Burn and other exposure injuries

Man's primitive fascination with fire has led to affliction with burn injuries since the dawn of our history. Therapy has evolved from the application of mud and excrement in Egyptian times, to dressings impregnated with pig fat and resin in the Roman era, to the emergence of a relatively modern concept of first aid from the military battlefield [1]. Still today, burn injuries and their sequelae represent one of the most potentially devastating and challenging conditions in medicine. Over one million burns occur annually in the USA, with the majority being treated in an outpatient setting. Children up to 4 years of age and working age adults comprise nearly 90 % of patients with burn injuries. Injuries to children largely involve scald injuries, whereas flame burns are predominant in the working age population [2]. Presentation may vary considerably, from simple sunburns requiring no more than counseling and a topical agent to extensive tissue loss resulting in multi-organ system failure and a protracted ICU course. In more serious cases, it is imperative that burn care extend far beyond the initial insult. Burns can significantly alter quality of life and are a common cause of disability. Debilitating contractures and cosmetically unacceptable scars may have long-lasting physical and psychological consequences, requiring continued physician involvement and support.