Early burn wound excision significantly reduces blood loss

M. H. Desai, D. N. Herndon, L. Broemeling, R. E. Barrow, R. J. Nichols, R. L. Rutan

Research output: Contribution to journalArticlepeer-review

170 Scopus citations

Abstract

The hypothesis that near-total early excision of large burns in children can be performed safely with a reduction in blood loss was tested. Of 1662 acutely burned patients admitted to this institution between 1982 and 1989, 594 underwent near-total excision of cutaneous flame or scald burn injuries in a single procedure. Operations took less than 3 hours and there were no operative deaths. Blood losses in burns of more than 30% total body surface area (TBSA) were significantly less at 0.40 ± 0.06 mL/cm2 and 0.49 ± 0.49 mL/cm2 excised when surgery was performed within the first 24 hours or after the 16th day after burn, respectively, when compared to 0.75 ± 0.02 mL/cm2 for those excised between 2 and 16 days after burn (p < 0.05). Blood loss for burns of less than 30% TBSA was of 1.19 ± 0.13 mL/cm2. Early excision did not inrease mortality rate when compared to later excision times. We suggest that near-total excision of large burns within the first 24 hours reduces blood requirements and morbidity without adversely altering hemodynamic stability or increasing mortality risks.

Original languageEnglish (US)
Pages (from-to)753-762
Number of pages10
JournalAnnals of surgery
Volume211
Issue number6
DOIs
StatePublished - 1990

ASJC Scopus subject areas

  • Surgery

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