Effects of Delayed Wound Excision and Grafting in Severely Burned Children

Wu, Xiaowu

doi:10.1001/archsurg.137.9.1049

Cited by 163 publications

(70 citation statements)

References 25 publications

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“…However, an improved understanding of the pathophysiology of burns allowed the advancement of multiple intra-and postoperative medical and surgical techniques that has resulted in gradual decreases in morbidity and mortality (66,87,127,181,196,200,470). Medical support to maintain hemodynamic and respiratory function within the trauma intensive care unit and operating theater, the provision of early adequate nutrition, and the use of surgical techniques that minimize blood and heat loss allowed this approach to become the standard of care for large thermal injuries in modern burn centers.…”

Section: Early Excision and Burn Wound Closurementioning

confidence: 99%

“…Furthermore, shortening the period of wound inflammation, which in turn reduces the development of hypertrophic scarring, may optimize the outcome in terms of function and appearance (12,97,398). This is achieved by early removal of necrotic tissue (e.g., eschar) and wound closure with autograft, allograft, or skin substitutes in selected patients (15,66,196,286,390,470).…”

Section: Early Excision and Burn Wound Closurementioning

confidence: 99%

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Burn Wound Infections

Church

Elsayed

Reid³

et al. 2006

Clin Microbiol Rev

1,623

1,345

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SUMMARYBurns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. Significant thermal injuries induce a state of immunosuppression that predisposes burn patients to infectious complications. A current summary of the classifications of burn wound infections, including their diagnosis, treatment, and prevention, is given. Early excision of the eschar has substantially decreased the incidence of invasive burn wound infection and secondary sepsis, but most deaths in severely burn-injured patients are still due to burn wound sepsis or complications due to inhalation injury. Burn patients are also at risk for developing sepsis secondary to pneumonia, catheter-related infections, and suppurative thrombophlebitis. The introduction of silver-impregnated devices (e.g., central lines and Foley urinary catheters) may reduce the incidence of nosocomial infections due to prolonged placement of these devices. Improved outcomes for severely burned patients have been attributed to medical advances in fluid resuscitation, nutritional support, pulmonary and burn wound care, and infection control practices.

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Section: Early Excision and Burn Wound Closurementioning

confidence: 99%

Section: Early Excision and Burn Wound Closurementioning

confidence: 99%

Burn Wound Infections

Church

Elsayed

Reid³

et al. 2006

Clin Microbiol Rev

1,623

1,345

View full text Add to dashboard Cite

show abstract

“…Furthermore, dilutional effects of severe fluid resuscitation and diminished half-lives of platelets in circulation may also contribute to an apparent reduction in PCs [24,25]. Although ongoing blood loss in excision surgery might contribute to PC decline, early excision and graft surgery are advocated [29]. Taken together, the pathophysiologic mechanisms underlying the large PC declines in severely burnt patients are complicated and still need to be elucidated.…”

Section: E5mentioning

confidence: 99%

Association of platelet counts decline and mortality in severely burnt patients

Guo

Wang

Huan

et al. 2012

Journal of Critical Care

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“…Second, it is important to assess whether a burn requires surgical intervention as early as possible to minimize scarring and bacterial colonization of the wounds. The delayed intervention associated with classifying partial thickness burns has been shown to increase the length of hospitalization and risks of infection, metabolic distortions, and organ-failure [3,4]. Finally, multi-region burns are common and will typically contain an amalgamation of burn depths [5].…”

Section: Introductionmentioning

confidence: 99%