Affiliation:
1. University of Texas Southwestern Medical Center and Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas
2. Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas
Abstract
Each year, within the United States, tens of thousands of individuals are hospitalized for burn-related injuries. The treatment of deep burns often involves skin grafts to accelerate healing and reduce the risk of infection. The grafting procedure results in a physical disruption between the injured and subsequently debrided host site and the skin graft placed on top of that site. Both neural and vascular connections must occur between the host site and the graft for neural modulation of skin blood flow to take place. Furthermore, evaporative cooling from such burn injured areas is effectively absent, leading to greatly impaired thermoregulatory responses in individuals with large portions of their body surface area burned. Hospitalization following a burn injury can last weeks to months, with cardiovascular and metabolic consequences of such injuries having the potential to adversely affect the burn survivor for years postdischarge. With that background, the objectives of this article are to discuss 1) our current understanding of the physiology and associated consequences of skin grafting, 2) the effects of skin grafts on efferent thermoregulatory responses and the associated consequences pertaining to whole body thermoregulation, 3) approaches that may reduce the risk of excessive hyperthermia in burn survivors, 4) the long-term cardiovascular consequences of burn injuries, and 5) the extent to which burn survivors can “normalize” otherwise compromised cardiovascular responses. Our primary objective is to guide the reader toward an understanding that severe burn injuries result in significant physiological consequences that can persist for years after the injury.
Funder
Gouvernement du Canada | Natural Sciences and Engineering Research Council of Canada
HHS | ACL | National Institute on Disability, Independent Living, and Rehabilitation Research
HHS | NIH | National Institute of General Medical Sciences
U.S. Department of Defense
Publisher
American Physiological Society
Subject
Physiology (medical),Physiology
Reference121 articles.
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5. Burn Support for Operation Iraqi Freedom and Related Operations, 2003 to 2004
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