Treatment and repair of burn wound sepsis

Burn is a common wound in peacetime and wartime, which hurts the body surface. However, if the burn area exceeds 30% of the body surface area (half of children), it will affect the physiological and pathophysiological changes of many organs and systems in the whole body. The larger the burn area, the deeper the burn depth, the greater the blow to the body, and the improvement of the cure rate and quality of life. Burn treatment includes two aspects: maintaining internal environment stability and wound repair.

As far as the wound is concerned, the wound repair with different burn depths has its own characteristics:

The superficial second-degree burn wound is a superficial repair of epidermis and dermis, which does not involve the remodeling of connective tissue and wound. The basic process of repair is the proliferation, differentiation and migration of epithelial cells;

The tissue damage of deep second-degree burn wounds includes deep dermal damage besides epidermis. In addition to the proliferation, differentiation and migration of epithelial cells in residual skin appendages, the basic process of repair includes the proliferation of vascular endothelial cells and fibroblasts, connective tissue and wound remodeling.

The third-degree burn wound is a full-thickness skin defect. The basic process of repair is the proliferation of vascular endothelial cells, fibroblasts and connective tissue, and finally the wound is reconstructed. Due to the full-thickness destruction of dermis and the lack of residual skin attachments, except a small-scale full-thickness skin defect can be repaired by the proliferation and differentiation of epithelial cells at the edge of wound and the migration on granulation tissue, a large-scale full-thickness skin defect exceeds the expansion ability of epithelial cells at the edge of wound, and epidermal repair can only be completed by transplanting autologous free flap or cultured epidermal cell membrane.

The repair of burn wounds is closely related to the correctness of treatment and runs through the whole process of treatment. The treatment of severe burns is a systematic process, not only to save lives, but also to reduce deformities, restore functions and improve the quality of life as much as possible. Practice has proved that there are many factors affecting functional recovery, including injury, early treatment and rehabilitation measures. As far as wound repair is concerned, there are systemic and local factors, biochemical, histological, physical and microenvironment factors. At different stages after injury, such as cell proliferation, granulation tissue formation and wound remodeling, the influencing factors are also different. It is very important to understand the whole picture and essence of wound repair and take corresponding measures.