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عمومی::
ناحیه استاز
Once the inciting focus is removed, however, the response of local tissues can lead to injury in the deeper layers. fte area of cutaneous or superficial injury has been divided into three zones: zone of coagulation, zone of stasis, and zone of hyperemia (Fig. 19-1). fte necrotic area of burn where cells have been disrupted is termed the zone of coagula- tion. ftis tissue is irreversibly damaged at the time of injury. fte
area immediately surrounding the necrotic zone has a moderate degree of insult with decreased tissue perfusion. ftis is termed the zone of stasis and, depending on the wound environment, can either survive or go on to coagulative necrosis. fte zone of stasis is associated with vascular damage and vessel leakage. ftrombox- ane A2, a potent vasoconstrictor, is present in high concentrations in burn wounds, and local application of inhibitors improves blood flow and decreases the zone of stasis.
Local endo- thelial interactions with neutrophils mediate some of the local inflammatory responses associated with the zone of stasis.
Treat- ment directed at the control of local inflammation immediately after injury may spare the zone of stasis, indicated by studies demonstrating the blockage of leukocyte adherence with anti- CD18 or anti-intercellular adhesion molecules; monoclonal anti- bodies improve tissue perfusion and tissue survival in animal models. fte last area is the zone of hyperemia, which is character- ized by vasodilation from inflammation surrounding the burn wound. ftis region contains the clearly viable tissue from which the healing process begins and is generally not at risk for further necrosis.
The zones of stasis and hyperemia are defined in response to the injury.
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