In burns involving 50% of body surface area, there is maximum possible fluid loss and it remains same even if more than 50% of body surface area is burned. Any adult burn more than 15% and pediatric burn more than 10% will land up in hypovolaemic shock if not adequately resuscitated. Body surface area burns is usually calculated by Wallace's rule of ‘9’ in adults and Lund and Browder's chart in adults and children. The amount of fluid loss will depend on extent of burns. This plasma loss is the cause of hypovolaemic shock in burns. By 48 hours either capillary permeability returns back to normal or they are thrombosed and are no more the part of circulation. Increased capillary permeability and resultant plasma leak persists till 48 hours and is maximum in first 8 hours. This causes plasma to leak out from capillaries to interstitial spaces. There is generalized increase in capillary permeability due to heat effect and damage. This article emphasizes on how the pathophysiology, healing and management of a burn wound is different from that of other wounds. It may take years for scar maturation in burns. Even after complete epithelisation of burn wound, remodelling phase is prolonged. The subeschar plane harbours the micro-organisms and many of these agents are not able to penetrate the eschar. Antimicrobial creams and other dressing agents used for traumatic wounds are ineffective in deep burns with eschar. Eschar and blister are specific for burn wounds requiring a specific treatment protocol. Even though the burn wounds are sterile in the beginning in comparison to most of other wounds, yet, the death in extensive burns is mainly because of wound infection and septicemia, because of the immunocompromised status of the burn patients. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock while whole blood loss is the cause of shock in other acute wounds. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. The ABA does not endorse any specific product, service or treatment.Management of burn injury has always been the domain of burn specialists. It is not a substitute for professional medical advice, diagnosis, or treatment, which you should seek from your physician. This material is for information purposes only. The American Burn Association and the Burn Prevention Committee are not responsible or liable for any untoward complications suffered by any individual following these suggested guidelines. It is important to note that the consumer should always seek the advice of a healthcare provider if there is any question regarding the healing process of a minor burn. This information is from the American Burn Association. Learn more about our doctors and care team who treat burns. If you have a non-urgent burn and would like a second opinion, schedule an appointment or call 800-TEMPLE-MED (80) today. If you have experienced a burn that requires urgent medical attention, please call 911 or go to the nearest emergency room. Most burns require immediate medical attention.
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