![]() Those patients with a delay in presentation or removal of burned tissues are at greatest risk of this condition. Specimens of this tissue must undergo histopathologic and microbiologic analysis to assist in the identification of the causative organism(s). Urgent resuscitation measures are required, along with broad-spectrum antimicrobial agents, antifungals, and surgical debridement of the affected area. This situation often is accompanied by signs of sepsis and changes in the burn wound such as black, blue, or brown discoloration of the eschar. Invasive infection of burn wounds is a surgical emergency because of the high concentrations of bacteria (>10 5 CFU) in the wound and surrounding area, together with new areas of necrosis in unburned tissues. Occasionally, lymphangitis may be observed, but this is less common. It is the result of infection of the otherwise-healthy tissues surrounding the wound and often is accompanied by increased warmth within the area, pain or tenderness, advancing swelling, or induration. Burn wound cellulitis can be observed when the area of erythema extends beyond what would be expected for the injury alone. The presence of cellulitis is the foundation of the clinical diagnosis. However, no evidence exists that the infection is invasive. The result is a loss of epithelium from an area that had re-epithelialized.īurn wound colonization may be diagnosed when bacteria are present at low concentrations (10 5 organisms/g of tissue) of bacteria in the burn wound and scab. īurn wound impetigo, also referred to as graft ghostings and folliculitis when the scalp is involved, usually is caused by bacterial colonization rather than invasive infection. The frequency of pneumonia was greater in patients who had been injured by fire and those with four or more days of mechanical ventilation. Over the last 10 years, the most frequent clinical complications reported in patients admitted to a certified burn center were pneumonia (3.5%), cellulitis (3%), and urinary tract infection (2.6%). Sepsis and the accompanying invasive infection continue to be the primary reason for death after the first 24 h, with these often culminating in the demise of the patient after the first 2 wks of admission. The total annual number of burn-related deaths is approximately 3,400. Advances in modern medical care incorporating aggressive fluid resuscitation, alleviation of the hypermetabolic response, adequate and effective surgical grafting and coverage of burn wounds, pulmonary toilet and ventilation, nutritional support, and infection control measures have ensured that the majority of patients reaching the hospital will survive. However, around 40,000 of these people are admitted, with 75% of them needing specialized treatment at a certified burn center. Most of these do not require admission to a hospital. Every year, approximately half a million Americans sustain burn injuries requiring medical intervention. ![]()
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