Survival from severe burns is no longer the exception, but unfortunately death still occurs [1].Owing to the fact that the burn injury is multifaceted, the advances cross many injury processes. the following site These issues range from the management of the catabolic state [6] to modern wound care. One important aspect is that burn treatment has become more proactive, by searching out new technologies to solve old problems. Now the treatment approach is altering its focus on manipulating the course of a burn and its final outcome. The survival rate is still of course the most important issue, but not the only issue [7]. The question of whether and to what degree the patient is able to enjoy a normal quality of life becomes more and more essential in how the outcome of the burn treatment is evaluated [7].

Restoring function and esthetics are crucial in the difficult process of social reintegration and the return to a normal life. Great efforts were made in the past to develop epidermal and dermal replacements to overcome the problem of poor skin quality and scar contraction. In large and deep burns, the approach has changed to rapid excision [1] and lesion-specific coverage of the burn wound, eliminating the burn as a source of complications. Rapid and effective wound coverage and closure are of utmost importance, but infection control and the preservation of active and passive motion are also essential for optimal recovery.Nonviable burn tissue is well recognized to be the driving force behind wound infection and burn wound sepsis. Infection in burn patients remains the significant source of morbidity and mortality.

Williams and colleagues, who determined the predominant causes of death of burned children admitted between 1989 and 2009, found that the dominant cause of death is sepsis (47% of all deaths) [1]. Moreover, they found an increase of deaths due to multidrug-resistant organisms from 42% to 86% over the past 20 years. The aggressive use of antimicrobials has significantly improved survival, but has also led to an increased colonization of pathogens that have resistance to current therapies. In general, early removal and excision of the necrotic tissue with a consecutive rapid and effective closure of the burn wound has become the standard in the management of severe burns.

Research has proven that application of antimicrobial dressings or early excision and grafting is the key to avoid burn wound infection and its extension to systemic infection [8-10]. The timing and extent of surgery may vary, as well as the method of closing, between different burn centers, but the principal concept is almost the same.Based on the findings of Williams Carfilzomib and colleagues, respiratory failure accounted for 29% of all deaths – 83% of these were due to acute respiratory distress syndrome [1].