oa Central African Journal of Medicine - The treatment of burns

Volume 5, Issue 10
  • ISSN : 0008-9176



Young and elderly burn patients have hazards over and above those of the age groups between them. This should be constantly taken into consideration during treatment. The first aid treatment of burns should be based on the principle that all new burns are sterile and should be kept as clean as possible, with minimum of additional trauma. Hospital management should centre on keeping the wound clean, relieving pain with narcotics and preventing or treating shock. Reliance on formulae for fluid given intravenously and vigorous forcing of fluids to prevent shock should be discouraged. It is easier to manage the first signs of shock from insufficient fluids than it is to manage shock from circulatory collapse due to over-treatment. Pushing fluids to maintain a desired urinary output is also to be discouraged. As long as urine is being put out consistently and the vital signs are good, the doctor should not force fluids. Generally, it was pointed out that considerably less fluids are often effective without the danger of overloading the circulatory system, particularly in the very young and the aged. The value of clinical judgment (vital signs and regular urinary output) was stressed. The value of blood was emphasised, and its use may often be preferred, or it may be combined with the use of plasma instead of the use of plasma alone, which heretofore has been considered the standard treatment. The final handling of the wound may be by dressings (vaseline on firm mesh gauze, gauze alone or gauze impregnated with antibiotics) left on some ten days or moist dressings changed often (for badly infected burns) or by exposure. Page Five Hundred and Fifty Exposure treatment IS often the method of choice when positioning the patient permits its use, because (1) it is simpler; (2) uses fewer dressings; (3) causes less odour; (4) gives results at least equal to other methods (if not greater); and (5) gives no greater hazard of infection (and actually may lessen it). A simple technique of applying skin grafts is possible with simple blades when more elaborate equipment is not available. The main concern is to develop a precise technique resulting in as little trauma as possible. Vigilance should never be relaxed and treatment may include antibiotics, transfusion, sterile wet dressings to prevent septic toxaemia and to reverse progressive anaemia.

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