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Excision of the Burn Wound in Patients With Large Burns
William F. McManus, MD;
Arthur D. Mason, Jr, MD;
Basil A. Pruitt, Jr, MD
Arch Surg. 1989;124(6):718-720.
Abstract
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• The known major determinants of survival for patients with burn injury are age, burn size, inhalation injury, and infection. The clinical courses of 210 patients with burns of 30% of the body surface or greater treated from Jan 1, 1983, through Dec 31, 1985, were reviewed to determine whether excision of the burn wound could be identified as a factor in survival after massive burn injury. The predominant site of infection changed from the burn wound to the lung, with pneumonia being the most common bacterial infection in patients whose wounds were treated as described. Effective topical control of bacterial proliferation and excision of the burn wound have resulted in replacement of invasive bacterial wound infection by nonbacterial burn wound infection. The apparent advantages of excision, particularly in large burns, may reflect only patient selection, since only those patients who are considered to be physiologically stable and able to tolerate the physiologic stress of excision are considered for operation.
(Arch Surg 1989;124:718-720)
Author Affiliations
From the US Army Institute of Surgical Research, Fort Sam Houston, Tex.
Footnotes
Accepted for publication Sept 30, 1988.
Read before the 94th Annual Session of the Western Surgical Association, Detroit, Nov 18, 1986.
The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.
Reprint requests to Medical Library, US Army Institute of Surgical Research, Fort Sam Houston, TX 78234.
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