Why is there obvious
fever in patients treated with MEBT/MEBO and Does it indicate the
infection or sepsis?
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.
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