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Life, Death

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Invasive burn wound infections

  Invasive burn wound infections are infections that go deeper than just the top layer of skin and can cause tissue necrosis or death in the wound bed, skin grafts and surrounding tissue. Necrosis may present as red skin early on that slowly changes to a purple/blue hue before finally turning a purple or black color.   How to tell if a burn is infected   Invasive burn wound infections can be identified by the burn wound bed changing color, oozing and producing a foul odor. You may also experience a slow loss of sensation in the affected parts. While invasive wound infections do not always turn into sepsis or septic shock, medical attention should be sought early to prevent significant tissue loss or amputation.   Treatment options   Treatment options for invasive wound infections include cleaning the infected tissue, administering oral or intravenous (IV) antibiotics and applying antimicrobial ointment. If the infection continues to progress, aggressive surgical intervention may be necessary to remove all of the dead and infected skin, tissue and muscle (which may include amputation) to salvage as much healthy skin and tissue as possible and stop the infection from spreading. https://burncenters.com/community/is-your-burn-wound-infected-heres-how-to-tell/

Sepsis and septic shock

  Sepsis is a generalized infection that has spread throughout the body and can be deadly for those trying to heal from burns, wounds or other comorbidities. It is complicated to diagnose sepsis and septic shock as they have become terms used to describe generalized infections of the body. However, burn patients who are delayed in receiving medical treatment or having their wounds or dead tissue cleaned and debrided are at the greatest risk of developing sepsis and septic shock. Sepsis can be extremely life-threatening, especially to those with compromised immune systems or comorbidities, because it negatively affects the body’s ability to heal.   How to tell if a burn is infected   To be diagnosed with sepsis, another infection usually needs to be present. However, according to the American Burn Association, the symptoms of sepsis include a progressively rapid heartbeat (over 110 beats per minute), a fever, rapid breathing (over 25 breaths per minute), high blood sugar (without a history of diabetes), inability to eat food orally and the presence of an infection. Of course, these criteria may differ when diagnosing children.   *Sepsis and septic shock are medical emergencies that require immediate transfer to a hospital. https://burncenters.com/community/is-your-burn-wound-infected-heres-how-to-tell/

Sepsis: The signs and symptoms of sepsis include:

• Rise in temperature.
• Progressive tachycardia (an abnormally rapid heart rate).
• Progressive tachypnea (abnormal, rapid breathing).
• Thrombocytopenia (low blood platelet count-this condition is not applicable until 3 days after initial resuscitation).
• Hyperglycemia (elevated blood glucose level) in the absence of already existing diabetes mellitus.
• Inability to proceed with enteral feedings (supply of nutrients directly into the gastrointestinal tract) for more than 24 hours.
• Presence of infection that has been confirmed through a culture test or identified from a pathologic tissue source.

Bacterial Infections: In the early stage of infection, Staphylococcus aureus is the first microorganism to be identified in burn wound infection, including the Methicillin-resistant Staphylococcus aureus (MRSA). After five days following burn injury, Pseudomonas aeruginosa is common in burn wounds and contributes to the development of biofilms. In the later stages, fungal or yeast infections can either occur independently or in unison with a pre-existing bacterial infection.   Fungal Infections: The signs and symptoms of fungal infections include:

• There will be a change in the wound appearance, especially the unanticipated separation of eschar, which is the classical sign of invasion of fungal infections in a burn wound.
• A partial-thickness burn gets rapidly converted to a deep-thickness or a full-thickness burn wound.
• The burn wound tissues start to blacken.
• A persistent fever that remains unaffected by antibiotic therapy.
https://www.icliniq.com/articles/infectious-diseases/burn-wound-infections

Phase one lasted up until day 5, phase two up until day 15 and phase three until the end of the study’s observational period, which was at day 150. They found that these phases differed significantly in their mortality rates and positive blood culture results. Phase two and three had the majority of deaths, at 63%. Phase three also saw a renewal of positive blood cultures, which may indicate inability to overcome the infection or growth of secondary infections.   https://www.news-medical.net/health/The-Stages-of-Sepsis.aspx