Yeni Puspawani
Department of Surgery, Universitas Prima Indonesia

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Pathophysiology, classification, and management of burns Oktariadi Manao; Yeni Puspawani
Buletin Kedokteran & Kesehatan Prima Vol. 5 No. 2 (2026): September
Publisher : Fakultas Kedokteran, Kedokteran Gigi, dan Ilmu Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/bkkp.v5i2.8756

Abstract

Burn injuries are common forms of trauma in clinical practice and remain a serious public health problem because they can cause tissue damage, permanent disability, and death. These injuries result from exposure to external agents such as heat, electricity, chemicals, radiation, or friction, which damage the epidermis and/or dermis and impair the skin’s protective, thermoregulatory, sensory, and fluid-balance functions. This narrative literature review summarizes the anatomy and physiology of the skin, the definition, epidemiology, etiology, pathophysiology, classification according to burn depth and extent, wound healing, methods for estimating the total body surface area affected by burns, principles of initial management, complications, and prognosis. The methods used to estimate burn extent include the Rule of Nines, the Pediatric Rule of Nines, the palmar surface method, and the Lund and Browder chart. This review was conducted using a narrative literature review approach based on an examination of relevant scientific literature. A comprehensive understanding of burn injuries is essential for health care professionals, particularly medical students, to facilitate accurate diagnosis, severity assessment, and appropriate management. These competencies may help reduce complication and mortality rates and improve patients’ quality of life.
Hemorrhagic shock: A mini review Edwin Sani Erico Simaremare; Yeni Puspawani
Buletin Kedokteran & Kesehatan Prima Vol. 5 No. 2 (2026): September
Publisher : Fakultas Kedokteran, Kedokteran Gigi, dan Ilmu Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/bkkp.v5i2.8757

Abstract

Hemorrhagic shock is a life-threatening condition caused by acute intravascular volume loss, leading to systemic tissue hypoperfusion, cellular hypoxia, and circulatory failure. It remains a leading cause of preventable death after injury worldwide. This review synthesizes current evidence on the pathophysiology, classification, diagnosis, and clinical management of hemorrhagic shock. Pathophysiologically, acute blood loss reduces cardiac preload and output, triggering neurohormonal compensation, anaerobic metabolism, and progression toward the lethal triad of trauma: hypothermia, metabolic acidosis, and coagulopathy. Diagnostic evaluation relies on the Advanced Trauma Life Support (ATLS) classification system, point-of-care ultrasound, and serial biomarker assessment. Contemporary clinical management emphasizes damage control resuscitation (DCR), including early definitive hemostasis, restrictive crystalloid administration, permissive hypotension, balanced transfusion of blood products, and damage control surgery. Prompt recognition and protocol-driven resuscitation significantly improve survival.