New insights in the pathophysiology of burns: Implications for the prevention of wound progression
AbstractTraditionally burn shock has been considered a form of hypovolaemic shock. Medical students used to be taught that the burn patient developed shock because large amounts of fluid and proteins leaked out through the burn wound.1 This has now been proven to be a much too simplistic picture. For instance, the amount of fluid leaking out through the burn wound is less with deeper burns than with superficial burns, as in the former most of the skin vessels have been thrombosed and therefore cannot leak. Yet the shock is more profound in deep burns. Indeed, most of the fluid loss in large, deep burns does not occur in the burn wound, but through leaky capillaries in the non-burned areas of the body. On the other hand, at the end of the first week after a major burn, most of the burn oedema is resorbed, despite a fall in albumin levels.
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