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. 2017 Jun 30;30(2):95-102.

Burn injury: review of pathophysiology and therapeutic modalities in major burns

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Burn injury: review of pathophysiology and therapeutic modalities in major burns

I Kaddoura et al. Ann Burns Fire Disasters. .

Abstract

Despite a considerable decrease in their incidence worldwide, burn injuries remain one of the commonest forms of trauma and account for a weighty proportion of trauma cases in health-care emergencies around the globe. Although the latest data reveal a substantial decline in burn-related mortality and hospital admissions in the US over the past three decades, severe thermal injuries continue to trigger devastating morbidity and significant mortality while their management remains a dynamic challenge for the entire medical and paramedical community. Concrete evidence continues to be established regarding burn-associated pathophysiologic responses, and their destructive sequelae and deleterious effects in survivors at cellular, systemic as well as socio-economic level. Better understanding of these responses have contributed to advances in therapeutic strategies, improved long-term outcomes and catalyzed the reintegration of victims back into society. This paper describes the current understanding of the pathophysiology of a burn injury and characterizes both local and systemic pathophysiologic responses in terms of metabolic, hemodynamics, cardiac, renal, hepatic, gastro-intestinal, immunologic, endocrine as well as male reproductive systems in an attempt to understand the corresponding treatment modalities for this unique patient population.

Malgré une diminution importante de leur incidence mondiale, les brûlures demeurent un des traumatismes les plus fréquents et représentent une proportion importante des traumatismes nécessitant un recours aux services d’urgences. Bien que les dernières données étatsuniennes montrent une diminution de la mortalité et des hospitalisations liées aux brûlures sur les 30 dernières années, les brûlures étendues restent responsables d’une mortalité significative et d’une morbidité considérable dont la prise en charge reste un défi pour la communauté soignante. Des données factuelles continuent à s’accumuler concernant la physiopathologie des brûlures et ses conséquences, aux niveaux cellulaire comme systémique et socio-économique. La meilleure compréhension de cette physiopathologie a permis des progrès dans la stratégie thérapeutique, ayant pour objectif d’améliorer l’évolution à distance et la réintégration sociétale. Cet article décrit les connaissances actuelles de la physiopathologie des brûlures et les caractéristiques locales comme systémiques des réponses aux niveaux métabolique, hémodynamique, cardiaque, rénal, hépatique, gastro-intestinal, immunologique, endocrine (comprenant le système reproducteur masculin) afin de comprendre les modalités de traitement de ce groupe de patients.

Keywords: burn injury; major burns; modulators; pathophysiology.

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