Emergency War Surgery NATO Handbook: Part I: Types of Wounds and Injuries: Chapter III: Burn Injury

Pathophysiology

United States Department of Defense
Peer Review Status: Internally Peer Reviewed

Thermal injury, regardless of the etiologic agent, results in cell death by coagulation necrosis. In areas of cell death and cell damage, capillary permeability is increased with the loss of integrity of the vascular system and the escape of the nonformed blood elements. This is manifested clinically by edema, which forms most rapidly in the immediate postburn period and reaches a maximum in the second postburn day. Thereafter, as vascular integrity is restored and fluid resorption begins, edema slowly resolves. This increase in capillary permeability results in a decrease in blood volume and an increase in blood viscosity, causing an increase in peripheral resistance and a decrease in cardiac output. Fluid resuscitation is carried out in the immediate postburn period to minimize these changes by maintaining blood volume at a level adequate for organ perfusion.

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Operational Medicine 2001

Health Care in Military Settings

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