![]() The treatment team should aim to decrease fluid losses from the wound and slow bacterial growth. It is important to initiate fluid resuscitation as quickly as possible, and the patient will sometimes require several liters acutely. Early treatment of thermal burns is critical. Once the patient is stabilized, treatment is then aimed at patient survival, rapid wound healing, and reduction of scarring/abnormal pigmentation all while being cost-effective. Hyperbaric oxygen therapy addresses these physiological derangements and can be beneficial to patients. Goals of treating burns are minimizing the edema, keeping tissue viable in the stasis zone of the burn, protecting the microvasculature, and enhancing host defenses to stave off infection. This causes a decrease in intravascular oncotic pressure, and fluid can easily leak out of the vasculature and into the interstitial space. The burn also causes extensive edema, which is caused by an increase in capillary permeability, leading to hypoproteinemia. The injury can remain in a state of flux for 72 hours, and the lack of oxygenation causes ischemic necrosis rather quickly. The microcirculation is compromised to the greatest extent during the first 12 to 24 hours after the burn has occurred. The destruction and obstruction of microvascularization impede cellular and humoral immunity and alters macrophage function. ![]() The characteristic of a burn is described as a zone of coagulation, surrounded by an area of stasis, and bordered by erythema. There are multiple factors to why thermal burns are difficult to treat, and hyperbaric oxygen therapy (HBO) can be used as part of the treatment regimen to reduce healing time and improve outcomes. Medical treatment of burns is critical, especially when they are second degree or worse and when a substantial amount of body surface area is affected. Thermal burns are common in the United States, and approximately 2 million people are injured every year, with about 155 per million patients needing admission to a hospital, and 6500 cases resulting in death. Burns are complex and dynamic injuries that cause profound activation of platelets and white cells, destruction of the microvasculature by coagulation or thrombosis, and accumulation of edema. ![]()
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