Die Akutversorgung von Brandverletzten

Abstract

Burn injuries can be caused by thermal, electrical, chemical, or mechanical trauma or radiation and are relatively rare, as they represent only about 1% of all emergencies. They are caused by accidents at home, during recreational activities, or in the occupational environment. Minor burn traumas are much more common than severe burn injuries with their systemic and potentially life-threatening effects. Altogether, these circumstances may result in a lack of routine for treating such injuries properly by physicians and their colleagues in the emergency room or intensive care unit. A clearly outlined concept for preclinical and clinical treatment can be the keystone of successful further clinical progress. The following article summarizes the current guidelines for first medical aid at the injury scene, burn stabilization and assessment in the emergency room, and the interdisciplinary approach for further clinical care. The treatment of dermatologic emergencies (acute epidermolytic syndromes) or caustic injuries by chemical agents is similar to the treatment of burn victims in many aspects but must be adapted in selected cases.

Standardisierung der Initialbehandlung von Schwerbrandverletzten: Die notwendige Übertragung von Konzepten aus der Schwerverletztenversorgung

“…Alternativ können auch intraossäre Zugänge verwendet werden [5]. Die Verwendung von balancierten kristalloiden, idealerweise vorgewärmten Flüssigkeitslösungen wird empfohlen [14,17,25,26].…”

From First Aid to Plastic Surgery - Special Considerations in the Treatment of the Burned Hand

“…Daneben besteht die Möglichkeit der Aufarbeitung von Spalthauttransplantaten als Gitternetz (Abb. 6b) mit unterschiedlichen Expansionsraten ("mesh grafts") bis hin zur Meek-Technik (9). Die Anwendung von "Meshgrafts" im Bereich der Hand wird jedoch in der Literatur kontrovers diskutiert.…”

“…Lässt die klinische Situation keine sofortige Deckung zu, kann auf eine Vielzahl von temporären Deckungsverfahren zurückgegriffen werden (9). Seit vielen Jahren sind Xenotransplantate im klinischen Gebrauch, wobei heutzutage vorwiegend Schweinehaut zur Behandlung von Verbrennungwunden eingesetzt wird (16).…”

Methodological approaches to evidence based guidelines in burn injury

“…The score in this domain was the lowest of all, with a mean of 17%. Four CPGs (17%) scored >60% (32,33,36,40). Potential conflicts of interests of CPG developers were recorded only in 3 CPGs (12%) (32,33,40).…”

“…Four CPGs (17%) scored >60% (32,33,36,40). Potential conflicts of interests of CPG developers were recorded only in 3 CPGs (12%) (32,33,40). Evidence-based CPGs scored much better but still only about one third of them reported these issues as compared to 8% of CB CPGs.…”