Chronic intermittent intra-abdominal hypertension and limitation of chest wall expansion: a possible cause of morbidity in extensive, unyielding trunk burn scaring

Trunk burn patients usually present with many predictable complaints that are directly related to burn scare such as postural deformity, truncal inclination and pelvic tilt,anteriorabdominal wall asymmetry, malposition orabsense of the umbilicus, and exercise and daily activity limitations.However, a significant and unyielding trunk scar has many implications on apparently unrelated organs. Some patients have early fatigue in daily activities, breathing difficulty on moderate to heavy exercise, sleep disturbance, post-meal and rest abdominal and chest pain, and early satietyThe abdominal cavity is enclosed by the diaphragm, vertebral column, and abdominal wall musculature. The only expansible parts of the abdominal cavity are the anterolateral wall and the diaphragm. In addition, the expansion of the lungs is affected by the capacity of the thorax, which is determined by the mobility of the skeletal muscles, the elasticity of the surrounding soft tissues, and the intensity of the respiratory muscles.In conclusion, IAH and physiological respiratory disturbance many occur in recovered trunk burn patient populations.In all patients who are at risk, the focus should be on the early recognition and prevention of these implications.From the above explanations, because of chronic intermittent IAH and chest wall expansion limitation in trunk scarring, gastrointestinal, respiratory, cardiac, and even neurological implications should be considered when evaluating trunk burn patients. The most likely complications in this patient population are as follows:1 Increased risk and severity of gastroesophageal reflux2 Breathing difficulty and early fatigue3 Increased risk of preeclampsia in pregnant women