1. 2.1.7. Why is there obvious fever in patients treated with MEBT/MEBO and Does it indicate the infection or sepsis?
    • 2010/10/25 10:46:48
    Firstly, no matter what kind of method is adopted, patients with extensive burns will suffer from fever inevitablely. Skin is the largest tissue organ of human body and also a major organ responsible for body temperature regulation. In case of extensive burns, the function of skin is impaired and thus can not regulate body temperature normally.
    Secondly, large amount of phlogogen and pyrogen factors such as burns toxins, and inflammatory mediums etc are generated from burns wound, which will also lead to fever.
    Thirdly, the necrotic tissues of the dry wound are dry and coagulate (burns toxins are confined in the eschar), with local microcirculation compressed and blocked, while burns wound treated with MEBT/MEBO is always maintained moist, leaving the necrotic tissue swelling and soft, and local microcirculation and lymphatic vessels are open and unblocked, which allows more absorption of toxins and inflammatory mediums Therefore, fever is more manifest in extensive patients treated with MEBT/MEBO.
    To sum up, for extensive burns patients, as long as the burns wound is treated in terms of standard application of MEBT/MEBO in clinic, with necrosis and liquefied matters cleared away timely, wound drainage was kept smooth and the body temperature was around 38 was regarded as a relative normal condition.
    Moreover, it is not proper to consider fever as infection or sepsis casually in clinic. The diagnosis should be determined by close observe the general state of the patient (such as invigorating or not, consciousness, emotional expression), condition of the wound surface and wound edge (bleeding points and necrotic lesions) and there also have to be some indicators, i.e. body temperature (above 39.5 or below 36), heart rate (>140 t/min) and toxic granules detection in blood neutrophile granulocytes. Only when the aforementioned three conditions are satisfied simultaneously, can the invasive infection be diagnosed.