To explore the treatment experience of senile severe burn complicated with sepsis and persistent hypothermia in the elderly, and to improve the attention of burn surgeons to large area burn accompanied by hypothermia.

The course of disease and diagnosis and treatment of an elderly patient with severe burn complicated with sepsis and persistent hypothermia was reported. Carbapenem resistant pathogens were repeatedly detected in the patient on the 5th day after injury, and serum inflammatory-related indicators were abnormally high. Sepsis was diagnosed twice on the 9th and 39th day after injury. Hypothermia began to persist on day 10th day after injury and cardiac arrest due to hypothermia during skin grafting on day 17th day after injury. Since then, attention had been paid to the prevention and treatment of hypothermia, and measures such as wound treatment, anti-infection treatment and nutritional support had been strengthened. Wanfang database and CNKI were searched with the Chinese keywords "burn" , "hypothermia" and "sepsis" , and PubMed was searched with the English keywords "severe burn/major burn" , "hypothermia" and "sepsis" . The related literatures from August 2010 to August 2021 were searched and analyzed.

The sepsis of the patient was effectively controlled, and the organ function was good. The hypothermia that lasted for nearly a month was ended on the 33rd day after injury, and the wound was healed on the 128th day after injury. Six literatures related to the influencing factors and treatment of hypothermia caused by severe burns combined with sepsis were retrieved. The results suggested that burn area, age, infection, etc were risk factors for hypothermia, and taking a series of preoperative, intraoperative and postoperative comprehensive thermal insulation measures was an effective way to solve the problem of hypothermia.

The key to the treatment of extremely severe burns complicated with sepsis lies in early detection and early treatment, attaching importance to the microbial culture drug sensitivity test and continuous monitoring of inflammation-related indicators, predicting the disease progression, and formulating reasonable diagnosis and treatment strategies. Attention should be paid to the elderly patients with low body weight or malnutrition especially, should be early prevention of hypothermia.