With respect to wound infections in patients with thermal injuries (burns), discuss under the following headings:
a) Risk factors (10% marks)
b) Local signs (30% marks)
c) Systemic features (20% marks)
d) Diagnostic challenges (40% marks)
Most marks were allocated to part d), and most candidates included the difficulty differentiating infection from SIRS and contamination from infection, however, this was the usual extent of the answer. Candidates should use the associated marking allocation throughout the question, to guide them to the breadth and depth of answers required
With the exception of those who have worked in burns units, the trainees would have found themselves adrift here, unless they had purposefully read about this topic during their preparation.
Is this a "burns" question or an "infectious diseases" question? Well. If this were a question about fluid resuscitation in the burns patient, would it end up in the "fluids and electrolytes" section? The thermal injury is the unique aspect here, not the film of Pseudomonas. Ergo, it was grouped with the other burns-related questions.
a) Risk factors:
b) Local signs:
c) Systemic features:
d) Diagnostic challenges:
Schultz, Laura, et al. "Identification of predictors of early infection in acute burn patients." Burns 39.7 (2013): 1355-1366.
Lago, Kathryn, et al. "Difficult to treat infections in the burn patient." Surgical infections 22.1 (2021): 95-102.
American Burn Association Consensus Conference on Burn Sepsis and Infection Group, et al. "American Burn Association consensus conference to define sepsis and infection in burns." Journal of burn care & research 28.6 (2007): 776-790.