Herndon DN, Barrow RE, Rutan RL, Rutan TC, Desai MH, Abston S, et al.
Annals of surgery. Date of publication 1989 May 1;volume 209(5):547-52; discussion 552-3.
1. Ann Surg. 1989 May;209(5):547-52; discussion 552-3.
A comparison of conservative versus early excision. Therapies in severely burned
patients.
Herndon DN(1), Barrow RE, Rutan RL, Rutan TC, Desai MH, Abston S.
Author information:
(1)Department of Surgery, University of Texas Medical Branch, Shriners Burns
Institute, Galveston 77550.
Early excision and grafting of small burn wounds is a generally accepted
treatment. Early excision of burn injuries greater than 30% total body surface
area (TBSA) in adults, however, has not been universally accepted. In this study,
85 patients whose ages ranged from 17 to 55 years with greater than 30% total
body surface area (TBSA) burns were randomly assigned to either early excision or
topical antimicrobial therapy and skin grafting after spontaneous eschar
separation. Mortality from burns without inhalation injury was significantly
decreased by early excision from 45% to 9% in patients who were 17 to 30 years of
age (p less than 0.025). No differences in mortality could be demonstrated
between therapies in adult patients older than 30 years of age or with a
concomitant inhalation injury. Children (n = 259) with similar large burns
treated by early excision showed a significant increase in mortality with
increasing burn size and with concomitant inhalation injury (p less than 0.05).
The mean length of hospital stay of survivors was less than one day per per cent
of TBSA burn in both children and adults.
PMCID: PMC1494069
PMID: 2650643 [Indexed for MEDLINE]
