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Head and neck burns. Evaluation and current management.

J D Osguthorpe1

  • 1Department of Otolaryngology and Communicative Sciences, Medical University of South Carolina, Charleston, SC 29425.

Archives of Otolaryngology--Head & Neck Surgery
|September 1, 1991
PubMed
Summary

Head and neck burns affect over half of hospitalized burn patients, with inhalation injuries posing significant risks. Advances in care have reduced mortality, but respiratory issues and sepsis remain primary concerns.

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Area of Science:

  • Medical research
  • Burn care
  • Trauma surgery

Background:

  • Head and neck burns are common, affecting over 50% of 150,000 annual US hospitalizations.
  • Inhalation injuries occur in 3-7% of burn patients, increasing mortality risk.
  • Mortality for extensive burns (75-90% body surface area) has decreased from near 100% to 24%.

Purpose of the Study:

  • To review the management of head and neck burn injuries.
  • To highlight the challenges in treating concomitant inhalation injuries.
  • To discuss strategies for minimizing sepsis and addressing reconstructive needs.

Main Methods:

  • Diagnosis of inhalation injury via laryngoscopy.
  • Airway management including intubation and tracheotomy.

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  • Serial bronchoscopy for airway clearance.
  • Surgical management including eschar excision and autografting.
  • Temporary wound coverage with allografts or skin substitutes.

    • Main Results:

    • Respiratory complications and sepsis are the leading causes of death.
    • Early surgical intervention (eschar excision, grafting) is crucial for sepsis control.
    • Advances in fluid resuscitation and specialized care have improved survival rates.
    • Head and neck reconstruction requires attention to aesthetic units.

    Conclusions:

    • Effective management of head and neck burns involves multidisciplinary care.
    • Prompt diagnosis and treatment of inhalation injuries are vital.
    • Minimizing sepsis through surgical intervention is key to survival.
    • Reconstructive and rehabilitative challenges in the head and neck must be addressed comprehensively.