[Thermal trauma in a combination with respiratory tract burn]

The detection rate of microbial contamination of burn wounds after flame burn was studied in dynamics to 3 weeks in 56 patients forming 2 similar groups: basic--with thermo-inhalation lesions (TIL) and control--without TIL. General area of skin burns in all the patients was less than 50% of the body surface, on average it was 40%, the area of deep burns was 23%. Cytological and bacteriologic methods were used for study microphlora in the sputum and in bronchoalveolar lavage. There were 186 cases of wound microbial contamination (gram-negative microorganisms--64.4% cases, gram-positive--34%, pathogenic fungi--1.6%). In 80% cases the microphlora of the wounds was polymicrobial, in 47% cases the microphlora were detected on the second week. Microphlora was detected 2 times more often in the basic group than in the control, corresponded to skin burn area; the greatest exceeding of critical level of wound contamination was revealed on the first 2 weeks. In TIL besides wound contamination, polymicrobial microphlora revealed in tracheobronchial tree, presented on the first 2 weeks with association of gram-positive and gram-negative microorganisms, combining on week 3 with fungal phlora. Early leukocytosis, not reducing during first 3 weeks of the study, due to intoxication by burn products, occurred in TIL. Early lymphopenia in TIL was the sign of resistant immunodeficiency.