Improving survival in the burned patient.

Area of Science:

• Burn Care
• Trauma Surgery
• Critical Care Medicine

Background:

• Burn patient survival has improved over the last decade across most burn units.
• No single factor has been identified as solely responsible for these survival improvements.
• Significant survival gains are observed in patients with 50-90% Total Body Surface Area (BSA) burns, but not in those with >90% BSA burns.

Purpose of the Study:

• To review factors contributing to improved burn patient survival.
• To highlight the persistent challenge of high mortality in extensive burns (>90% BSA).
• To discuss ongoing research into advanced treatments for severe burns.

Main Methods:

• Review of clinical data and literature on burn patient survival.
• Analysis of survival trends based on burn severity (percentage of BSA).
• Discussion of current and investigational treatment modalities.

Main Results:

• Multiple factors contribute to improved survival, including topical antimicrobials, antibiotics, critical care, wound care, and nutritional support.
• Survival rates for patients with burns >90% BSA have shown minimal improvement.
• The MUSC burn service is exploring early excision and grafting with cultured epithelial autografts for severe burns.

Conclusions:

• Improved survival in burn patients is multifactorial, with no single dominant factor identified.
• Advanced treatments, such as skin substitutes and cultured skin grafts, are needed to improve outcomes for extensive burns.
• Further investigation into aggressive surgical interventions is warranted for the most severe burn cases.