Early partial excision of major burns in children

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Abstract

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.

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Cited by (21)

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    2014, Burns
    Citation Excerpt :

    Burns in children are a common type of injury. By far the majority of burns in children under four years are partial thickness scald burns, and while for full thickness burns the established opinion since long is that early wound excision and grafting is the standard accepted procedure [61–63], for partial thickness burns there is no consensus on the optimal treatment modality. In many clinics SSD or tulle gauze, with or without an antiseptic are the standard of treatment [64].

  • An Historical Perspective on Advances in Burn Care Over the Past 100 Years

    2009, Clinics in Plastic Surgery
    Citation Excerpt :

    Because fungi, particularly the phycomycetes, readily penetrate tissue planes, amputation of an entire limb may be necessary to control the infection.62 Although primary excision was often used for burns of limited extent in the early decades of the twentieth century,63 excision of burns involving more than 20% of the body surface, often in an attempt to salvage septic patients, was typically reported as showing increased mortality or, at best, mortality comparable to that of patients in whom the eschar was debrided on a daily basis and the wounds grafted in piecemeal fashion.64 In the 1970s, with the use of effective topical chemotherapy to control microbial density within the burn wound and the availability of broad spectrum antibiotics and biologic dressings, excision at the level of the investing fascia was found to improve survival in patients with 40% to 60% burns when the excised wounds could be immediately closed.65

  • Early burn excision and grafting

    1987, Surgical Clinics of North America
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1

Clinical Associate in Surgery, Harvard Medical School; Surgical Chairman Children's Service and Associate Visiting Surgeon, Massachusetts General Hospital.

2

Instructor in Surgery Harvard Medical School, Associate Visiting Surgeon Massachusetts General Hospital.

3

Formerly Assistant Resident in Surgery, Massachusetts General Hospital; currently Captain, Medical Corps, U. S. Army Surgical Research Unit, Brook Army Medical Center, San Antonio, Texas.

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