injuries, and in rare instances requires extracorporeal membrane oxygenation (ECMO). Over a ten-year period, our hospital trust, an ECMO centre and burns facility, had five major burn patients requiring ECMO, whose burn injuries would normally be managed at trusts with higher levels of burn care. Three patients (60%) survived to hospital discharge, one (20%) died at our trust, and one patient died after repatriation. All patients required regular, time-intensive dressing changes from our specialist nursing team, beyond their regular duties. This review presents these patients, as well as a review of the literature on the use of ECMO in burn injury patients. A formal review of the overlap between the networks that cater to ECMO and burn patients is recommended.


2008 ◽  
Vol 18 (12) ◽  
pp. 1621-1630 ◽  
Author(s):  
Asgjerd Litleré Moi ◽  
Eva Gjengedal

Focusing beyond survival, the priority of modern burn care is optimal quality of life. Our aim with this study, which was informed by phenomenology, was to describe and identify invariant meanings in the experience of life after major burn injury. Fourteen adults having sustained a major burn were interviewed, on average, 14 months postinjury, and asked about their experience of important aspects of life. The accident meant facing an extreme situation that demanded vigilance, appropriate action, and the need for assistance. The aftermath of the burn injury and treatment included having to put significant effort into creating coherence in their disrupted personal life stories. Continuing life meant accepting the unchangeable, including going through recurrent processes of enduring, grief, fatalism, comparisons with others, and new feelings of gratefulness. Furthermore, a continuous struggle to change what was changeable, to achieve personal goals, independence, relationships with others, and a meaningful life, were all efforts to regain freedom, aiming for a life as it was before—and sometimes even better.


2020 ◽  
Vol 48 (2) ◽  
pp. 89-92
Author(s):  
John E Greenwood

Early excision of deep burn eschar and the expeditious closure of the resultant wounds have become established as gold standard burn care. However, early burn excision has been accepted as up to four days post injury based on a series of misconceptions, not least that the patient is too unwell to undergo surgery and tolerate anaesthesia too soon after injury. There are several reasons why immediate burn excision yields superior survival outcomes, and these are expounded in this article. The systemic pathophysiology following major burn injury, especially when complicated by the respiratory pathophysiology accompanying smoke inhalation, evolves. The hours immediately after burn injury offer several windows of surgical opportunity, windows closed by the pathophysiological events that peak 24 hours later and make surgery and anaesthesia at that time both dangerous and ill-advised.


Burns ◽  
2011 ◽  
Vol 37 (2) ◽  
pp. 356-359 ◽  
Author(s):  
Sammy Al-Benna ◽  
Jörg Willert ◽  
Hans-Ulrich Steinau ◽  
Lars Steinstraesser

2020 ◽  
Vol 8 ◽  
Author(s):  
Silvia Corcione ◽  
Tommaso Lupia ◽  
Francesco G De Rosa ◽  

Abstract Burn damage can lead to a state of immune dysregulation that facilitates the development of infections in patients. The most deleterious impact of this dysfunction is the loss of the skin’s natural protective barrier. Furthermore, the risk of infection is exacerbated by protracted hospitalization, urinary catheters, endotracheal intubation, inhalation injury, arterial lines and central venous access, among other mainstays of burn care. Currently, infections comprise the leading cause of mortality after major burn injuries, which highlights the improvements observed over the last 50 years in the care provided to burn victims. The need to implement the empirical selection of antibiotic therapy to treat multidrug-resistant bacteria may concomitantly lead to an overall pervasiveness of difficult-to-treat pathogens in burn centres, as well as the propagation of antimicrobial resistance and the ultimate dysregulation of a healthy microbiome. While preliminary studies are examining the variability and evolution of human and mice microbiota, both during the early and late phase burn injury, one must consider that abnormal microbiome conditions could influence the systemic inflammatory response. A better understanding of the changes in the post-burn microbiome might be useful to interpret the provenance and subsequent development of infections, as well as to come up with inferences on the prognosis of burn patients. This review aims to summarise the current findings describing the microbiological changes in different organs and systems of burn patients and how these alterations affect the risks of infections, complications, and, ultimately, healing.


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