The critically burned child

Abstract

In summary, the following points might be reviewed: 1. 1. In the case of the critically burned child prepare to modify some of the technics recommended for adults. 1 2. 2. Anticipate primary or secondary shock from six to eight hours after inception of the burn. Give massive doses of plasma and electrolytes to correct circulatory imbalance. 3. 3. Discontinue plasma after twenty-four hours and substitute whole blood. 4. 4. As soon as granulation of wounds begins alternate the dressings between grease and wet. 5. 5. If the patient is listless, is deficient in nitrogen and has a low hemoglobin, institute homografting preliminary to autografting. 6. 6. Perform autografts with the thinnest possible thickness of skin (0.006 to 0.008 inch) in order to obtain rapid healing of donor sites so that removal of a second, third or fourth crop from the original donor sites can be done without too great an interval between surgical interventions. 7. 7. Take massive autografts to cut down subsequent autografting. A new system of slitting large grafts gives increased coverage. 8. 8. Organize teams for both taking grafts and applying grafts. A three-man team is needed for the application of the grafts. The patient should not be under surgery for more than one hour.