Conservative treatment of scald burns is superior to early excision

M. H. Desai, R. L. Rutan, David Herndon

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Early excision of deep burns has been advocated; however, it is difficult to clinically determine the depth of scald burns during the early postburn period. This prospective, randomized study was designed to determine whether early excision was superior to conservative treatment of scald injuries. Patients with scald injuries (which were not caused by grease) of clinically indeterminant depth were randomized to early (n = 12) or late (n = 12) excision; all patients with obvious superficial and full-thickness injuries were excluded. In the early excision group, all deep wounds were tangentially excised and grafted within 72 hours of admission, whereas in the late treatment group wounds were excised and grafted after 2 weeks had passed since injury. Area excised, postburn day of excision, percent graft take, operating-room time, blood replacement, incidence of infection, and length of hospital stay were compared. No patient experienced a significant wound infection or systemic sepsis. A significantly smaller area of excision was necessary for those patients who were treated with delayed surgery, and concomitant decreases in operating-room time and blood loss were observed. Notably, only one half of the patients who were randomized to the delayed excision group ultimately required surgical intervention to achieve wound closure. Graft take was comparable for both groups, as was length of hospital stay. Early clinical evaluation of scald injuries appears to be equivocal, and later evaluations reveal a less severe injury. Financial gains can be made when surgical excision of scald injuries is delayed until 2 weeks after injury because of a related reduction in hospital expenditures.

Original languageEnglish (US)
Pages (from-to)482-484
Number of pages3
JournalJournal of Burn Care and Rehabilitation
Volume12
Issue number5
StatePublished - 1991

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Burns
Wounds and Injuries
Length of Stay
Operating Rooms
Conservative Treatment
Transplants
Wound Infection
Health Expenditures
Sepsis
Prospective Studies
Incidence

ASJC Scopus subject areas

  • Emergency Medicine
  • Rehabilitation
  • Surgery
  • Nursing(all)
  • Health Professions(all)

Cite this

Conservative treatment of scald burns is superior to early excision. / Desai, M. H.; Rutan, R. L.; Herndon, David.

In: Journal of Burn Care and Rehabilitation, Vol. 12, No. 5, 1991, p. 482-484.

Research output: Contribution to journalArticle

Desai, MH, Rutan, RL & Herndon, D 1991, 'Conservative treatment of scald burns is superior to early excision', Journal of Burn Care and Rehabilitation, vol. 12, no. 5, pp. 482-484.
Desai, M. H. ; Rutan, R. L. ; Herndon, David. / Conservative treatment of scald burns is superior to early excision. In: Journal of Burn Care and Rehabilitation. 1991 ; Vol. 12, No. 5. pp. 482-484.
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