The short-term and long-term effect of burn on organ dysfunction: mechanisms and strategies

Burns constitute a form of severe trauma and may affect multi-organ systems. Secondary multi-organ dysfunction is the primary driver of disability, death, and poor prognosis in patients with severe burns, and has become a pressing global public health challenge. In the acute phase of burns, hypovolemic shock and uncontrolled systemic inflammatory response are the most important lethal mechanisms. In addition to localized skin damage, burns can rapidly induce acute dysfunction in the cardiovascular, immune, endocrine, coagulation, musculoskeletal, digestive, and central nervous systems. The pathological pathways of various organs interact and amplify one another in a cascade, forming a self-perpetuating cycle that exacerbates the condition and can rapidly progress to multi-organ dysfunction, leading to premature mortality. This article presents a comprehensive review of burn-related literature published over the past decade. Recent studies have revealed that burns are not merely acute trauma but a chronic disease. Severe burns are characterized by chronic pathological progression. Burn survivors remain in a state of hypermetabolism, chronic inflammation, oxidative stress imbalance, and endocrine disruption following injury, which can lead to organ fibrosis, chronic metabolic abnormalities, and long-term neurocognitive impairment. Their physical motor function, mental and psychological health, and overall quality of life may progressively deteriorate for years or even decades after the injury. This article provides a comprehensive review of the pathological mechanisms underlying acute and chronic multi-organ injury caused by severe burns, outlines comprehensive prevention and treatment strategies combining symptomatic interventions during the acute phase with long-term targeted repair, summarizes the limitations of existing technologies, and explores the application prospects of novel intervention targets and repair techniques, thereby providing a theoretical basis for the standardized prevention and treatment of burn-related multi-organ injury throughout its entire course.