An Evaluation of Nutritional Practice in a Paediatric Burns Unit (Original Articles) (Clinical Report)

An Evaluation of Nutritional Practice in a Paediatric Burns Unit (Original Articles) (Clinical Report)

An Evaluation of Nutritional Practice in a Paediatric Burns Unit (Original Articles) (Clinical Report)

There have been rapid advances in burn care since 1939. Before World War II, the average burn size associated with a 50% mortality rate was less than 30% of total body surface area (TBSA) burnt; currently, the LD50 has increased to 65–80% TBSA. (1) This progress came about from effective resuscitation, infection control, early surgery, management of inhalation injuries and nutritional support. A burn injury exceeding 15–20% TBSA evokes a major and integrated systemic metabolic stress response, with changes in the metabolism of carbohydrates, proteins and lipids, thermal homoeostasis, and haematological, biochemical and endocrine systems, leading to severe catabolism, tissue breakdown, diminished immunity, retarded wound healing and multi-organ dysfunction. (2) These conditions can persist until wound coverage and healing have completed–sometimes for up to 2 years. (2)

An Evaluation of Nutritional Practice in a Paediatric Burns Unit (Original Articles) (Clinical Report)

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