Total Burn Care

Pathophysiology of the Burn Scar

Introduction Prehistoric and Historic Perspectives Wounds due to combat, hunting injuries, accidents, and thermal injuries have been the leading causes of death in humans for millennia, whereas prolonged survival of large full-thickness wounds is a recent phenomenon. Complex biological responses…

Molecular and Cellular Basis of Hypertrophic Scarring

Introduction Clinically postburn hypertrophic scars (HTS) are elevated, erythematous, pruritic, and inelastic. In addition to poor cosmesis, these scars typically form contractures resulting in dysfunction and discomfort, leading to significant morbidity for burn patients ( Fig. 45.1 ). HTS is…

The Burn Problem: A Pathologist’s Perspective

Introduction A large burn is not a simple injury but a very complicated disease. This statement, restated from its publication in 1840, holds true with additional force in 2016. Massive destruction of skin tissue by burns stimulates many complex reactions…

Burn Injuries of the Eye

Introduction Both immediate and delayed presentations exist for eye problems in burned patients. Accordingly, in burns, the structure and function of a normal eye can be disrupted by concurrent blunt or penetrating injury, electrical current, thermal energy, or chemical agents.…

Radiation Injuries and Vesicant Burns

Radiation Injury: Introduction In the aftermath of 9/11 and more recent acts of unrelenting terrorism, such as the mass killings in Paris, Brussels, and Orlando, the possibility of the use of nuclear weapons or crude nuclear devices in attacks on…

Chemical Burns

Introduction Chemical burns represent a small percentage of burn injuries yet up to one third of burn-related deaths. Many common household and industrial compounds have the potential to induce severe chemical burns. The American Association of Poison Control Centers' National…

Cold-Induced Injury: Frostbite

History of Frostbite Frostbite is a traumatic injury caused by the failure of normal protective mechanisms against the environment, resulting in freezing of tissue. Cold-induced injury remains surprisingly frequent in the United States owing to increasing interest in outdoor winter…

Electrical Injuries

Introduction The harnessing of electricity may be the technical advance with the greatest impact on human life and culture in recorded history. The tools of modern life are increasingly powered by electricity, and life without it would be unrecognizable. There…

Surgical Management of Complications of Burn Injury

Introduction Various surgical complications can occur in burn patients resulting from pathologic progression of the burn injury itself or from iatrogenic etiologies. Multiple organ system injuries can exist that require both a thorough assessment and expeditious management according to advanced…