الفهرس 
Burn InjuryOnly 14 pages are availabe for public view
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Abstract
Burned patients don’t suffer only from cutaneous affection but also from systemic changes associated with serious pathophysiological complications.
The body response to burn injury is determined by the depth and extent of burned area, which may be either local pathological changes (Jackson’s burn zones : zone of coagulation, zone of stasis, zone of hyperemia) or general pathological changes including (fluid changes, cardiovascular and haemodynamic changes, renal changes, pulmonary changes, hematological changes, immunological changes, gastrointestinal changes and metabolic changes).
The magnitude of post burn hypermetabolism increase in a curvilinear manner reaching its maximum level 2 – 2.5 times the normal metabolic rate in patients with burn involving 50% of the body surface area. The resting energy expenditure increase as much as 100% above predictions.
The hypermetabolic changes include carbohydrate, fat and protein changes. The carbohydrate metabolic
changes include increased rate of glycolysis, glycogenolysis and gluconeogenesis, while fat metabolic changes include increased lipolysis and protein changes summarized in increased proteolysis.
Patients whose burns are extensive require intensive nutritional support until their wounds heal completely. Different methods of estimating caloric requirement and nutritional support are available.
The management of metabolic changes can be done by nonpharmacological and pharmacological modalities. The nonpharmacological modalities include early excision and closure, prompt treatment of sepsis, nutritional support, environmental support, exercise and adjunctive measures. While the pharmacological modalities include the use of anabolic hormones and anticatabolic agents.