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The pathogenesis of burn wound conversion.
Ann Plast Surg 2007; 59(1):109-15AP

Abstract

OBJECTIVE

Burn wound progression is a poorly understood process by which certain superficial partial-thickness burns spontaneously advance into deep partial-thickness or full-thickness wounds. Progression of an injury into deeper tissue is an important phenomenon in the treatment of thermal injury due to the fact that burn wound depth may be a significant determinant of morbidity and treatment. This article reviews current knowledge of the pathogenesis, molecular and cellular mechanisms, local and systemic factors, and treatment modalities related to wound conversion.

DATA SOURCES AND STUDY SELECTION

All peer-reviewed, original, and review articles published in English-language literature relevant to the topic of burn wound conversion on animals and human subjects were selected for this review.

DATA EXTRACTION AND SYNTHESIS

After assessing data relevance, independent extraction by a sole reviewer was performed. Data were tabulated according to the following categories: pathogenesis, mechanisms, local and systemic factors, and treatment.

CONCLUSIONS

Burn wound progression is complex and caused by additive effects of inadequate tissue perfusion, free radical damage, and systemic alterations in the cytokine milieu of burn patients, leading to protein denaturation and necrosis. Even though insufficient evidence exists for causal inferences, infection, tissue desiccation, edema, circumferential eschar, impaired wound perfusion, metabolic derangements, advanced age, and poor general health play important roles. Although consensus-building research is ongoing, current mainstays of treatment include adequate fluid resuscitation, nutritional support, and local wound care, with an emphasis on topical antimicrobial agents and biosynthetic dressings. Identifying early indicators by elucidating possible interacting or synergistic mechanisms and by developing preventative strategies will enhance prevention and treatment.

Authors+Show Affiliations

Johns Hopkins Burn Center, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Baltimore, MD 21224, USA. sghva@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17589272

Citation

Singh, Vijay, et al. "The Pathogenesis of Burn Wound Conversion." Annals of Plastic Surgery, vol. 59, no. 1, 2007, pp. 109-15.
Singh V, Devgan L, Bhat S, et al. The pathogenesis of burn wound conversion. Ann Plast Surg. 2007;59(1):109-15.
Singh, V., Devgan, L., Bhat, S., & Milner, S. M. (2007). The pathogenesis of burn wound conversion. Annals of Plastic Surgery, 59(1), pp. 109-15.
Singh V, et al. The Pathogenesis of Burn Wound Conversion. Ann Plast Surg. 2007;59(1):109-15. PubMed PMID: 17589272.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The pathogenesis of burn wound conversion. AU - Singh,Vijay, AU - Devgan,Lara, AU - Bhat,Satyanarayan, AU - Milner,Stephen M, PY - 2007/6/26/pubmed PY - 2007/9/26/medline PY - 2007/6/26/entrez SP - 109 EP - 15 JF - Annals of plastic surgery JO - Ann Plast Surg VL - 59 IS - 1 N2 - OBJECTIVE: Burn wound progression is a poorly understood process by which certain superficial partial-thickness burns spontaneously advance into deep partial-thickness or full-thickness wounds. Progression of an injury into deeper tissue is an important phenomenon in the treatment of thermal injury due to the fact that burn wound depth may be a significant determinant of morbidity and treatment. This article reviews current knowledge of the pathogenesis, molecular and cellular mechanisms, local and systemic factors, and treatment modalities related to wound conversion. DATA SOURCES AND STUDY SELECTION: All peer-reviewed, original, and review articles published in English-language literature relevant to the topic of burn wound conversion on animals and human subjects were selected for this review. DATA EXTRACTION AND SYNTHESIS: After assessing data relevance, independent extraction by a sole reviewer was performed. Data were tabulated according to the following categories: pathogenesis, mechanisms, local and systemic factors, and treatment. CONCLUSIONS: Burn wound progression is complex and caused by additive effects of inadequate tissue perfusion, free radical damage, and systemic alterations in the cytokine milieu of burn patients, leading to protein denaturation and necrosis. Even though insufficient evidence exists for causal inferences, infection, tissue desiccation, edema, circumferential eschar, impaired wound perfusion, metabolic derangements, advanced age, and poor general health play important roles. Although consensus-building research is ongoing, current mainstays of treatment include adequate fluid resuscitation, nutritional support, and local wound care, with an emphasis on topical antimicrobial agents and biosynthetic dressings. Identifying early indicators by elucidating possible interacting or synergistic mechanisms and by developing preventative strategies will enhance prevention and treatment. SN - 0148-7043 UR - https://www.unboundmedicine.com/medline/citation/17589272/The_pathogenesis_of_burn_wound_conversion_ L2 - http://dx.doi.org/10.1097/01.sap.0000252065.90759.e6 DB - PRIME DP - Unbound Medicine ER -