大面積燒傷治療

The Treatment of Major Burn Injuries

大面積燒傷是全身性的疾病，除了充分了解傷口癒合機轉外，正確燒傷深度判斷和面積評估是大面積燒傷治療重要的基本步驟。由於治療方法的快速進步，包括適當體液復甦術、早期傷口切除、早期植皮、有效的熱量補充和積極的敗血症治療等，已大大提升了大面積燒傷的存活率。然而，對大面積燒傷的存活者而言，疤痕肥厚攣縮僵硬導致關節活動受限制是後續臨床的挑戰性問題。總結，大面積燒傷治療與復健過程漫長且多面向，需要一個完整的治療計畫，及一個包括醫師、護理人員、社工、復健師和心理師的健全團隊，透過彼此間充分的溝通與相互的支持，完成協助病人重返社會為最終治療目的。

Major burn injuries constitute a systemic disease. In addition to completely understanding the mechanisms of wound healing, precise burn depth and area assessment is critical to the successful management of burn injuries. The recent advancements in post-burn fluid resuscitation, tangential burn excision and grafting, effective enteral tube feeding, and aggressive sepsis treatment have helped greatly increase the survival rates for major burn injuries. However, the restricted joint motion that results from hypertrophic scar contracture remains the main challenge facing burn survivors. In conclusion, as the course of the treatment and rehabilitation is prolonged and multifaceted, a complete treatment plan is always necessary in addition to teamwork among physicians, nurses, social workers, physical therapists, and psychologists. Finally, social return is the final goal of treatment and may be achieved only through mutual support and understanding among the members of the burn treatment and rehabilitation team.