Management of the lower gastrointestinal system in burn: A comprehensive review

Burns : Journal of the International Society for Burn Injuries
J W G NgC P O'Boyle

Abstract

Burn produces complex gastrointestinal (GI) responses. Treatment, including large volume fluid resuscitation and opioid analgesia, may exacerbate GI dysfunction. Complications include constipation and opioid-induced bowel dysfunction (OBD), acute colonic pseudo-obstruction (ACPO), bacterial translocation and sepsis, and abdominal compartment syndrome (ACS). Contamination of perineal burns contributes to delayed healing, skin graft failure and sepsis and may impact upon morbidity and mortality. The authors carried out a literature review on management of the lower GI system in burn. This study aimed to explain: current prevention and treatment modalities; drawbacks and complications associated with available treatments, and to provide direction for development of best practice guidelines. ACS is associated with high mortality and should be treated with careful fluid resuscitation and diuresis, to minimise and remove oedema. A comprehensive search of English language literature was performed on PubMed, Medline and Embase. Both MeSH and keywords searches were used. Evidence available on the management of lower gastrointestinal system in burn is summarised. Levels of evidence available are generally low (level III-IV). Structured, ...Continue Reading

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Citations

Oct 4, 2016·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Yan WangZhengxin Liu
Aug 24, 2019·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Jessica L MaschMatthew C Bozeman
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