Which of the following lists the phases of metabolism after burns?

• A. Ebb, Flow, Adaptive
• B. Ebb, Adaptive
• C. Flow, Adaptive
• D. Ebb

Answer: (A)

Metabolic response after major burns unfolds in three sequential stages: an initial Ebb phase, followed by a Flow phase, and then an Adaptive phase. The Ebb phase happens right after injury and involves lower metabolic activity and reduced tissue perfusion as the body stabilizes and fluid shifts are addressed. Once stabilized, the Flow phase sets in, a period of hypermetabolism and catabolism driven by stress hormones and inflammatory mediators, with higher energy and protein needs to support wound healing and immune function. As healing progresses, the Adaptive phase emerges, during which metabolism begins to normalize and anabolic processes predominate to rebuild tissues. The option that lists Ebb, Flow, and Adaptive captures this full progression, whereas the other options omit one or more phases. Understanding this sequence helps guide nutrition strategies across the course of burn recovery.