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Prevention and treatment of gastrointestinal dysfunction following severe burns: a summary of recent 30-year clinical experience Xiao SC; Zhu SH; Xia ZF; Lu W; Wang GQ; Ben DF; Wang GY; Cheng DSWorld J Gastroenterol 2008[May]; 14 (20): 3231-5AIM: To sum up the recent 30-year experience in the prevention and treatment of gastrointestinal dysfunction in severe burn patients, and propose practicable guidelines for the prevention and treatment of gastrointestinal (GI) dysfunction. METHODS: From 1980 to 2007, a total of 219 patients with large area and extraordinarily large area burns (LAB) were admitted, who were classified into three stages according the therapeutic protocols used at the time: Stage 1 from 1980 to 1989, stage 2 from 1990 to 1995, and stage 3 from 1996 to 2007. The occurrence and mortality of GI dysfunction in patients of the three stages were calculated and the main causes were analyzed. RESULTS: The occurrence of stress ulcer in patients with LAB was 8.6% in stage 1, which was significantly lower than that in stage 1 (P < 0.05). No massive hemorrhage from severe stress ulcer and enterogenic infections occurred in stages 2 and 3. The occurrence of abdominal distension and stress ulcer and the mortality in stage 3 patients with extraordinarily LAB was 7.1%, 21.4% and 28.5%, respectively, which were significantly lower than those in stage 1 patients (P < 0.05 or P < 0.01), and the occurrence of stress ulcer was also significantly lower than that in stage 2 patients (P < 0.05). CONCLUSION: Comprehensive fluid resuscitation, early excision of necrotic tissue, staged food ingestion, and administration of specific nutrients are essential strategies for preventing gastrointestinal complications and lowering mortality in severely burned patients.|Adolescent[MESH]|Adult[MESH]|Bacterial Infections/prevention & control[MESH]|Burns/complications/mortality/pathology/*therapy[MESH]|Child[MESH]|Gastrointestinal Diseases/etiology/mortality/*prevention & control[MESH]|Humans[MESH]|Middle Aged[MESH]|Peptic Ulcer/prevention & control[MESH]|Practice Guidelines as Topic[MESH]|Severity of Illness Index[MESH]|Stress, Physiological[MESH]|Treatment Outcome[MESH] |
