Abstract
The "pathological vicious cycle" of skin barrier disruption and immune disorders following severe burns renders infection a primary complication and main cause of death of patients, with burn sepsis accounting for more than 50% of all burn-associated deaths. Currently, the prevention and treatment of burn infection are confronted with multiple challenges: the superimposed effects of uncontrolled inflammatory response and immune disorder triggered by infection, the rapid progression from local wound to systemic damage, and the massive colonization of multidrug-resistant bacteria, which significantly increases the difficulty of antibacterial therapy. This paper conducted an in-depth analysis of the mechanisms underlying immune dysfunction after burn infection from phenotypic manifestations to intrinsic regulation. It systematically elaborated on the crucial roles and mechanisms of immune evasion by which multidrug-resistant bacteria, imbalance of immune responses, intestinal flora, and novel subtypes of immune regulatory cells play in the development of immune disorder. This paper further reported the emerging technologies for infection assessment and immune monitoring among burn patients by integrating the latest advancements in intelligent wound detecting system and novel biomarkers. Focusing on innovative therapeutic strategies for targeted burn immune regulation and local microenvironment remodeling, it further analyzed the challenges in clinical translation and future development directions of innovative therapeutic strategies.