Introduction

Though infections in burn patients are common and are the major cause of death, they are poorly understood. Believing infections are straight forward is to fail to appreciate their gravity and to be over-optimistic. There is more to an infection than identification of the causative agent and choosing a suitable antibiotic. They are complicated, insidious, incestuous, and intricate. Infections do not all occur in the same manner. Each is different in the way it gets started, how it progresses, and how it ends. There are three components to an infection: the host, the infecting organism, and the timing. In addition, each component has the elements of being qualitative, quantitative, and dynamic.

The skin has four major functions:

1. to keep heat inside the body,

2. to keep water inside the body,

3. to keep invading organisms outside the body, and

4. to give contour to the body.

Care for a burn victim is directed at restoring these functions. Of the four, keeping invading organisms under control is the most difficult to duplicate.

The immunological consequences of a burn are far reaching. Once the injury is larger than 10–15% total body surface area in size, the physiological impact is no longer local, but affects distant and systemic protective mechanisms. Burn patients can have early infections from unusual circumstances, but usually become infected at 5–7 days post-injury.