Over the last 50 years, medical science has made huge strides in the treatment of burn injuries. For example, in the 1960s, the survival rate of children with burns covering 40% of their body was about 50%. Today, the lethal burn size for 50% of children exceeds 95% of their total body area.
This section will provide some examples of the advances that medical science has made with burn care. It will also discuss some techniques that may be used in the near future. Due to the fact that there have been so many advances, this section is by no means exhaustive. It is, however, an impressive example of humans becoming much better at healing themselves.
Excision is the process of removing the burned, necrotic tissue from a patient’s burn.
Although medical professionals recognized the benefits of excising the burned tissue and closing the wound as soon as possible in the late 1940s, the practice was not practical until the 1970s because of high rates of infection and wound failure.
Early excision improves survival rates, shortens hospital stays, and can lead to better long-term function. It is now the standard method for treating all burns.
Up until the early 1980s, skin grafts were the most common method of treating wounds. Artificial skin grafts are now commonly used in place of actual skin tissue.
These grafts generally use a collagen scaffold to cover the affected area. They are often seeded with a patient’s own skin cells. The scaffolding touches the healthy skin surrounding the wound, encouraging it to grow more quickly.
The proper fluid mixture for fluid replacement in adults has been known for some time. The proper mixture for children, however, was not fully developed until the early 1980s.
Further, modern developments have seen adjustments to the fluid regiment based on not only the size and depth of the injury, but also the other injuries suffered concurrently with the burn, including smoke inhalation.
Finally, modern research has conclusively shown that outcomes—survival, permanent injury, and recovery—improve if fluid replacement occurs quickly after the injury.
Infections are one of the main causes of death from a burn injury. Early excision and grafting have had a dramatic effect on lowering the occurrence of infections, but other developments have also had an influence on improvements in infection control.
Antimicrobial ointments are used to kill possible infections before they have a chance to develop. The use of baths, once a daily staple to treat burn injuries, has declined because medical professionals realized that the baths allow patients to sit in dangerous bacteria. Instead, dressings are now generally changed on tables, where wounds can be cleaned and antimicrobial agents can be applied in an area that drains well.
Infection prevention has also been aided by the development of other methods of that prevent infection, including dressings that can remain on the burn for up to a week at a time.