Nutritional Management of the Burn Patient

ABSTRACT

The incidence of burn injuries is on the increase in Africa due to migration to urban areas and the development of slum areas; but there is a paucity of such data on the African continent. The South African Medical Research Council has indicated that 3.2of the South African population is burned annually; with 50of individuals who suffer burns being younger than 20 years. The Red Cross Children's Hospital admits 650 to 900 children with burn injuries annually.1 Burn injury; the most severe type of injury from a metabolic point of view; is characterised by the most profound alterations in basal metabolic rate and urinary nitrogen excretion. In addition; requirements for 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 nutritional 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 ventilatorassociated pneumonia (VAP); being the leading causes of death.2;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)