Burn injury and long-term nervous system morbidity

Long-term neuronal damage postburn injury is being increasingly identified. Systemic alterations in nerve fibre density,1 elevated levels of substance P positive nerve fibres (associated with pain and itch) in burn grafts,2 rapid and prolonged activation of microglial cells in the spinal cord,3 apoptosis in ventral horn motor neurons of the spinal cord4 and increased brain tissue levels of tumour necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6 5 have all been identified postburn injury. However, the clinical implications of these changes for postburn morbidity remain unclear