[Tolerance to heat in burnt patients]

Body temperature regulated within the homeostatic range, is essential for the stability of the "milieu intérieur" and for maintaining intact body functioning. Those individuals in the population who cannot adapt to heat stress and whose body temperature will rise earlier and at a higher rate than expected under predetermined conditions are considered as 'heat intolerant". Patients with deep burns are intolerant to heat because of the injured dermis and the destruction of the imbedded eccrine sweat glands and the peripheral vascular bed and its post-synaptic innervations, which common treatment with split-thickness skin grafts cannot restore. Thus, the extent of the inability to regulate body temperature is associated with the percent of the burnt area - the Larger the affected area, the lower is the ability to thermoregulate. The cumulative data suggest that the state of heat intolerance in deep-burnt patients is a persisting condition and cannot be alleviated by heat acclimation.