• Rebecca Knackstedt and James Gatherwright.
• Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, United States. Electronic address: knacksr@ccf.org.
• Burns. 2020 Aug 1; 46 (5): 1005-1012.

IntroductionBurn patients represent a combination of nutritionally deplete and calorically demanding individuals who are susceptible to morbidity and mortality. A source of sepsis in thermal injury patients is the gastrointestinal tract with its interaction of normal and potentially pathogenic bacteria. The normal flora of the intestines maintains the equilibrium of the gut and prevents bacterial translocation (BT) through numerous mechanisms, all of which are disrupted as a consequence of thermal injury. Probiotic supplements with varying strains of bacteria have the potential to stabilize the integrity of the gut lining and decrease the incidence of BT after thermal injury.MethodsA literature review was conducted for animal and human studies in English addressing probiotic therapy in thermal injury. Keywords, "probiotics," "thermal injury" and "burn" were utilized. Reference lists for each analyzed article were also examined to ensure completeness of literature search. Each article was reviewed for methodology, results and conclusions.ResultsEleven and six unique articles were identified addressing probiotics in thermal injury in animal and human studies, respectively. Heterogeneity between studies and limited demographic and outcome reporting prevented meta-analysis and comprehensive recommendations to be formalized.ConclusionWhile heterogeneity did not allow for meta-analysis, the results overall suggest a preventative, if not therapeutic, potential for probiotics in patients after thermal injury. Despite initial concern that probiotic therapy could lead to systemic infection in immune compromised individuals, this was not observed in the analyzed studies. Numerous unanswered questions exist in regards to optimizing probiotic therapy in patients after thermal injury.Copyright © 2019 Elsevier Ltd and ISBI. All rights reserved.

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