烧伤后会出现明显的炎症反应和高能量代谢反应，而这些相互关联的反应比其他创伤形式更为显著，且在烧伤患者中持续≥3年。烧伤后患者面临老年疾病的风险增加，其中包括癌症、糖尿病和心血管疾病，因此需要有效的长期策略来缓解烧伤后的应激反应。目前，用于烧伤后恢复的治疗策略包括采用手术切除和创面修复、营养补充和康复运动来尽量减少高能量代谢和炎症反应，同时减少瘦体重的损失。本文简要概述了炎症和高能量代谢反应，并更新烧伤患者的当前治疗策略。本文还审查了确保足够的能量摄入以支持烧伤后高能量代谢和对抗分解反应的持久营养挑战，同时减少高血糖和高三酰甘油血症的时间。患者需要个性化治疗方案，因为在烧伤后，每个人的系统反应都是独特的，并需采用精准药物治疗策略来改善患者的临床和生理结果。因此，本文讨论了代谢灵活性评估的效用，以辅助临床决策并开处营养补充和康复运动的处方。 © The Author(s) 2023. Published by Oxford University Press.

There is a marked inflammatory and hypermetabolic response following a burn injury. The interlinked responses are more pronounced than for other forms of trauma and can persist for ≥3 years post-injury in burned patients. After a burn, patients have an increased risk of diseases of ageing including cancer, diabetes and cardiovascular disease, highlighting the need for effective long-term strategies to ameliorate the stress response post-burn. Current therapeutic strategies for post-burn recovery include removal of damaged tissue with surgical excision and wound repair, nutritional supplementation and rehabilitative exercise. These strategies aim to minimize the hypermetabolic and inflammatory responses, as well as reducing the loss of lean body mass. This review briefly summarises the inflammatory and hypermetabolic responses and provides an update on the current therapeutic strategies for burned patients. The review examines the persistent nutritional challenge of ensuring sufficient energy intake of each macronutrient to fuel the hypermetabolic and counteract the catabolic response of burn injury, whilst reducing periods of hyperglycaemia and hypertriglyceridemia. Patients require individualized treatment options tailored to unique systemic responses following a burn, facilitated by a precision medicine approach to improve clinical and physiological outcomes in burned patients. Thus, this review discusses the utility of metabolic flexibility assessment to aid clinical decision making and prescription relating to nutritional supplementation and rehabilitative exercise in the burned patient.© The Author(s) 2023. Published by Oxford University Press.