Burns in children: standard and new treatments

Abstract

Outcomes of patients with burns have improved substantially over the past two decades. Findings from a 2012 study in The Lancet showed that a burn size of more than 60% total body surface area burned (an increase from 40% a decade ago) is associated with risks and mortality. Similar data have been obtained in adults and elderly people who have been severely burned. We discuss recent and future developments in burn care to improve outcomes of children.

Figure:. Alleviation of hypermetabolic response to improve outcomes after burn injury with early excision and grafting, high ambient temperatures, exercise, and diet

(A) Muscle protein net balance in paediatric patients with severe burns. Early excision alleviates muscle protein loss compared with late excision. Error bars show standard error of the mean. (B) A high carbohydrate diet is beneficial for muscle protein synthesis compared with a high fat diet. (C) High room temperatures can reduce the metabolic needs of patients with burns (ie, hypermetabolism). The higher the room temperature the lower the metabolic demand. (D) Long-term exercise can substantially increase strength and decrease hypermetabolism. Reproduced from Williams and colleagues, by permission of Elsevier.