J.Jpn. Surg. Soc.. 86(9): 997-1000, 1985

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Report on the annual meeting

PHYSIOLOGICAL RESPONSES AND INITIAL TREATMENT OF EXTENSIVE BURNS

Two hundred and twenty seven patients with extensive burns were treated at our department during the period 1975 to 1984, the overall mortality rate being 48.5%.
Physiological responses were analysed after dividing the patients into three groups according to the year of treatment, the first group consisting of 83 patients treated during 1976ー1978, the second group of 81 patients treated during 1979ー1981 and the third group of 55 patients treated during 1982ー1984. Survival rates increased gradually during this period, the rates being 44.6%, 54.3% and 56.4% in the first, second and third groups, respectively.
It is believed that these improvements resulted from substantial changes in therapy between each period, which include : 1) estimation of hemodynamics for early volume resuscitation; 2) massive fluid resuscitation with lactated Ringer's solution and protein, which ameliorates the shock and acute renal failure due to burns ;3) rapid institution of nutritional support and early grafting essential in preventing infection and sepsis.
Significant improvements in survival rates were noted after more aggressive treatment.

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