Early Burn Excision Research Articles

Early partial excision of major burns in children

Partial primary excision and grafting has been performed in 16 children during the past 7 years. There were 3 deaths, none related to the operative procedure. Great emphasis should be placed on the fact that these were highly selected cases, representing only a very small number of the burns in children seen during this time. This method has merit and should be considered in a child with a large expanse of indubitably full-thickness burn whose condition permits an operative procedure and who has available surface from which skin grafts can be taken. Recently this method has been used in conjunction with 0.5 per cent silver nitrate topical therapy for that part of the burn which has not been excised, and it is felt that the combination of these two methods deserves further trial.

Escharotomy in Early Burn Care

IN a symposium on burns in 1951, Blocker and Moyer 1 recommended escharotomy for constricting upper extremity burns. A. B. Wallace, 2 in 1955, recommended multiple incisions in the eschar of the upper extremity where distal ischemia was apparent and stated that the procedure in no way jeopardized the maintenance of a subsequently dry surface. He also advocated tracheostomy in cases of severe edema of the neck with resultant pressure on the trachea. Bennett and Lewis, 3 in 1958, considered the problem of operative decompression of constricting burns, stating that decompression could be accomplished either by single or multiple incisions or by immediate excision of the burn. It was their practice to incise through the length of the burn and down to the level of the deep fascia. As noted, they advocated early excision and grafting of such burns. R. J. Meade, 4 writing in 1958, emphasized that escharotomy should

Hydrofluoric acid burns of the hands

Summary 1.Three cases of hydrofluoric burns of the hands are reported. 2.The basis of the standard methods of treatment is reviewed. 3.Early excision of burns failing to respond to the standard conservative methods of treatment is advocated.

A new technique in the clinical assessment of burns.

iTCOMEsasa great relief these days to find that with the passage of time the classification of certain diseases becomes simpler rather than more complex. Thus the modern classification of burns into partial skin loss and whole skin loss cuts clean through the more traditional and even more confusing earlier descriptions of burn depth. This new classification has the additional advantage that it not only describes the lesion accurately but also indicates the correct line of treatment. Partial skin loss implies the presence of sufficient epithelial cells in the dermis, hair follicles and sweat glands to resurface the area, whereas whole skin loss implies complete destruction of all epithelial elements so that healing can only occur by migration from the periphery or contracture of the bed of the wound. Thus theoretically all partial thickness burns should heal provided they are properly cared for, whereas the ideal treatment for full thickness burns should be excision and closure of the wound, either by suture or skin graft. In practice, the value of early excision of full thickness burns has been amply confirmed by several workers but there are three very significant limitations to this therapeutic procedure: 1. Biological. The skin is the largest single organ of the human body, and there would appear to be limits to its destruction by burning or excision beyond which survival of the patient is impossible. 2. Technical. In the excision of major burns, particularly in the very young and the aged, there are very real problems of blood loss including its estimation and replacement before, during and after operation; dangers of

Effect of early excision of experimental burns

Effect of early excision of experimental burns