Benefits and limitations of burn wound excision

Monafo, William W.; Bessey, Palmer Q.

doi:10.1007/bf02067112

Cited by 22 publications

(3 citation statements)

References 34 publications

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“…54 Due to its limitation on literature since 2000, the evidence map does not in include many publications of the last decades of the past millennium that investigated surgical techniques of excision by knife or diathermia. 51,[55][56][57] Nonetheless, classical tangential or epifascial excision can still be considered as the standard of care and is the predominant modality of burn wound debridement in most countries worldwide.…”

Section: Hydrosurgerymentioning

confidence: 99%

Evidence and Trends in Burn Wound Debridement: An Evidence Map

et al. 2020

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Treatment of the burn wound is crucial in care of severely burned patients. Surgical strategies differ in technique and timing of wound excision and are considered to have an impact on morbidity and mortality of burn patients. Most techniques and strategies have been established during the last century and are still standard of care. Nonetheless, several newer techniques have been presented and evaluated recently. To summarize the evidence and trends for eschar removal by burn wound debridement currently available, an evidence map as variant of the systematic review, was prepared. For this purpose, a systematic literature search was performed in the PubMed databases until December 2016. While overall evidence in this domain is low, recent publications focus on optimal timing of wound excision, enzymatic debridement, and hydrosurgery. Several studies report the benefit of an early wound excision in terms of shorter hospital stay, lower wound infection rate, and reduction of postburn metabolic changes. Enzymatic debridement has been shown to be an effective tool for early eschar removal and in addition reduces the need for autografting of the debrided burn wound with a relatively high level of evidence (LoE 2-). Wound debridement by means of hydrosurgery is more precise compared to conventional wound excision and preserves viable dermis, but a positive effect on wound healing or scar formation could not been shown (LoE 2). Furthermore, rarely reported techniques comprise larvae therapy, debridement by laser, and other technical adjuncts, but the level of evidence is limited (LoE 4-/5).

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Section: Hydrosurgerymentioning

confidence: 99%

Evidence and Trends in Burn Wound Debridement: An Evidence Map

et al. 2020

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“…Although mindful of the need for expeditious burn excision, there appear to be additional timing considerations in those patients requiring ICU admission 1–7 . There appears to be a window of opportunity, which opens at the time of the burn injury and closes 48–72 h later.…”

Section: Factors Taken Into Consideration In Protocol Developmentmentioning

confidence: 99%

Development of Patient Pathways for the Surgical Management of Burn Injury

Greenwood¹

2006

ANZ Journal of Surgery

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“…Burn injury remains a prominent global health burden, with over 11 million burn injuries receiving medical attention per annum, especially in low and middle-income countries [1]. For full thickness and deep partial thickness burns, the widely accepted practice is early excision and autografting [2,3]. While outcomes are undoubtedly improved as a result of this strategy, early aggressive debridement exposes susceptible patients to considerable potential risk in the operating room, including the development of hypothermia and its sequelae [4].…”

Section: Introductionmentioning

confidence: 99%