Primary excision and immediate wound closure

Intensive Care Medicine
W C QuinbyC C Bondoc

Abstract

Surgical principles of early excision of devitalized tissue and prompt wound closure which govern the management of all traumatic injuries have been developed in the primary treatment of burns. Topical and systemic antibodies which delay wound infection and control invasive sepsis provide an initial period of two to three weeks in which wound excision and closure is safe and effective. Full support of the central and peripheral circulation, respiratory function, nutrition, and musculoskeletal function are essential features of care until the burn wound is eliminated and closed. Following initial evaluation, wound excision is carried beyond the deepest level of injured tissue. Excision to the level of muscle fascia is used for full-thickness injury and sequential excision in or below the dermis for deep dermal injury. Techniques of skin grafting and subsequent care of the graft are described, including the use of human allografts. Primary excision has reduced mortality, morbidity and later reconstructive measures by a factor of 50% when compared to results obtained by awaiting spontaneous separation of eschar with later grafting. With massive burns the use of allografts from familial donors of close immunologic type and immunosu...Continue Reading

References

Aug 1, 1976·The Journal of Trauma·J F BurkeJ P Remensnyder
Feb 11, 1975·Archives of Surgery·R J Lewis, W C Quniby
May 1, 1974·The Journal of Trauma·J F BurkeW C Quinby
Aug 1, 1968·Journal of Pediatric Surgery·W H HendrenB E Zawacki
Sep 1, 1971·Annals of Surgery·C C Bondoc, J F Burke
Apr 1, 1966·Archives of Surgery·J A MoncriefB A Pruitt
Jun 1, 1965·Archives of Surgery·C A MOYERW W MONAFO
Aug 1, 1960·Annals of Surgery·D JACKSONE J LOWBURY

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Citations

Jan 14, 2011·Plastic and Reconstructive Surgery·Ioannis V YannasJohn F Burke
Dec 25, 2007·Annals of Surgery·Jeff S IsenbergDavid D Roberts
Oct 30, 2009·Journal of the Royal Society, Interface·Rostislav V ShevchenkoS Elizabeth James
Apr 15, 2006·Clinical Microbiology Reviews·Deirdre ChurchRobert Lindsay
Oct 5, 2007·Journal of Materials Science. Materials in Medicine·Xavier GarricJean-Pierre Molès
Jan 1, 1984·Scandinavian Journal of Plastic and Reconstructive Surgery·E VernerssonM Aberg
Nov 22, 2011·Clinics in Plastic Surgery·Florian GroeberKatja Schenke-Layland
Jan 19, 2011·Advanced Drug Delivery Reviews·Florian GroeberKatja Schenke-Layland
Mar 17, 2007·The Journal of Investigative Dermatology·Mette Møller-KristensenKazue Takahashi
Dec 29, 2005·Burns : Journal of the International Society for Burn Injuries·M Vehmeyer-HeemanW Boeckx
Apr 27, 2019·Scientific Reports·Mayuko UeharaReza Abdi
Dec 3, 2016·Essays in Biochemistry·Lucas B NavesSeeram Ramakrishna
Dec 7, 2019·Journal of Burn Care & Research : Official Publication of the American Burn Association·Li-Wu QianKai P Leung

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