Abstract
During ',`is period, the physician should I the moment, whi : i 4isbe first at which debrlcsMa nt of part or all of the burned tissue can safely be done. The concept that a burned area must show healthy granulations before it is ready to graft has, we hope, disappeared forever. This change of condept is one of the greatest advances of this decade in the treatment of burns. ore grafting procedures are done. e burn wound becom s extremely i ful; this pain persists on motion In an unburned person, the fat underlying freshly excised skin is the best possible recipient site for a graft once complete hemostasis is secured. In the burned patient, this ideal bed is closely approximated by the fat underlying the burned tissue if the subcutaneous fat is itself unburned, if it is uninfected, and if thick red exuberant granulation tissue has not formed. If all goes well, these three conditions will co-exist sometime between the second and fifth week. If blood volume is also good, the golden moment has arrived. This is the time to cover the burned areas to the maximum possible extent with split thickness grafts taken from every available donor area. The surgeon can expect truly phenomenal success with the grafts under these conditions.
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