Intensive care of burn injuries: principles of treatment

Mantas Fomkinas1, Žilvinas Jucius1, Gediminas Samulėnas2  

1Lithuanian University of Health Sciences, Academy of Medicine, A. Mickevičiaus st 9, LT 44307, Kaunas, Lithuania.

2Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Department of Plastic and Reconstructive Surgery, Eivenių st 2, LT 50009 Kaunas, Lithuania.


Burns are one of the most damaging and life-threatening injuries and the fourth most common type of injury worldwide, following traffic accidents, falls and interpersonal violence. Burns can be classified according to the main damaging factor – hot liquid or steam, flame or contact with a hot object, noxious chemicals, electric current and radiation. Thermal damage to the skin results in necrosis of the epidermis and deeper tissues. Also, a severe burn triggers a mass systemic response that disrupts the homeostasis. Although significant progress has been made in recent decades in the treatment and care of patients who have experienced burns. Despite these advances in treatment strategies, including better wound care, infection control, and inhalation injury management, the severity of the burn injury and the threat to the victim’s life vary with the extent of the burn, from minor to major or critical, causing complex metabolic changes and risk for life. Accordingly, the treatment of burns is based on specialized intensive care, wound treatment, infection control, treatment of inhalation injuries, and correction of the hypermetabolic response to trauma. However, major burns remain threatening injuries affecting almost all organ systems and affecting morbidity and mortality. Therefore, understanding these physiological consequences and the ability to accurately assess the extent of injury are important in understanding the principles of treatment and applying them in practice. Although, much progress has been made in the care and treatment of burned patients, the principles of treatment can be complex, as some treatments remain controversial due to a lack of high level scientific evidence.


Keywords: burn injuries, burns, intensive care unit, ICU, burn shock, resuscitation.