Nutritional Management of the Burn Patient

Abstract

The incidence of burn injury is on the increase in Africa, due to migration to urban areas with the development of slum areas but there is a paucity of such data in the African continent. The South African Medical Research council has indicated that 3.2% of the South African population are burned annually with 50% of individuals who suffer burns being younger than 20 years. The Red Cross children’s hospital admits 650 – 900 children with burn injuries annually.1 Burn injury, the most severe type of injury from a metabolic point of view, is characterized by the most profound alterations in basal metabolic rate and urinary nitrogen excretion. In addition, requirements and/or metabolism of macro and micronutrients are altered or increased. The major improvement in burn survival can be attributed to many factors, one being the development and implementation of improved methods of nutrition support that optimise host defences, enhance wound healing and support the metabolic response to stress.2 The greatest threats to survival from burns are still infection/sepsis, with burn wound sepsis and nosocomial pneumonia, including ventilator-associated pneumonia (VAP), being the leading causes of death2,3 Effective medical nutrition therapy in patients with burn injuries requires an understanding of the physiologic and metabolic alterations that accompany the burn injury, alterations in the immune system and the role of reactive oxygen species (ROS).