Acute burns

Burn injuries are complex cutaneous traumas cared for by many plastic surgeons. Care is stratified by burn size, depth, and associated injuries. Advances in surgical technique, wound care, and bioengineered skin have resulted in excellent outcomes for most burn survivors. Moderate burn injuries can be treated effectively by an interested and experienced plastic surgeon.     

Acute burns

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Describe the pathophysiology of burn injury. 2. Identify patient criteria for transfer to a burn center. 3. Calculate burn size and resuscitation requirements. 4. Treat inhalation injury in the acute setting. 5. Describe treatment options for burn injuries. 6. Describe preoperative selection, intraoperative procedures, and postoperative protocols for patients who require surgical care for their burn injuries. 7. Understand the survival and functional outcomes of burn injury. SUMMARY: The review article summarizes basic issues in the treatment of acute burn injury as practiced in 2008. The pathophysiology, treatment options, and expected outcomes for an acute burn are described and discussed. Special attention is directed to the nonoperative and surgical management of small to moderate-size burns that might be treated by the practicing plastic surgeon.     

Cell therapy of burns

Severe burns remain a life-threatening local and general inflammatory condition often with serious sequelae, despite remarkable progress in their treatment over the past three decades. Cultured epidermal autografts, the first and still most up-to-date cell therapy for burns, plays a key role in that progress, but drawbacks to this need to be reduced by using cultured dermal-epidermal substitutes. This review focuses on what could be, in our view, the next major breakthrough in cell therapy of burns - use of mesenchymal stromal cells (MSCs). After summarizing current knowledge, including our own clinical experience with MSCs in the pioneering field of cell therapy of radiation-induced burns, we discuss the strong rationale supporting potential interest in MSCs in treatment of thermal burns, including limited but promising pre-clinical and clinical data in wound healing and acute inflammatory conditions other than burns. Practical options for future therapeutic applications of MSCs for burns treatment, are finally considered.