Burn Wound Infections: A 35-year Review of Advances, Diagnostic Challenges, and Evidence-based Strategies

Abstract

Introduction

Severe burns represent a critical public health issue, with high mortality and morbidity associated with wound infections, which are the leading cause of death in these patients. The present article aims to provide a comprehensive evidence-based approach for the diagnosis and management of invasive burn wound infections, highlighting recent scientific advances and effective clinical strategies.

Materials and Methods

A thorough review of 35 years of scientific literature was conducted using recognized databases such as PubMed, EMBASE, and Cochrane Library. The information was synthesized and validated by a committee of experts in surgery and burn care. The medical subject heading (MESH) terms used were: Burns, Infection, Burn wound infections, Sepsis, and Multi-drug resistant.

Results

The analysis shows that more than 45% of patients with severe burns develop infections. The pathophysiology includes immunosuppression secondary to hypermetabolism and inflammatory dysregulation, which predispose patients to infections by multidrug-resistant microorganisms. Additionally, biomarkers such as procalcitonin and strategies based on specific cultures improve diagnostic accuracy. The implementation of personalized protocols reduces complications and mortality in this population.

Conclusion

The present study establishes an evidence-based guide for the early diagnosis and effective management of burn infections, promoting the rational use of antibiotics and comprehensive care. The findings contribute to standardizing clinical practices, optimizing hospital resources, and improving clinical outcomes. This review serves as a crucial reference for advancing burn patient care and fostering future research in the field.

Keywords

burns - burn units - surgery department - sepsis - hospital infections - drug resistance

Approval from the Research Ethics Committee

This article is a review, so it did not include patients and was not conducted at a specific healthcare institution. We understand that, according to the journal's requirements, a letter from the ethics committee is not necessary. We remain available for any additional requests.

Publication History

Received: 20 January 2025

Accepted: 24 March 2025

Article published online:
25 June 2025

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