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PATHOGENESIS AND CLINIC OF BURNING TOXEMIA AND SEPTIKOTOXEMIA

At the heart of the pathogenesis of burn toxemia is the resorption of the products of decay of tissues from the burn wound into the blood and lymph. This process is especially pronounced in the first several days after the burn was received, when granulation, which is a "wound barrier" in the way of toxins absorption, has not yet formed.

At present, it has been clarified that in the pathogenesis of intoxication from the very beginning, the microbial factor is of significant importance. Any burn wound is primarily infected. A wet burn scab is permeable to microbes. In combination with a significant inhibition of all the body's defenses, characteristic of severe burn injuries, the infectious process has a pronounced tendency to spread and generalize, i.e. development of burn sepsis. Thus, the isolation during the burn disease of the individual stages of toxemia and septicotoxemia is largely conditional. The criterion for the replacement of toxemia by septicotoxemia is considered to be the development of suppuration of a burned scab.

The duration of the burn toxemia period averages from 2 to 4 to 10 to 15 days. The end of this period coincides with the onset of severe suppuration in the burn wounds. With deep and extensive lesions, toxemia passes to the third stage of the course of burn disease - septicotoxemia, with lighter - ends in recovery.

Leading signs of burn toxemia are fever with a body temperature of 38-39 ° C without chills or with slight chills, without significant differences in morning and evening temperatures, with moderate tachycardia and tachypnea.
The use of antibiotics and antipyretic drugs does not significantly affect the temperature response. The expressed intoxication at which functions of all organs and systems suffer.

The clinic burns septicotoxemia depends on the severity and localization of purulent-septic processes and developing complications. The leading syndrome of this stage of the disease is purulent-resorptive fever, which disappears when the wounds are cleared of necrosis and pus, which decreases with the appointment of antipyretic agents.

An important symptom of the third stage of a burn disease is difficult to replenish the protein loss caused by a purulent-septic process. Preserving or progressive intoxication combined with dystrophic lesions in vital organs leads to depletion of the reparative abilities of the body. Progression of depletion, often the development of sepsis. Burn wounds cease to heal, granulations become flaccid, dull, with a gray coating and abundant purulent discharge. Skin grafts cease to settle down. Such a condition has been called BURNING EFFECTS. The prognosis for its development and the absence of intensive treatment becomes unfavorable.
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PATHOGENESIS AND CLINIC OF BURNING TOXEMIA AND SEPTIKOTOXEMIA

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