~ SpringerWienNewYork
Marc G. Jeschke, Lars-Peter Kamolz, Folke Sjöberg, Steven E. Wolf (editors)
Handbook of Burns
Acute Burn Care
Volume 1
SpringerWienNewYork
Marc G. Jeschke, M.D., Ph.D.
Sunnybrook Health Sciences Centre, Department of Surgery, Division of Plastic Surgery, University of Toronto, Sunnybrook Research Institute, Toronto, ON, Canada
Lars-Peter Kamolz, M.D., M.Sc.
Plastische, Aesthetische und Rekonstruktive Chirurgie, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria
Folke Sjöberg, M.D., Ph.D.
Department of Hand and Plastic Surgery and Intensive Care, Linköping University Hospital, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
Steven E. Wolf, M.D.
Brooke Army Medical Center, Fort Sam Houston, TX, USA
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The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
© 2012 Springer-Verlag/Wien
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SPIN: 12679065
With 95 (partly coloured) figures
Library of Congress Control Number: 2011943771
ISBN 978-3-7091-0347-0 SpringerWienNewYork
Preface
Severe burn injuries are maybe not the most common injuries occurring on a daily basis however, it is estimated that within North America approximately 300,000–500,000 patients are hospitalized annually due to a burn related injury and that worldwide approximately 500,000–1,000,000 people die due to a burn related injury. Once a burn injury has occurred it is one of the most severe forms of any injury, inducing a complex cascade of various responses including inflammatory, hypermetabolic, immune, as well as infectious responses. These responses interact with each other and are extremely complex and difficult to treat. Specialized centers, protocolized treatment, multi-centre trials and close collaborations improved morbidity and mortality after severe burn injury over the last two decades. However, a vast morbidity and mortality post burn still occurs and represent one of the major problems in burn treatment.
One of the major characteristics of burn injury that has been evolving over the last 5 years is that a burn injury is not treated and healed once the wounds are healed. This used to be a landmark that no longer exists. Various studies have indicated that a burn injury and its pathphysiologic sequelae persist for at least 5-10 years, and not only in terms of scarring, infection, metabolism and the various other responses. Therefore this leads to the importance of the current two volumes of these burn books. It
has been speculated and hypothesized that early intervention and alleviation of these detrimental responses benefit in terms of clinical outcomes, therefore the individual book chapters focus on the treatment and complexity of each of these responses to improve outcomes. The up to date chapters provide evidence based medicine and current state of the art treatments for any practitioner dealing with acute burn wounds, chronic burn wounds, and all other types of burn wounds. The second volume will then delineate the importance for long term treatment as it describes the reconstructive and alternative approaches of long term treatments post burn. Therefore the design of the two volume book was now to focus on early treatment as well as later treatment. This is unique and therefore will hopefully improve the outcome of burn patients by guiding various kinds of burn practitioners from nursing, physicians, occupational therapy, physical therapy, pharmacy and so forth. The focus of each chapter is not only to give an overview but also to focus current best treatments and to make it easy for each reader to easily access the treatment options and knowledge.
We hope that these books will raise as much enthusiasm as it has for the contributors of these books.
Marc Jeschke, MD PhD FACS FRCSC
Contents
List of contributers . . . . . . . . . . . . . . . . . . . . . . . . . . |
IX |
History, epidemiology, prevention |
|
and education |
|
L. C. Cancio, S. E. Wolf |
|
A history of burn care . . . . . . . . . . . . . . . . . . . . . . . |
3 |
M. D. Peck |
|
Epidemiology and prevention of burns |
|
throughout the world . . . . . . . . . . . . . . . . . . . . . . . |
19 |
A. Arno, J. Knighton |
|
Prevention of burn injuries . . . . . . . . . . . . . . . . . . |
61 |
J. B. Lundy, L. C. Cancio |
|
Burns associated with wars and disasters . . . . . |
75 |
K. Jindal, S. Shahrokhi |
|
Education in burns . . . . . . . . . . . . . . . . . . . . . . . . . |
89 |
P. Brychta |
|
European practice guidelines for burn care: |
|
Minimum level of burn care provision in |
|
Europe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
97 |
Pre-hospital and initial management |
|
of burns |
|
F. Sjöberg |
|
Pre-hospital, fluid and early management, |
|
burn wound evaluation . . . . . . . . . . . . . . . . . . . . . |
105 |
H. L. Haller, M. Giretzlehner, |
|
J. Dirnberger, R. Owen |
|
Medical documentation of burn injuries . . . . . . |
117 |
G. Gauglitz, M. G. Jeschke |
|
Pathophysiology of burn injury . . . . . . . . . . . . . . |
131 |
L. C. Woodson, E. Sherwood, |
|
A. McQuitty, M. D. Talon |
|
Anesthesia for patients with acute burn |
|
injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
151 |
T. L. Palmieri, R. L. Gamelli |
|
Diagnosis and management of inhalation |
|
injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
163 |
R. Cartotto |
|
Respiratory management . . . . . . . . . . . . . . . . . . . |
173 |
VII
Contents
Acute burn care and therapy |
|
K. L. Butler, R. L. Sheridan |
|
Organ responses and organ support . . . . . . . . . . |
193 |
M. M. Berger, S. Shahrokhi, |
|
M. G. Jeschke |
|
Critical care of thermally injured patient . . . . . . |
203 |
G. G. Gauglitz, S. Shahrokhi, |
|
M. G. Jeschke |
|
Treatment of infection in burns . . . . . . . . . . . . . . |
221 |
G. Gauglitz, M. G. Jeschke |
|
Acute treatment of severely burned pediatric |
|
patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
241 |
P. Dziewulski, J.-L. Villapalos, |
|
J. P. Barret |
|
Adult burn management . . . . . . . . . . . . . . . . . . . . |
259 |
T. N. Pham |
|
Burns in older adults . . . . . . . . . . . . . . . . . . . . . . . . |
279 |
P. Dziewulski, J.-L. Villapalos |
|
Acute management of facial burns . . . . . . . . . . . |
291 |
B. P. Amis, M. B. Klein |
|
Hand burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
303 |
L. K. Branski, M. Dibildox, |
|
S. Shahrokhi, M. G. Jeschke |
|
Treatment of burns – established and novel |
|
technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
311 |
D. A. Brown, N. S. Gibran |
|
Wound healing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
325 |
R. Girtler, B. Gustorff |
|
Pain management after burn trauma . . . . . . . . . |
339 |
A. Cochran, J. R. Saffle, C. Graves |
|
Nutrition support for the burn patient . . . . . . . . |
361 |
H. Andel |
|
HBO and burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
381 |
J. Knighton, M. Jako |
|
Nursing management of the burn-injured |
|
person . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
387 |
B. Hartmann, C. Ottomann |
|
Outpatient burn care . . . . . . . . . . . . . . . . . . . . . . . . |
431 |
Non-thermal burns |
|
B. D. Arnoldo, J. L. Hunt, G. F. Purdue |
|
Electrical injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
443 |
L. Kolios, G. Germann |
|
Symptoms, diagnosis and treatment of |
|
chemical burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
453 |
D. A. Sieber, G. J. Abood, |
|
R. L. Gamelli |
|
Necrotizing and exfoliative diseases |
|
of the skin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
463 |
P. Kraincuk, M. Keck, D. Lumenta, |
|
L.-P. Kamolz |
|
Frostbite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
479 |
Subject index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
485 |
VIII
List of contributers
Gerard J. Abood, M.D.
Stritch School of Medicine;
The Robert J. Freeark Professor Department of
Surgery
Burn and Shock Trauma Institute
Burn Center
Loyola University Medical Center
Maywood, IL, USA
Benjamin Amis, M.D.
Department of Orthopaedic Surgery
University of Washington
Seattle, WA, USA
Harald Andel M.D., Ph.D., M.Sc.
Department of Anaesthesie and General
Intensive Care
Medical University of Vienna
Vienna, Austria
Anna Arno, M.D.
Burn unit and Plastic Surgery Department Vall d’Hebron University Hospital Autonomous University of Barcelona Barcelona, Spain
Ross Tilley Burn Centre
Sunnybrook Health Sciences Centre
Department of Surgery
Division of Plastic Surgery
University of Toronto
Toronto, ON, Canada
Brett D. Arnoldo, M.D.
UT Southwestern Medical Center
Dallas, TX, USA
Joan Pere Barret, M.D.
Val D’Hebron Hospital
Barcelona, Spain
Mette M. Berger, M.D.
Adult ICU and Burn Unit
University Hospital (CHUV)
Lausanne, Switzerland
Ludwik K. Branski, M.D., M.M.S
Department of Plastic, Hand and Reconstructive
Surgery
Hannover Medical School
Hannover, Germany
David A. Brown, M.D.
University of Washington
Department of Surgery
WA, USA
Pavel Brychta, M.D., Ph.D.
European Burns Association (EBA), President
Department of Burns and Reconstructive Surgery
University Hospital Brno
Czech Republic
IX
List of contributers
Kathryn L. Butler, M.D.
Shriners Hospital for Children
Massachusetts General Hospital
Harvard Medical School
Boston, MA, USA
Leopoldo C. Cancio, M.D., FACS
USAISR
Ft. Sam Houston
TX, USA
Roberto Cartotto M.D., FRCS(C)
Ross Tilley Burn Centre at Sunnybrook
Health Sciences Centre
Department of Surgery
University of Toronto
Toronto, ON, Canada
Amalia Cochran, M.D., FACS
Burn-Trauma Center
University of Utah Health Center
Salt Lake City, UT, USA
Manuel Dibildox, M.D.
Ross Tilley Burn Centre
Sunnybrook Health Sciences Centre
Department of Surgery
Division of Plastic Surgery
University of Toronto
Toronto, ON, Canada
DI(FH) Johannes Dirnberger
Research Unit for Medical-Informatics RISC Software GmbH
Johannes Kepler University Linz Upper Austrian Research GmbH Hagenberg, Austria
Peter Dziewulski, M.D., Ph.D., FFICM FRCS FRCS (Plast)
St. Andrews Centre for Plastic Surgery and Burns Chelmsford, Essex, UK
Richard L. Gamelli, M.D., F.A.C.S.
Stritch School of Medicine
The Robert J. Freeark Professor Department
of Surgery
Burn and Shock Trauma Institute
Burn Center
Loyola University Medical Center
Maywood, IL, USA
Gerd G. Gauglitz, M.D.
Department of Dermatology and Allergy
Ludwig Maximilians University
Munich, Germany
Günter Germann, M.D., Ph.D.
ETHIANUM, Clinic for Plastic,
Aesthetic & Preventive Medicine at Heidelberg University Hospital
Heidelberg, Germany
Nicole S. Gibran, M.D.
Director, UW Burn Center
Professor, Department of Surgery
Harborview Medical Center,
Seattle, WA, USA
Michael Giretzlehner, M.D.
Research Unit for Medical-Informatics RISC Software GmbH
Johannes Kepler University Linz Upper Austrian Research GmbH Hagenberg, Austria
Richard Girtler, M.D.
Abteilung für Anästhesie und Intensivmedizin am Wilhelminenspital der Stadt Wien Vienna, Austria
Caran Graves, M.D.
Burn-Trauma Center
University of Utah Health Center
Salt Lake City, UT, USA
Burkhard Gustorff, M.D., Ph.D.
Abteilung für Anästhesie und Intensivmedizin am Wilhelminenspital der Stadt Wien Vienna, Austria
Herbert L. Haller, M.D.
UKH Linz der AUVA
Linz, Austria
Bernd Hartmann, M.D.
Zentrum für Schwerbrandverletzte mit Plastischer Chirurgie Unfallkrankenhaus Berlin
Berlin, Germany
X
List of contributers
John L. Hunt, M.D.
UT Southwestern Medical Center
Dallas, TX, USA
Mary Jako, M.D.
Ross Tilley Burn Centre
Sunnybrook Health Sciences Centre
Department of Surgery
Division of Plastic Surgery
University of Toronto
Toronto, ON, Canada
Marc G. Jeschke, M.D., Ph.D., FACS, FRCSC
Ross Tilley Burn Centre
Sunnybrook Health Sciences Centre
Department of Surgery
Division of Plastic Surgery
University of Toronto
Toronto, ON, Canada
Kunaal Jindal, M.D.
Ross Tilley Burn Centre
Sunnybrook Health Sciences Centre
Department of Surgery
Division of Plastic Surgery
University of Toronto
Toronto, ON, Canada
Lars-Peter Kamolz, M.D., Ph.D., M.Sc.
Section of Plastic, Aesthetic and
Reconstructive Surgery
Department of Surgery
Landesklinikum Wiener Neustadt
Wiener Neustadt, Austria
Division of Plastic and Reconstructive Surgery
Department of Surgery
Medical University of Vienna
Vienna, Austria
Maike Keck, M.D.
Division of Plastic and Reconstructive Surgery
Department of Surgery
Medical University of Vienna
Vienna, Austria
Matthew B. Klein, M.D., MS, FACS
David and Nancy Auth-Washington Research Foundation
Endowed Chair for Restorative Burn Surgery Division of Plastic Surgery
University of Washington Seattle, WA, USA
Judy Knighton, M.D.
Ross Tilley Burn Centre
Sunnybrook Health Sciences Centre
Department of Surgery
Division of Plastic Surgery
University of Toronto
Toronto, ON, Canada
Leila Kolios, M.D.
Clinic for Hand-, Plastic & Reconstructive Surgery
– Burn Center –
Clinic for Plastic and Hand Surgery at Heidelberg University Hospital
BG Trauma Center Ludwigshafen Ludwigshafen, Germany
Paul Kraincuk, M.D.
Universitätsklinik für Anästhesie
Allgemeine Intensivmedizin und Schmerztherapie Vienna, Austria
David B. Lumenta, M.D.
Division of Plastic and Reconstructive Surgery
Department of Surgery
Medical University of Vienna
Vienna, Austria
Jonathan B. Lundy, M.D.
US Army Institute of Surgical Research
Fort Sam Houston
TX, USA
Alexis McQuitty, M.D.
Shriners Hospital for Children
Department of Anesthesiology
UTMB
Galveston, TX, USA
XI
List of contributers
Christian Ottomann, M.D.
Plastische Chirurgie und Handchirurgie Intensiveinheit für Schwerbrandverletzte Universitätsklinikum Schleswig Holstein Campus Lübeck, Germany
DI Robert Owen, MSc.
Research Unit for Medical-Informatics
RISC Software GmbH
Johannes Kepler University Linz
Upper Austrian Research GmbH
Hagenberg, Austria
Tina L. Palmieri, M.D.
University of California Davis Regional Medical Center Shriners Hospital for Children Northern California USA
Michael D. Peck, M.D., Sc.D., FACS
Arizona Burn Center
Maricopa Medical Center
Phoenix, AZ, USA
Tam N. Pham, M.D.
University of Washington Burn Center
Harborview Medical Center
Seattle, WA, USA
Gary F. Purdue, M.D.
UT Southwestern Medical Center
Dallas, TX, USA
Jeffrey R. Saffle, M.D.
Burn-Trauma Center
University of Utah Health Center
Salt Lake City, UT
Shahriar Shahrokhi, M.D., FRCSC FACS
Ross Tilley Burn Centre
Sunnybrook Health Sciences Centre
Department of Surgery
Division of Plastic Surgery
University of Toronto
Toronto, Canada
Robert L. Sheridan, M.D.
Shriners Hospital for Children
Massachusetts General Hospital
Harvard Medical School
Boston, MA, USA
Edward Sherwood, M.D.
Shriners Hospital for Children
Department of Anesthesiology
UTMB
Galveston, TX, USA
David A. Sieber, M.D.
Stritch School of Medicine
The Robert J. Freeark Professor Department of Surgery
Burn and Shock Trauma Institute
Burn Center
Loyola University Medical Center
Maywood, IL, USA
Folke Sjöberg, M.D., Ph.D.
Department of Hand and Plastic Surgery and
Intensive Care
Linköping University Hospital, and
Department of Clinical and Experimental Medicine
Linköping University
Linköping, Sweden
Mark D. Talon, M.D.
Shriners Hospital for Children
Department of Anesthesiology
UTMB
Galveston, TX, USA
Jorge-Leon Villapalos, M.D., FRCS (Plast)
Chelsea and Westminster Hospital Burns Service
London, UK
Steven E. Wolf, M.D., FACS
Professor and Vice Chairman for Research
Betty and Bob Kelso Distinguished Chair in Burn and Trauma Surgery
University of Texas Health Science Center at San Antonio
San Antonio, TX, USA
Lee C. Woodson, M.D., PhD
Shriners Hospital for Children
Department of Anesthesiology
UTMB
Galveston, TX, USA
XII