Burns: Classification and Treatment

Burns are the most devastating form of trauma that has afflicted mankind since ancient times, and their short- and long-term consequences leave severe sequelae in the patients involved. The costs they generate to health systems are very high, and at present there are only few hospital centers specialized in the treatment of these affections. A burn is defined as an injury to the skin or other organic tissue primarily caused by heat or flame (>90%) or due to radiation, radioactivity, electricity, friction, or contact with chemicals (10%). Burn severity classification is determined by the patient’s age; the percentage of total body surface area burned; depth of burn; type of burn; whether it is associated with gas inhalation; or specific body parts involved. The majority of burn injuries are minor and either do not require treatment or can be treated by any caregiver. On the other side, severe burns (>20% TBSA) can result in clinically significant morbidity as they cause not only significant injury at the local burn site but also a systemic response throughout the body. Inflammatory and vasoactive mediators such as histamines, prostaglandins, and cytokines are released causing a systemic capillary leak, intravascular fluid loss, and large fluid shifts. Failure to properly treat these injuries will lead to rapid development of organ failure and death. The initial approach of the severely burned patient in the shock phase is critical for patients’ survival; the main pillars of the treatment are fluid resuscitation, airway distress management, and surgical debridement. A multidisciplinary team is essential for a proper management.