The burn autopsy. Fatal complications of burns.

Abstract

The pathologic findings and interpretations of 335 autopsies performed on patients who died of extensive cutaneous burns during the period 1960 to 1967 are presented. The information accumulated during this period is unique in that the burn wounds were systematically examined postmortem, the patients studied were young, and the number with preexisting disease was negligible. Comparison of the major fatal complications prior and subsequent to topical antibacterial therapy confirms the marked decline in sepsis due to invasive bacterial infection of the burn wound that has been reported previously. There has been an increase in fungal colonization and infection of the burn wound coincident with the use of the topical antibacterial agent, Sulfamylon. Sepsis, although reduced in magnitude due to control of one of its major sources, continues to be the single most frequent fatal complication of burns. Infective and respiratory complications together account for two-thirds of deaths in patients who survive the initial phase of thermal injury. The infected cannulated vein now rivals infection of the burn wound as a source of sepsis in burned patients. The increase in deaths attributed to respiratory complications has occurred only in patients with extensive burns and may be an apparent rather than a real increase.