Traumatic exhaustion (synonym: wound wasting, dystrophy of the wounded) is a severe dystrophic process that occurs during chronic intoxication associated with prolonged suppuration in seriously injured patients with extensive and deep burns. Traumatic exhaustion is also observed in chronic, long-standing pleural suppurations, purulent arthritis. Traumatic exhaustion develops after a long fever, which is characterized by chills, sweating. On examination of a patient with traumatic exhaustion, dramatic exhaustion is striking, the sallow pallor of the skin, trophic disorders in the form of pressure sores (see). Patients are sluggish, apathetic, indifferent to the surrounding. Severe dysfunction of the digestive tract accompanied by a lack of appetite, continuous diarrhea . Temperature often subfebrile, and in the final phase of the disease, it decreases to normal numbers.
Wound healing processes are impaired. The wounds are covered with flaccid pale granulations; very often granulations are completely absent. Wounds in such cases are covered with a grayish purulent-necrotic coating without a clear boundary. Constant absorption of decay products and bacterial toxins leads to damage to the nervous system, liver, kidneys, heart, adrenal glands, etc. The pulse becomes frequent, weak filling, blood pressure drops, and severe anemia builds up. In the urine protein is detected, red blood cells , a large number of white blood cells. Immunobiological activity of the organism is sharply reduced.
Prevention : traumatic exhaustion can be prevented by timely surgical treatment of wounds, early skin grafting for burns, opening of purulent wipes, resection of the affected joints. If the body develops irreversible changes, removal of the source of infection and intoxication does not lead to recovery.
Treatment: good nutrition with high content of proteins and vitamins, transfusion of blood , plasma, solutions containing glucose, salts of sodium, potassium and calcium.