THE BURN WOUND INJURY ITS CAUSES AND MANAGEMENT
Main Article Content
Keywords
Burn, Management, Patients, Treatment, Wound
Abstract
Burn injuries are a significant global health concern, resulting from various sources such as thermal, electrical, chemical, and radiation exposures. These injuries can range from minor to severe, with severe cases potentially being life-threatening and leading to long-term complications. Effective management of burn injuries is essential for improving patient outcomes and involves several critical steps. Immediate first aid, such as cooling the burn with water and covering it with a clean cloth, is vital to minimize damage. Key wound care procedures, including cleaning, debridement, and appropriate dressing, are crucial for promoting healing and preventing infection. Infection control through the use of antibiotics and maintaining sterile techniques is paramount. In severe cases, surgical interventions such as escharotomy, fasciotomy, and skin grafting may be required to restore function and appearance. Supportive care, including fluid resuscitation, pain management, and nutritional support, is essential for stabilizing the patient and facilitating recovery. Rehabilitation, which includes physical therapy and psychological support, is crucial for addressing the long-term effects of burn injuries and improving the quality of life for survivors.
References
1. American Burn Association. National Burn Repository 2019 Update, Report of data from 2009. https://ameriburn.siteym.com/store/ViewProduct.aspx?id=14191872 (2019)
2. Lee RC: Injury by electrical forces: pathophysiology, manifestations, and therapy. Current Problem Surgery. 1997.34, 677–764 (1997).
3. Nguyen CM, Chandler R, Ratanshi I, Logsetty S: in Handbook of Burns Vol. 1 (eds. Jeschke, M. G., Kamolz, L.-P., Sjöberg, F. & Wolf, S. E.) 529–547 (Springer, 2020).
4. Jeschke MG, Gauglitz GG, Kulp GA, Finnerty CC, Williams FN, Kraft R, Suman OE, Mlcak RP, Herndon DN: Long-term persistance of the pathophysiologic response to severe burn injury. PLoS One. 2011;6(7):
5. Jeschke MG, Chinkes DL, Finnerty CC, Kulp G, Suman OE, Norbury WB, Branski LK, Gauglitz GG, Mlcak RP, Herndon DN: Pathophysiologic response to severe burn injury. Ann Surg. 2008 Sep;248(3):387-401.
6. Jeschke, M. G. et al. Pathophysiologic response to severe burn injury. Ann. Surg. 248, 387–401 (2008).
7. Stanojcic, M., Abdullahi, A., Rehou, S., Parousis, A. & Jeschke, M. G. Pathophysiological response to burn injury in adults. Ann. Surg. 267, 576–584 (2018).
8. Schaefer T.J., Tannan S.C. Stat Pearls. Stat Pearls Publishing; Treasure Island, FL, USA: 2022. Thermal Burns.
9. Spies C., Trohman R.G. Narrative Review: Electrocution and Life-Threatening Electrical Injuries. Ann. Intern. Med. 2006;145:531–537. doi: 10.7326/0003-4819-145-7-200610030-00011.
10. Fish R.M. Electric Injury, Part II: Specific Injuries. J. Emerg. Med. 2000;18:27–34. doi: 10.1016/S0736-4679(99)00158-4.
11. Koh D.-H., Lee S.-G., Kim H.-C. Incidence and Characteristics of Chemical Burns. Burns. 2017;43:654–664. doi: 10.1016/j.burns.2016.08.037.
12. Bhattacharya S. Radiation Injury. Indian J. Plast. Surg. 2010;43:S91–S93. doi: 10.1055/s-0039-1699465.
13. Logsetty, S. et al. Mental health outcomes of burn: a longitudinal population-based study of adults hospitalized for burns. Burns 42, 738–744 (2016).
14. Mason, S. A. et al. Increased rate of long-term mortality among burn survivors. Ann. Surg. 269, 1192–1199 (2019).
15. Stone, J. et al. Outcomes in adult survivors of childhood burn injuries as compared with matched controls. J. Burn Care Res. 37, e166–e173 (2016).
16. Rybarczyk, M. M. et al. A systematic review of burn injuries in low- and middle-income countries: epidemiology in the WHO-defined African region. Afr. J. Emerg. Med. 7, 30–37 (2017)
17. Stylianou, N., Buchan, I. & Dunn, K. W. A review of the international Burn Injury Database (iBID) for England and Wales: descriptive analysis of burn injuries 2003–2011. BMJ Open 5, e006184 (2015).
18. Padalko, A., Cristall, N., Gawaziuk, J. P. & Logsetty, S. Social complexity and risk for pediatric burn injury: a systematic review. J. Burn Care Res. 40, 478–499 (2019).
19. Peck, M. & Pressman, M. A. The correlation between burn mortality rates from fire and flame and economic status of countries. Burns 39, 1054–1059 (2013).
20. Spiwak, R., Logsetty, S., Afifi, T. O. & Sareen, J. Severe partner perpetrated burn: examining a nationally representative sample of women in India. Burns 41, 1847–1854 (2015).
21. Smolle, C. et al. Recent trends in burn epidemiology worldwide: a systematic review. Burns 43, 249–257 (2017).
22. World Health Organization. Burns. WHO https://www.who.int/en/news-room/fact-sheets/detail/burns (WHO, 2018).
23. Peck, M. & Pressman, M. A. The correlation between burn mortality rates from fire and flame and economic status of countries. Burns 39, 1054–1059 (2013).
24. Greenhalgh, D. G. Management of burns. N. Engl. J. Med. 380, 2349–2359 (2019).
25. Bayuo, J., Agbenorku, P., Amankwa, R. & Agbenorku, M. Epidemiology and outcomes of burn injury among older adults in a Ghanaian tertiary hospital. Burns Open 2, 98–103 (2018).
26. Sanghavi, P., Bhalla, K. & Das, V. Fire-related deaths in India in 2001: a retrospective analysis of data. Lancet 373, 1282–1288 (2009).
27. Tegtmeyer, L. C. et al. Retrospective analysis on thermal injuries in children—demographic, etiological and clinical data of German and Austrian pediatric hospitals 2006–2015—approaching the new German burn registry. Burns 44, 150–157 (2018).
28. Dissanaike, S. & Rahimi, M. Epidemiology of burn injuries: highlighting cultural and socio-demographic aspects. Int. Rev. Psychiatry 21, 505–511 (2009).
29. Atwell, K., Bartley, C., Cairns, B. & Charles, A. The effect of pre-existing seizure disorders on mortality and hospital length of stay following burn injury. J. Burn Care Res. 40, 979–982 (2019).
30. Demling RH. Fluid replacement in burned patients. Surg Clin North Am. 1987;67:15–30.
31. Demling RH, Will JA, Belzer FO. Effect of major thermal injury on the pulmonary microcirculation. Surgery, 1978;83:746–751.
32. Clark WR. Death due to thermal trauma. Dolecek R, Brizio-Molteni L, Molteni A, Traber D (eds): “Endocrinology of thermal trauma” 1990:6–27.
33. Lund T, Reed RK. Acute hemodynamic effects of thermal skin injury in the rat. Circ Shock. 1986;20:105–114.
34. Leape LL. Kinetics of burn edema formation in primates. Ann Surg. 1972;176:223–226.
35. Demling RH, Mazess RB, Witt RM, Wolberg WH. The study of burn wound edema using dichromatic absorptiometry. J Trauma. 1978;18:124–128.
36. Settle JAD. Fluid therapy in burns. J Roy Soc Med. 1982;1:7–11.
37. Arturson G, Jakobsson OR. Oedema measurements in a standard burn model. Burns. 1985;1:1–7.
38. Leape LL. Initial changes in burns: tissue changes in burned and unburned skin of rhesus monkeys. J Trauma. 1970;10:488–492.
39. Onarheim H, Lund T, Reed R. Thermal skin injury: II. Effects on edema formation and albumin extravasation of fluid resuscitation with lactated Ringer’s, plasma, and hypertonic saline (2,400 mosmol/l) in the rat. Circ Shock. 1989;27:25–37.
40. Shires GT, Cunningham JN, Baker CR, Reeder SF. Alterations in cellular membrane dysfunction during hemorrhagic shock in primates. Ann Surg. 1972;176:288–295.
41. Nakayama S, Kramer GC, Carlsen RC, Holcroft JW, Cala PM. Amiloride blocks membrane potential depolarization in rat skeletal muscle during hemorrhagic shock (abstract). Circ Shock. 1984;13:106–107.
42. Mazzoni MC, Borgstrom P, Intaglietta M, Arfors KE. Lumenal narrowing and endothelial cell swelling in skeletal muscle capillaries during hemorrhagic shock. Circ Shock. 1989;29:27–39.
43. Brown JM, Grosso MA, Moore EE. Hypertonic saline and dextran: Impact on cardiac function in the isolated rat heart. J Trauma. 1990; 3 0:646–651.
44. Evans JA, Darlington DN, Gann DS. A circulating factor(s) mediates cell depolarization in hemorrhagic shock. Ann Surg. 1991; 213: 549–557.
45. Button B, Baker RD, Vertrees RA, Allen SE. Quantitative assessment of a circulating depolarizing factor in shock. Shock. 15;2001: 239–244.
46. Hart DW, Wolf SE, Mlcak R, Chinkes DL. Persistence of muscle catabolism after severe burn. Surgery. 2000; 128: 312–319.
47. Herndon DN, Abston S, Stein SD. Increased thromboxane B2 levels in the plasma of burned and septic burned patients. Surg Gynecol Obstet. 1984;159: 210–213.
48. Morykwas MJ, David LR, Schneider AM, Whang C. Use of sub atmospheric pressure to prevent progression of partial-thickness burns in a swine model. J Burn Care Rehabil. 1999;20:15–21.
49. Nwariaku FE, Sikes PJ, Lightfoot E, Mileski WJ, Baxter C. Effect of a bradykinin antagonist on the local inflammatory response following thermal injury. Burns. 1996;22:324–327.
50. Mlcak RP, Jeschke MG, Barrow RE, Herndon DN. The influence of age and gender on resting energy expenditure in severely burned children. Ann Surg. 2006;244:121–130.
51. Przkora R, Barrow RE, Jeschke MG, Suman OE. Body composition changes with time in pediatric burn patients. J Trauma. 2006;60:968–971.
52. Sheridan RL. A great constitutional disturbance. N Engl J Med. 2001;345:1271–1272.
53. Gauglitz GG, Herndon DN, Kulp GA, Meyer WJ 3rd, Jeschke MG. Abnormal insulin sensitivity persists up to three years in pediatric patients post-burn. J Clin Endocrinol Metab. 2009;94:1656–1664.
54. Jeschke MG, Chinkes DL, Finnerty CC, Julp G. Pathophysiologic response to severe burn injury. Ann Surg. 2008;248:387–401.
55. Herndon DN, Hart DW, Wolf SE, Chinkes DL, Wolfe RR. Reversal of catabolism by beta-blockade after severe burns. N Engl J Med. 2001;345: 1223–1229.
56. Bessey PQ, Jiang ZM, Johnson DJ, Smith RJ, Wilmore DW. Posttraumatic skeletal muscle proteolysis: the role of the hormonal environment. World J Surg. 1989;13:465–470.
57. Chang DW, DeSanti L, Demling RH. Anticatabolic and anabolic strategies in critical illness: a review of current treatment modalities. Shock. 1998;10:155–160.
58. Rennie MJ. Muscle protein turnover and the wasting due to injury and disease. Br Med Bull. 1985;41:257–264.
59. Childs C, Heath DF, Little RA, Brotherston M. Glucose metabolism in children during the first day after burn injury. Arch Emerg Med. 1990;7:135–147.
60. Hunt DG, Ivy JL. Epinephrine inhibits insulin-stimulated muscle glucose transport. J Appl Physiol. 2002;93:1638–1643.
61. Baron PW, Barrow RE, Pierre EJ, Herndon DN. Prolonged use of propranolol safely decreases cardiac work in burned children. J Burn Care Rehabil. 1997;18:223–227.
62. Michie DD, Goldsmith RS, Mason Jr AD. Effects of hydralazine and high molecular weight dextran upon the circulatory responses to severe thermal burns. Circ Res. 1963;13:46–48.
63. Chrysopoulo MT, Jeschke MG, Dziewulski P, Barrow RE, Herndon DN. Acute renal dysfunction in severely burned adults. J Trauma. 1999;46:141–144.
64. LeVoyer T, Cioffi WG Jr, Pratt L, Shippee R. Alterations in intestinal permeability after thermal injury. Arch Surg. 1992;127:26–29.
65. Wolf SE, Ikeda H, Matin S, Debroy MA. Cutaneous burn increases apoptosis in the gut epithelium of mice. J Am Coll Surg. 1999;188:10–16.
66. Carter EA, Udall JN, Kirkham SE, Walker WA. Thermal injury and gastrointestinal function. I. Small intestinal nutrient absorption and DNA synthesis. J Burn Care Rehabil. 1986;7:469–474.
67. Deitch EA, Rutan R, Waymack JP. Trauma, shock, and gut translocation. New Horiz. 1996;4:289–299.
68. Gore DC, Wolf SE, Sanford A, Herndon DN, Wolfe RR. Influence of metformin on glucose intolerance and muscle catabolism following severe burn injury. Ann Surg. 2005;241:334–342.
69. Thomas SJ, Morimoto K, Herndon DN, Ferrando AA. The effect of prolonged euglycemic hyperinsulinemia on lean body mass after severe burn. Surgery. 2002;132:341–347.
70. Klein GL. Burn-induced bone loss: Importance, mechanisms, and management. J Burns Wounds. 2006;5:e5.
71. Jeschke MG, Barrow RE, Herndon DN. Extended hypermetabolic response of the liver in severely burned pediatric patients. Arch Surg. 2004;139:641–647.
72. Moshage H. Cytokines and the hepatic acute phase response. J Pathol. 1997;181::257–266.
73. American Burn Association. Verification Criteria Effective October 1, 2019. ameriburn.org http://ameriburn.org/quality-care/verification/verification-criteria/verification-criteria-effective-october-1-2019/ (2019).
74. Peck, M., Molnar, J. & Swart, D. A global plan for burn prevention and care. Bull. World Health Organ. 87, 802–803 (2009).
75. World Health Organization. Burn prevention: success stories, lessons learned https://apps.who.int/iris/bitstream/handle/10665/97938/9789241501187_eng.pdf (WHO, 2011)
76. Harvey, L. A., Connolley, S. & Harvey, J. G. Clothing-related burns in New South Wales, Australia: impact of legislation on a continuing problem. Burns 41, 58–64 (2015)
77. Haddon, W. The changing approach to the epidemiology, prevention, and amelioration of trauma: the transition to approaches etiologically rather than descriptively based. Inj. Prev. 5, 231–235 (1999).
78. Sadeghi-Bazargani, H. et al. Exploring possible causes of fatal burns in 2007 using Haddon’s Matrix: a qualitative study. J. Inj. Violence Res. 7, 1–6 (2015).
79. Ready, F. L. et al. Epidemiologic shifts for burn injury in Ethiopia from 2001 to 2016: implications for public health measures. Burns 44, 1839–1843 (2018).
80. Burgess, J., Watt, K., Kimble, R. M. & Cameron, C. M. Combining technology and research to prevent scald injuries (the Cool Runnings intervention): randomized controlled trial. J. Med. Internet Res. 20, e10361 (2018).
81. Parbhoo, A., Louw, Q. A. & Grimmer-Somers, K. Burn prevention programs for children in developing countries require urgent attention: a targeted literature review. Burns 36, 164–175 (2010).
82. Jin, R., Wu, P., Ho, J. K., Wang, X. & Han, C. Five-year epidemiology of liquefied petroleum gas-related burns. Burns 44, 210–217 (2018)
83. Teven, C. M. & Gottlieb, L. J. The four-quadrant approach to ethical issues in burn care. AMA J. Ethics 20, 595–601 (2018).
84. Mohammad, A., Branicki, F. & Abu-Zidan, F. M. Educational and clinical impact of Advanced Trauma Life Support (ATLS) courses: a systematic review. World J. Surg. 38, 322–329 (2013).
85. Breederveld, R. S., Nieuwenhuis, M. K., Tuinebreijer, W. E. & Aardenburg, B. Effect of training in the emergency management of severe burns on the knowledge and performance of emergency care workers as measured by an online simulated burn incident. Burns 37, 281–287 (2011).
86. Kearns, R. D. et al. Advanced burn life support for day-to-day burn injury management and disaster preparedness: stakeholder experiences and student perceptions following 56 advance burn life support crimes. J. Burn Care Res. 36, 455–464 (2015).
87. Klein, M. B. et al. Geographic access to burn center hospitals. JAMA 302, 1774–1781 (2009). This examination of geographical distribution of regional burn care highlights the variation in access to verified burn centres by ground and rotary air transport across the USA, with ~80% of the US population being within 2 hours from a verified burn centre, illustrating the potential for limited resources in a disaster.
88. Mosier, M. J. et al. Early acute kidney injury predicts progressive renal dysfunction and higher mortality in severely burned adults. J. Burn Care Res. 31, 83–92 (2010).
89. Kumar, A. B. et al. Fluid resuscitation mediates the association between inhalational burn injury and acute kidney injury in the major burn population. J. Crit. Care 38, 62–67 (2017)
90. Sine, C. R. et al. Acute respiratory distress syndrome in burn patients. J. Burn Care Res. 37, e461–e469 (2016).
91. Cochran, A. Inhalation injury and endotracheal intubation. J. Burn Care Res. 30, 190–191 (2009).
92. Amtmann, D. et al. Satisfaction with life over time in people with burn injury: a National Institute on Disability, Independent Living, and Rehabilitation Research burn model system study. Arch. Phys. Med. Rehabil. 101, S63–S70 (2020).
93. Wiechman, S. A. et al. Reasons for distress among burn survivors at 6, 12, and 24 months postdischarge: a burn injury model system investigation. Arch. Phys. Med. Rehabil. 99, 1311–1317 (2018).
94. Davé, D. R., Nagarjan, N., Canner, J. K., Kushner, A. L. & Stewart, B. T. Rethinking burns for low & middle-income countries: differing patterns of burn epidemiology, care seeking behavior, and outcomes across four countries. Burns 44, 1228–1234 (2018).
95. Young, A. W. et al. Guideline for burn care under austere conditions. J. Burn Care Res. 38, e497–e509 (2017).
96. Jeng, J., Gibran, N. & Peck, M. Burn care in disaster and other austere settings. Surg. Clin. North. Am. 94, 893–907 (2014).
97. American College of Surgeons. Advanced Trauma Life Support. facs.org https://www.facs.org/quality%20programs/trauma/atls (2019).
98. Roberts, G. et al. The Baux score is dead. Long live the Baux score: a 27-year retrospective cohort study of mortality at a regional burns service. J. Trauma. Acute Care Surg. 72, 251–256 (2012).
99. Abraham J.P., Plourde B.D., Vallez L.J., Nelson-Cheeseman B.B., Stark J.R., Sparrow E.M., Gorman J.M. Theory and Applications of Heat Transfer in Humans. John Wiley & Sons, Ltd.; Hoboken, NJ, USA: 2018. Skin Burns; pp. 723–739.
100. Snell J.A., Loh N.-H.W., Mahambrey T., Shokrollahi K. Clinical Review: The Critical Care Management of the Burn Patient. Crit. Care. 2013;17:241. doi: 10.1186/cc12706.
101. Alvarado R., Chung K.K., Cancio L.C., Wolf S.E. Burn Resuscitation. Burns. 2009;35:4–14. doi: 10.1016/j.burns.2008.03.008.
102. Pruitt B.A. Protection from excessive resuscitation: “Pushing the pendulum back” J. Trauma-Inj. Infect. Crit. Care. 2000;49:567–568. doi: 10.1097/00005373-200009000-00030.
103. Yoshino Y., Ohtsuka M., Kawaguchi M., Sakai K., Hashimoto A., Hayashi M., Madokoro N., Asano Y., Abe M., Ishii T., et al. The Wound/Burn Guidelines–6: Guidelines for the Management of Burns. J. Dermatol. 2016;43:989–1010. doi: 10.1111/1346-8138.13288
104. Chung K.K., Rhie R.Y., Lundy J.B., Cartotto R., Henderson E., Pressman M.A., Joe V.C., Aden J.K., Driscoll I.R., Faucher L.D., et al. A Survey of Mechanical Ventilator Practices Across Burn Centers in North America. J. Burn Care Res. 2016;37:e131–e139. doi: 10.1097/BCR.0000000000000270.
105. Ong Y.S., Samuel M., Song C. Meta-Analysis of Early Excision of Burns. Burns. 2006;32:145–150. doi: 10.1016/j.burns.2005.09.005.
106. Spronk I., Legemate C., Oen I., van Loey N., Polinder S., van Baar M. Health related quality of life in adults after burn injuries: A systematic review. PLoS ONE. 2018;13:e0197507. doi: 10.1371/journal.pone.0197507.
107. Yakupu A., Zhang J., Dong W., Song F., Dong J., Lu S. The epidemiological characteristic and trends of burns globally. BMC Public Health. 2022;22:1596. doi: 10.1186/s12889-022-13887
108. Hop M.J., Hiddingh J., Stekelenburg C.M., Kuipers H.C., Middelkoop E., Nieuwenhuis M.K., Polinder S., van Baar M.E. The LDI Study Group Cost-Effectiveness of Laser Doppler Imaging in Burn Care in the Netherlands. BMC Surg. 2013;13:2. doi: 10.1186/1471-2482-13-2.
109. Monstrey S., Hoeksema H., Verbelen J., Pirayesh A., Blondeel P. Assessment of Burn Depth and Burn Wound Healing Potential. Burns. 2008;34:761–769. doi: 10.1016/j.burns.2008.01.009.
110. Machens H.-G., Berger A.C., Mailaender P. Bioartificial Skin. CTO. 2000;167:88–94. doi: 10.1159/000016772.
111. Shores J.T., Gabriel A., Gupta S. Skin Substitutes and Alternatives: A Review. Adv. Ski. Wound Care. 2007;20:493. doi: 10.1097/01.ASW.0000288217.83128.f3.
112. Gosk J. Skin substitute the present and future Polim. Med. 2012;42:109–114
113. Li A.T., Moussa A., Gus E., Paul E., Yii E., Romero L., Lin Z.C., Padiglione A., Lo C.H., Cleland H., et al. Biomarkers for the Early Diagnosis of Sepsis in Burns: Systematic Review and Meta-Analysis. Ann. Surg. 2022; 275:654–662. doi: 10.1097/SLA.0000000000005198.
114. Branski L.K., Al-Mousawi A., Rivero H., Jeschke M.G., Sanford A.P., Herndon D.N. Emerging Infections in Burns. Surg. Infect. 2009;10:389–397. doi: 10.1089/sur.2009.024.
115. Rizzo J.A., Rowan M.P., Driscoll I.R., Chan R.K., Chung K.K. Perioperative Temperature Management During Burn Care. J. Burn Care Res. 2017;38:e277–e283. doi: 10.1097/BCR.0000000000000371.
116. Hayashida K., Akita S. Surgical Treatment Algorithms for Post-Burn Contractures. Burn. Trauma. 2017;5:9. doi: 10.1186/s41038-017-0074-z.
117. Knuth C.M., Auger C., Jeschke M.G. Burn-induced hypermetabolism and skeletal muscle dysfunction. Am. J. Physiol. Cell Physiol. 2021;321:C58–C71. doi: 10.1152/ajpcell.00106.2021.
118. Gauglitz G.G., Williams F.N., Herndon D.N., Jeschke M.G. Burns: Where are we standing with propranolol, oxandrolone, recombinant human growth hormone, and the new incretin analogs? Curr. Opin. Clin. Nutr. Met. Care. 2011;14:176. doi: 10.1097/MCO.0b013e3283428df1.
119. Hrynyk M., Neufeld R.J. Insulin and wound healing. Burns. 2014;40:433–446. doi: 10.1016/j.burns.2014.03.020.
120. Mochizuki H., Trocki O., Dominioni L., Brackett K.A., Joffe S.N., Alexander J.W. Mechanism of Prevention of Postburn Hypermetabolism and Catabolism by Early Enteral Feeding. Ann. Surg. 1984;200:297. doi: 10.1097/00000658-198409000-00007.
121. Mosier M.J., Pham T.N., Klein M.B., Gibran N.S., Arnoldo B.D., Gamelli R.L., Tompkins R.G., Herndon D.N. Early Enteral Nutrition in Burns: Compliance with Guidelines and Associated Outcomes in a Multicenter Study. J. Burn Care Res. 2011; 32:104–109. doi: 10.1097/BCR.0b013e318204b3be.
122. Magnotti L.J., Deitch E.A. Burns, Bacterial Translocation, Gut Barrier Function, and Failure. J. Burn Care Rehabil. 2005;26: 383–391. doi: 10.1097/01.bcr.0000176878.79267.e8.
2. Lee RC: Injury by electrical forces: pathophysiology, manifestations, and therapy. Current Problem Surgery. 1997.34, 677–764 (1997).
3. Nguyen CM, Chandler R, Ratanshi I, Logsetty S: in Handbook of Burns Vol. 1 (eds. Jeschke, M. G., Kamolz, L.-P., Sjöberg, F. & Wolf, S. E.) 529–547 (Springer, 2020).
4. Jeschke MG, Gauglitz GG, Kulp GA, Finnerty CC, Williams FN, Kraft R, Suman OE, Mlcak RP, Herndon DN: Long-term persistance of the pathophysiologic response to severe burn injury. PLoS One. 2011;6(7):
5. Jeschke MG, Chinkes DL, Finnerty CC, Kulp G, Suman OE, Norbury WB, Branski LK, Gauglitz GG, Mlcak RP, Herndon DN: Pathophysiologic response to severe burn injury. Ann Surg. 2008 Sep;248(3):387-401.
6. Jeschke, M. G. et al. Pathophysiologic response to severe burn injury. Ann. Surg. 248, 387–401 (2008).
7. Stanojcic, M., Abdullahi, A., Rehou, S., Parousis, A. & Jeschke, M. G. Pathophysiological response to burn injury in adults. Ann. Surg. 267, 576–584 (2018).
8. Schaefer T.J., Tannan S.C. Stat Pearls. Stat Pearls Publishing; Treasure Island, FL, USA: 2022. Thermal Burns.
9. Spies C., Trohman R.G. Narrative Review: Electrocution and Life-Threatening Electrical Injuries. Ann. Intern. Med. 2006;145:531–537. doi: 10.7326/0003-4819-145-7-200610030-00011.
10. Fish R.M. Electric Injury, Part II: Specific Injuries. J. Emerg. Med. 2000;18:27–34. doi: 10.1016/S0736-4679(99)00158-4.
11. Koh D.-H., Lee S.-G., Kim H.-C. Incidence and Characteristics of Chemical Burns. Burns. 2017;43:654–664. doi: 10.1016/j.burns.2016.08.037.
12. Bhattacharya S. Radiation Injury. Indian J. Plast. Surg. 2010;43:S91–S93. doi: 10.1055/s-0039-1699465.
13. Logsetty, S. et al. Mental health outcomes of burn: a longitudinal population-based study of adults hospitalized for burns. Burns 42, 738–744 (2016).
14. Mason, S. A. et al. Increased rate of long-term mortality among burn survivors. Ann. Surg. 269, 1192–1199 (2019).
15. Stone, J. et al. Outcomes in adult survivors of childhood burn injuries as compared with matched controls. J. Burn Care Res. 37, e166–e173 (2016).
16. Rybarczyk, M. M. et al. A systematic review of burn injuries in low- and middle-income countries: epidemiology in the WHO-defined African region. Afr. J. Emerg. Med. 7, 30–37 (2017)
17. Stylianou, N., Buchan, I. & Dunn, K. W. A review of the international Burn Injury Database (iBID) for England and Wales: descriptive analysis of burn injuries 2003–2011. BMJ Open 5, e006184 (2015).
18. Padalko, A., Cristall, N., Gawaziuk, J. P. & Logsetty, S. Social complexity and risk for pediatric burn injury: a systematic review. J. Burn Care Res. 40, 478–499 (2019).
19. Peck, M. & Pressman, M. A. The correlation between burn mortality rates from fire and flame and economic status of countries. Burns 39, 1054–1059 (2013).
20. Spiwak, R., Logsetty, S., Afifi, T. O. & Sareen, J. Severe partner perpetrated burn: examining a nationally representative sample of women in India. Burns 41, 1847–1854 (2015).
21. Smolle, C. et al. Recent trends in burn epidemiology worldwide: a systematic review. Burns 43, 249–257 (2017).
22. World Health Organization. Burns. WHO https://www.who.int/en/news-room/fact-sheets/detail/burns (WHO, 2018).
23. Peck, M. & Pressman, M. A. The correlation between burn mortality rates from fire and flame and economic status of countries. Burns 39, 1054–1059 (2013).
24. Greenhalgh, D. G. Management of burns. N. Engl. J. Med. 380, 2349–2359 (2019).
25. Bayuo, J., Agbenorku, P., Amankwa, R. & Agbenorku, M. Epidemiology and outcomes of burn injury among older adults in a Ghanaian tertiary hospital. Burns Open 2, 98–103 (2018).
26. Sanghavi, P., Bhalla, K. & Das, V. Fire-related deaths in India in 2001: a retrospective analysis of data. Lancet 373, 1282–1288 (2009).
27. Tegtmeyer, L. C. et al. Retrospective analysis on thermal injuries in children—demographic, etiological and clinical data of German and Austrian pediatric hospitals 2006–2015—approaching the new German burn registry. Burns 44, 150–157 (2018).
28. Dissanaike, S. & Rahimi, M. Epidemiology of burn injuries: highlighting cultural and socio-demographic aspects. Int. Rev. Psychiatry 21, 505–511 (2009).
29. Atwell, K., Bartley, C., Cairns, B. & Charles, A. The effect of pre-existing seizure disorders on mortality and hospital length of stay following burn injury. J. Burn Care Res. 40, 979–982 (2019).
30. Demling RH. Fluid replacement in burned patients. Surg Clin North Am. 1987;67:15–30.
31. Demling RH, Will JA, Belzer FO. Effect of major thermal injury on the pulmonary microcirculation. Surgery, 1978;83:746–751.
32. Clark WR. Death due to thermal trauma. Dolecek R, Brizio-Molteni L, Molteni A, Traber D (eds): “Endocrinology of thermal trauma” 1990:6–27.
33. Lund T, Reed RK. Acute hemodynamic effects of thermal skin injury in the rat. Circ Shock. 1986;20:105–114.
34. Leape LL. Kinetics of burn edema formation in primates. Ann Surg. 1972;176:223–226.
35. Demling RH, Mazess RB, Witt RM, Wolberg WH. The study of burn wound edema using dichromatic absorptiometry. J Trauma. 1978;18:124–128.
36. Settle JAD. Fluid therapy in burns. J Roy Soc Med. 1982;1:7–11.
37. Arturson G, Jakobsson OR. Oedema measurements in a standard burn model. Burns. 1985;1:1–7.
38. Leape LL. Initial changes in burns: tissue changes in burned and unburned skin of rhesus monkeys. J Trauma. 1970;10:488–492.
39. Onarheim H, Lund T, Reed R. Thermal skin injury: II. Effects on edema formation and albumin extravasation of fluid resuscitation with lactated Ringer’s, plasma, and hypertonic saline (2,400 mosmol/l) in the rat. Circ Shock. 1989;27:25–37.
40. Shires GT, Cunningham JN, Baker CR, Reeder SF. Alterations in cellular membrane dysfunction during hemorrhagic shock in primates. Ann Surg. 1972;176:288–295.
41. Nakayama S, Kramer GC, Carlsen RC, Holcroft JW, Cala PM. Amiloride blocks membrane potential depolarization in rat skeletal muscle during hemorrhagic shock (abstract). Circ Shock. 1984;13:106–107.
42. Mazzoni MC, Borgstrom P, Intaglietta M, Arfors KE. Lumenal narrowing and endothelial cell swelling in skeletal muscle capillaries during hemorrhagic shock. Circ Shock. 1989;29:27–39.
43. Brown JM, Grosso MA, Moore EE. Hypertonic saline and dextran: Impact on cardiac function in the isolated rat heart. J Trauma. 1990; 3 0:646–651.
44. Evans JA, Darlington DN, Gann DS. A circulating factor(s) mediates cell depolarization in hemorrhagic shock. Ann Surg. 1991; 213: 549–557.
45. Button B, Baker RD, Vertrees RA, Allen SE. Quantitative assessment of a circulating depolarizing factor in shock. Shock. 15;2001: 239–244.
46. Hart DW, Wolf SE, Mlcak R, Chinkes DL. Persistence of muscle catabolism after severe burn. Surgery. 2000; 128: 312–319.
47. Herndon DN, Abston S, Stein SD. Increased thromboxane B2 levels in the plasma of burned and septic burned patients. Surg Gynecol Obstet. 1984;159: 210–213.
48. Morykwas MJ, David LR, Schneider AM, Whang C. Use of sub atmospheric pressure to prevent progression of partial-thickness burns in a swine model. J Burn Care Rehabil. 1999;20:15–21.
49. Nwariaku FE, Sikes PJ, Lightfoot E, Mileski WJ, Baxter C. Effect of a bradykinin antagonist on the local inflammatory response following thermal injury. Burns. 1996;22:324–327.
50. Mlcak RP, Jeschke MG, Barrow RE, Herndon DN. The influence of age and gender on resting energy expenditure in severely burned children. Ann Surg. 2006;244:121–130.
51. Przkora R, Barrow RE, Jeschke MG, Suman OE. Body composition changes with time in pediatric burn patients. J Trauma. 2006;60:968–971.
52. Sheridan RL. A great constitutional disturbance. N Engl J Med. 2001;345:1271–1272.
53. Gauglitz GG, Herndon DN, Kulp GA, Meyer WJ 3rd, Jeschke MG. Abnormal insulin sensitivity persists up to three years in pediatric patients post-burn. J Clin Endocrinol Metab. 2009;94:1656–1664.
54. Jeschke MG, Chinkes DL, Finnerty CC, Julp G. Pathophysiologic response to severe burn injury. Ann Surg. 2008;248:387–401.
55. Herndon DN, Hart DW, Wolf SE, Chinkes DL, Wolfe RR. Reversal of catabolism by beta-blockade after severe burns. N Engl J Med. 2001;345: 1223–1229.
56. Bessey PQ, Jiang ZM, Johnson DJ, Smith RJ, Wilmore DW. Posttraumatic skeletal muscle proteolysis: the role of the hormonal environment. World J Surg. 1989;13:465–470.
57. Chang DW, DeSanti L, Demling RH. Anticatabolic and anabolic strategies in critical illness: a review of current treatment modalities. Shock. 1998;10:155–160.
58. Rennie MJ. Muscle protein turnover and the wasting due to injury and disease. Br Med Bull. 1985;41:257–264.
59. Childs C, Heath DF, Little RA, Brotherston M. Glucose metabolism in children during the first day after burn injury. Arch Emerg Med. 1990;7:135–147.
60. Hunt DG, Ivy JL. Epinephrine inhibits insulin-stimulated muscle glucose transport. J Appl Physiol. 2002;93:1638–1643.
61. Baron PW, Barrow RE, Pierre EJ, Herndon DN. Prolonged use of propranolol safely decreases cardiac work in burned children. J Burn Care Rehabil. 1997;18:223–227.
62. Michie DD, Goldsmith RS, Mason Jr AD. Effects of hydralazine and high molecular weight dextran upon the circulatory responses to severe thermal burns. Circ Res. 1963;13:46–48.
63. Chrysopoulo MT, Jeschke MG, Dziewulski P, Barrow RE, Herndon DN. Acute renal dysfunction in severely burned adults. J Trauma. 1999;46:141–144.
64. LeVoyer T, Cioffi WG Jr, Pratt L, Shippee R. Alterations in intestinal permeability after thermal injury. Arch Surg. 1992;127:26–29.
65. Wolf SE, Ikeda H, Matin S, Debroy MA. Cutaneous burn increases apoptosis in the gut epithelium of mice. J Am Coll Surg. 1999;188:10–16.
66. Carter EA, Udall JN, Kirkham SE, Walker WA. Thermal injury and gastrointestinal function. I. Small intestinal nutrient absorption and DNA synthesis. J Burn Care Rehabil. 1986;7:469–474.
67. Deitch EA, Rutan R, Waymack JP. Trauma, shock, and gut translocation. New Horiz. 1996;4:289–299.
68. Gore DC, Wolf SE, Sanford A, Herndon DN, Wolfe RR. Influence of metformin on glucose intolerance and muscle catabolism following severe burn injury. Ann Surg. 2005;241:334–342.
69. Thomas SJ, Morimoto K, Herndon DN, Ferrando AA. The effect of prolonged euglycemic hyperinsulinemia on lean body mass after severe burn. Surgery. 2002;132:341–347.
70. Klein GL. Burn-induced bone loss: Importance, mechanisms, and management. J Burns Wounds. 2006;5:e5.
71. Jeschke MG, Barrow RE, Herndon DN. Extended hypermetabolic response of the liver in severely burned pediatric patients. Arch Surg. 2004;139:641–647.
72. Moshage H. Cytokines and the hepatic acute phase response. J Pathol. 1997;181::257–266.
73. American Burn Association. Verification Criteria Effective October 1, 2019. ameriburn.org http://ameriburn.org/quality-care/verification/verification-criteria/verification-criteria-effective-october-1-2019/ (2019).
74. Peck, M., Molnar, J. & Swart, D. A global plan for burn prevention and care. Bull. World Health Organ. 87, 802–803 (2009).
75. World Health Organization. Burn prevention: success stories, lessons learned https://apps.who.int/iris/bitstream/handle/10665/97938/9789241501187_eng.pdf (WHO, 2011)
76. Harvey, L. A., Connolley, S. & Harvey, J. G. Clothing-related burns in New South Wales, Australia: impact of legislation on a continuing problem. Burns 41, 58–64 (2015)
77. Haddon, W. The changing approach to the epidemiology, prevention, and amelioration of trauma: the transition to approaches etiologically rather than descriptively based. Inj. Prev. 5, 231–235 (1999).
78. Sadeghi-Bazargani, H. et al. Exploring possible causes of fatal burns in 2007 using Haddon’s Matrix: a qualitative study. J. Inj. Violence Res. 7, 1–6 (2015).
79. Ready, F. L. et al. Epidemiologic shifts for burn injury in Ethiopia from 2001 to 2016: implications for public health measures. Burns 44, 1839–1843 (2018).
80. Burgess, J., Watt, K., Kimble, R. M. & Cameron, C. M. Combining technology and research to prevent scald injuries (the Cool Runnings intervention): randomized controlled trial. J. Med. Internet Res. 20, e10361 (2018).
81. Parbhoo, A., Louw, Q. A. & Grimmer-Somers, K. Burn prevention programs for children in developing countries require urgent attention: a targeted literature review. Burns 36, 164–175 (2010).
82. Jin, R., Wu, P., Ho, J. K., Wang, X. & Han, C. Five-year epidemiology of liquefied petroleum gas-related burns. Burns 44, 210–217 (2018)
83. Teven, C. M. & Gottlieb, L. J. The four-quadrant approach to ethical issues in burn care. AMA J. Ethics 20, 595–601 (2018).
84. Mohammad, A., Branicki, F. & Abu-Zidan, F. M. Educational and clinical impact of Advanced Trauma Life Support (ATLS) courses: a systematic review. World J. Surg. 38, 322–329 (2013).
85. Breederveld, R. S., Nieuwenhuis, M. K., Tuinebreijer, W. E. & Aardenburg, B. Effect of training in the emergency management of severe burns on the knowledge and performance of emergency care workers as measured by an online simulated burn incident. Burns 37, 281–287 (2011).
86. Kearns, R. D. et al. Advanced burn life support for day-to-day burn injury management and disaster preparedness: stakeholder experiences and student perceptions following 56 advance burn life support crimes. J. Burn Care Res. 36, 455–464 (2015).
87. Klein, M. B. et al. Geographic access to burn center hospitals. JAMA 302, 1774–1781 (2009). This examination of geographical distribution of regional burn care highlights the variation in access to verified burn centres by ground and rotary air transport across the USA, with ~80% of the US population being within 2 hours from a verified burn centre, illustrating the potential for limited resources in a disaster.
88. Mosier, M. J. et al. Early acute kidney injury predicts progressive renal dysfunction and higher mortality in severely burned adults. J. Burn Care Res. 31, 83–92 (2010).
89. Kumar, A. B. et al. Fluid resuscitation mediates the association between inhalational burn injury and acute kidney injury in the major burn population. J. Crit. Care 38, 62–67 (2017)
90. Sine, C. R. et al. Acute respiratory distress syndrome in burn patients. J. Burn Care Res. 37, e461–e469 (2016).
91. Cochran, A. Inhalation injury and endotracheal intubation. J. Burn Care Res. 30, 190–191 (2009).
92. Amtmann, D. et al. Satisfaction with life over time in people with burn injury: a National Institute on Disability, Independent Living, and Rehabilitation Research burn model system study. Arch. Phys. Med. Rehabil. 101, S63–S70 (2020).
93. Wiechman, S. A. et al. Reasons for distress among burn survivors at 6, 12, and 24 months postdischarge: a burn injury model system investigation. Arch. Phys. Med. Rehabil. 99, 1311–1317 (2018).
94. Davé, D. R., Nagarjan, N., Canner, J. K., Kushner, A. L. & Stewart, B. T. Rethinking burns for low & middle-income countries: differing patterns of burn epidemiology, care seeking behavior, and outcomes across four countries. Burns 44, 1228–1234 (2018).
95. Young, A. W. et al. Guideline for burn care under austere conditions. J. Burn Care Res. 38, e497–e509 (2017).
96. Jeng, J., Gibran, N. & Peck, M. Burn care in disaster and other austere settings. Surg. Clin. North. Am. 94, 893–907 (2014).
97. American College of Surgeons. Advanced Trauma Life Support. facs.org https://www.facs.org/quality%20programs/trauma/atls (2019).
98. Roberts, G. et al. The Baux score is dead. Long live the Baux score: a 27-year retrospective cohort study of mortality at a regional burns service. J. Trauma. Acute Care Surg. 72, 251–256 (2012).
99. Abraham J.P., Plourde B.D., Vallez L.J., Nelson-Cheeseman B.B., Stark J.R., Sparrow E.M., Gorman J.M. Theory and Applications of Heat Transfer in Humans. John Wiley & Sons, Ltd.; Hoboken, NJ, USA: 2018. Skin Burns; pp. 723–739.
100. Snell J.A., Loh N.-H.W., Mahambrey T., Shokrollahi K. Clinical Review: The Critical Care Management of the Burn Patient. Crit. Care. 2013;17:241. doi: 10.1186/cc12706.
101. Alvarado R., Chung K.K., Cancio L.C., Wolf S.E. Burn Resuscitation. Burns. 2009;35:4–14. doi: 10.1016/j.burns.2008.03.008.
102. Pruitt B.A. Protection from excessive resuscitation: “Pushing the pendulum back” J. Trauma-Inj. Infect. Crit. Care. 2000;49:567–568. doi: 10.1097/00005373-200009000-00030.
103. Yoshino Y., Ohtsuka M., Kawaguchi M., Sakai K., Hashimoto A., Hayashi M., Madokoro N., Asano Y., Abe M., Ishii T., et al. The Wound/Burn Guidelines–6: Guidelines for the Management of Burns. J. Dermatol. 2016;43:989–1010. doi: 10.1111/1346-8138.13288
104. Chung K.K., Rhie R.Y., Lundy J.B., Cartotto R., Henderson E., Pressman M.A., Joe V.C., Aden J.K., Driscoll I.R., Faucher L.D., et al. A Survey of Mechanical Ventilator Practices Across Burn Centers in North America. J. Burn Care Res. 2016;37:e131–e139. doi: 10.1097/BCR.0000000000000270.
105. Ong Y.S., Samuel M., Song C. Meta-Analysis of Early Excision of Burns. Burns. 2006;32:145–150. doi: 10.1016/j.burns.2005.09.005.
106. Spronk I., Legemate C., Oen I., van Loey N., Polinder S., van Baar M. Health related quality of life in adults after burn injuries: A systematic review. PLoS ONE. 2018;13:e0197507. doi: 10.1371/journal.pone.0197507.
107. Yakupu A., Zhang J., Dong W., Song F., Dong J., Lu S. The epidemiological characteristic and trends of burns globally. BMC Public Health. 2022;22:1596. doi: 10.1186/s12889-022-13887
108. Hop M.J., Hiddingh J., Stekelenburg C.M., Kuipers H.C., Middelkoop E., Nieuwenhuis M.K., Polinder S., van Baar M.E. The LDI Study Group Cost-Effectiveness of Laser Doppler Imaging in Burn Care in the Netherlands. BMC Surg. 2013;13:2. doi: 10.1186/1471-2482-13-2.
109. Monstrey S., Hoeksema H., Verbelen J., Pirayesh A., Blondeel P. Assessment of Burn Depth and Burn Wound Healing Potential. Burns. 2008;34:761–769. doi: 10.1016/j.burns.2008.01.009.
110. Machens H.-G., Berger A.C., Mailaender P. Bioartificial Skin. CTO. 2000;167:88–94. doi: 10.1159/000016772.
111. Shores J.T., Gabriel A., Gupta S. Skin Substitutes and Alternatives: A Review. Adv. Ski. Wound Care. 2007;20:493. doi: 10.1097/01.ASW.0000288217.83128.f3.
112. Gosk J. Skin substitute the present and future Polim. Med. 2012;42:109–114
113. Li A.T., Moussa A., Gus E., Paul E., Yii E., Romero L., Lin Z.C., Padiglione A., Lo C.H., Cleland H., et al. Biomarkers for the Early Diagnosis of Sepsis in Burns: Systematic Review and Meta-Analysis. Ann. Surg. 2022; 275:654–662. doi: 10.1097/SLA.0000000000005198.
114. Branski L.K., Al-Mousawi A., Rivero H., Jeschke M.G., Sanford A.P., Herndon D.N. Emerging Infections in Burns. Surg. Infect. 2009;10:389–397. doi: 10.1089/sur.2009.024.
115. Rizzo J.A., Rowan M.P., Driscoll I.R., Chan R.K., Chung K.K. Perioperative Temperature Management During Burn Care. J. Burn Care Res. 2017;38:e277–e283. doi: 10.1097/BCR.0000000000000371.
116. Hayashida K., Akita S. Surgical Treatment Algorithms for Post-Burn Contractures. Burn. Trauma. 2017;5:9. doi: 10.1186/s41038-017-0074-z.
117. Knuth C.M., Auger C., Jeschke M.G. Burn-induced hypermetabolism and skeletal muscle dysfunction. Am. J. Physiol. Cell Physiol. 2021;321:C58–C71. doi: 10.1152/ajpcell.00106.2021.
118. Gauglitz G.G., Williams F.N., Herndon D.N., Jeschke M.G. Burns: Where are we standing with propranolol, oxandrolone, recombinant human growth hormone, and the new incretin analogs? Curr. Opin. Clin. Nutr. Met. Care. 2011;14:176. doi: 10.1097/MCO.0b013e3283428df1.
119. Hrynyk M., Neufeld R.J. Insulin and wound healing. Burns. 2014;40:433–446. doi: 10.1016/j.burns.2014.03.020.
120. Mochizuki H., Trocki O., Dominioni L., Brackett K.A., Joffe S.N., Alexander J.W. Mechanism of Prevention of Postburn Hypermetabolism and Catabolism by Early Enteral Feeding. Ann. Surg. 1984;200:297. doi: 10.1097/00000658-198409000-00007.
121. Mosier M.J., Pham T.N., Klein M.B., Gibran N.S., Arnoldo B.D., Gamelli R.L., Tompkins R.G., Herndon D.N. Early Enteral Nutrition in Burns: Compliance with Guidelines and Associated Outcomes in a Multicenter Study. J. Burn Care Res. 2011; 32:104–109. doi: 10.1097/BCR.0b013e318204b3be.
122. Magnotti L.J., Deitch E.A. Burns, Bacterial Translocation, Gut Barrier Function, and Failure. J. Burn Care Rehabil. 2005;26: 383–391. doi: 10.1097/01.bcr.0000176878.79267.e8.
Article Sidebar
Published
Jun 24, 2024
Article Details
How to Cite
Saima Azam, Muhammad Kamran Taj, Imran Taj, Sakina Khan, Masroora Ali Khan, Syed Ayesha Ali, Sikander Azam, Nazia Khan, Nargis Taj, Fahmeeda Rehman, Asima Safdar, Sumyya Jaffer, & Syed Jamal Shah. (2024). THE BURN WOUND INJURY ITS CAUSES AND MANAGEMENT. Journal of Population Therapeutics and Clinical Pharmacology, 31(6), 2596-2512. https://doi.org/10.53555/jptcp.v31i6.6941
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Author Biographies
Saima Azam
Center for Advanced Studies in Vaccinology and Biotechnology, University of Balochistan, Quetta, Pakistan
Muhammad Kamran Taj
Center for Advanced Studies in Vaccinology and Biotechnology, University of Balochistan, Quetta, Pakistan
Imran Taj
Center for Advanced Studies in Vaccinology and Biotechnology, University of Balochistan, Quetta, Pakistan
Sakina Khan
Center for Advanced Studies in Vaccinology and Biotechnology, University of Balochistan, Quetta, Pakistan
Masroora Ali Khan
Sardar Bahdur Khan Women’s University, Quetta, Pakistan
Syed Ayesha Ali
Sardar Bahdur Khan Women’s University, Quetta, Pakistan
Sikander Azam
Khyber Medical University, Peshawar, Pakistan
Nazia Khan
Sandeman Provincial Hospital Quetta, Pakistan
Nargis Taj
Bolan University of Medical and Health Sciences, Quetta, Pakistan
Fahmeeda Rehman
Sardar Bahdur Khan Women’s University, Quetta, Pakistan
Asima Safdar
University of Balochistan, Quetta, Pakistan
Sumyya Jaffer
Center for Advanced Studies in Vaccinology and Biotechnology, University of Balochistan, Quetta, Pakistan
Syed Jamal Shah
Center for Advanced Studies in Vaccinology and Biotechnology, University of Balochistan, Quetta, Pakistan
How to Cite
Saima Azam, Muhammad Kamran Taj, Imran Taj, Sakina Khan, Masroora Ali Khan, Syed Ayesha Ali, Sikander Azam, Nazia Khan, Nargis Taj, Fahmeeda Rehman, Asima Safdar, Sumyya Jaffer, & Syed Jamal Shah. (2024). THE BURN WOUND INJURY ITS CAUSES AND MANAGEMENT. Journal of Population Therapeutics and Clinical Pharmacology, 31(6), 2596-2512. https://doi.org/10.53555/jptcp.v31i6.6941