Current understanding of the chronic stress response to burn injury from human studies

Tyler Osborne; Bradley Wall; Dale W. Edgar; Timothy Fairchild; Fiona Wood

doi:10.1093/burnst/tkad007

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Current understanding of the chronic stress response to burn injury from human studies

Journal article

Open access

Peer reviewed

Current understanding of the chronic stress response to burn injury from human studies

Tyler Osborne, Bradley Wall, Dale W. Edgar, Timothy Fairchild and Fiona Wood

Burns and trauma, Vol.11, Art. tkad007

2023

DOI: https://doi.org/10.1093/burnst/tkad007

PMID: 36926636

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Abstract

Dermatology

Emergency Medicine

Life Sciences & Biomedicine

Science & Technology

Surgery

There is a marked inflammatory and hypermetabolic response following a burn injury. The interlinked responses are more pronounced than for other forms of trauma and can persist for >= 3 years post-injury in burned patients. After a burn, patients have an increased risk of diseases of ageing including cancer, diabetes and cardiovascular disease, highlighting the need for effective long-term strategies to ameliorate the stress response post-burn. Current therapeutic strategies for post-burn recovery include removal of damaged tissue with surgical excision and wound repair, nutritional supplementation and rehabilitative exercise. These strategies aim to minimize the hypermetabolic and inflammatory responses, as well as reducing the loss of lean body mass. This review briefly summarises the inflammatory and hypermetabolic responses and provides an update on the current therapeutic strategies for burned patients. The review examines the persistent nutritional challenge of ensuring sufficient energy intake of each macronutrient to fuel the hypermetabolic and counteract the catabolic response of burn injury, whilst reducing periods of hyperglycaemia and hypertriglyceridemia. Patients require individualized treatment options tailored to unique systemic responses following a burn, facilitated by a precision medicine approach to improve clinical and physiological outcomes in burned patients. Thus, this review discusses the utility of metabolic flexibility assessment to aid clinical decision making and prescription relating to nutritional supplementation and rehabilitative exercise in the burned patient.

Details

Title: Current understanding of the chronic stress response to burn injury from human studies
Authors/Creators: Tyler Osborne - Murdoch University
Bradley Wall - Murdoch University, Centre for Healthy Ageing
Dale W. Edgar - Fiona Stanley Hospital
Timothy Fairchild - Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics
Fiona Wood - Fiona Stanley Hosp, Govt Western Australia South Metropolitan Hlth Ser, State Adult Burns Unit, Murdoch, WA 6150, Australia
Publication Details: Burns and trauma, Vol.11, Art. tkad007
Publisher: Oxford Univ Press
Number of pages: 11
Identifiers: 991005567366807891
Murdoch Affiliation: Centre for Healthy Ageing
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.266 Wounds & Ulcers; 1.266.1023 Burns
Web Of Science research areas: Dermatology; Emergency Medicine; Surgery
ESI research areas: Clinical Medicine