Lightning rounds 57: Burn critical care with Clint Leonard

Burn critical care functions as a specialized subset of trauma medicine, requiring precise management of fluid resuscitation, wound excision, and long-term rehabilitation. Flame and scald injuries remain primary drivers for admission, triggering systemic inflammatory responses and hypermetabolism that necessitate aggressive, titrated care. Effective resuscitation balances fluid requirements against the risks of over-resuscitation, typically using hourly urine output as a primary clinical metric. Surgical intervention prioritizes early excision of necrotic tissue, followed by complex grafting techniques, including cadaveric skin, mesh autografts, and cultured epidermal autografts. Despite the severity of these injuries, patients with good pre-morbid health often achieve functional recovery. Success in this field relies on a multidisciplinary approach, integrating occupational therapy, specialized nutrition, and long-term psychosocial support to navigate the complex, prolonged recovery trajectory.