Wound Care

Assessment of Other Wound Types 209
Decreases in intestinal motility are not uncommon with
resultant reduction in absorption as well as peristalsis.
The burn patient may have experienced a paralytic ileus
in the acute setting.
The intestinal bacterial barrier is also often compromised
during the acute phase of treatment. This failure
may result in bacterial translocation and thereby cause
systemic sepsis and/or multiple organ dysfunction syndrome
(MPDS).
— Hematopoietic: burn patients may have significant losses
of red blood cells with resultant hypoxia during the early
treatment of the injuries.
The circulating levels of iron are also depressed after a
burn injury. These events may trigger the body to
increase erythrocyte production.
Bone marrow stores are often depleted during the early
phases of treatment.
Platelets may also be depleted in the early phase of
treatment.
Many burn victims have received transfusions of one or
more blood components during the acute phase of treatment
and may be experiencing anxiety concerning this.
— Renal: renal failure is not uncommon during the early
phase of treatment.
— Immunologic: during the treatment burn patients commonly
undergo profound immunologic changes.
Frequent problems are infections caused by gram negative
organisms as well as by fungi.
— Long-term physiologic sequelae:
Height/weight gain delays
Decreased bone density
Increased fracture rates
Temporary menses cessation
Increased potential for spontaneous abortion or premature
parturition