Local treatment for extensive deep dermal thickness burn and follow-up study

For the local treatment of extensive burn patients including superficial dermal thickness burn and deep dermal thickness burn, it is often difficult to determine whether conservative treatment should be followed consistently or grafting be employed. The present study was made to determine when grafting should be provided if required and the treatment method to provide the best results. For the study, a total of 41 cases were taken to which the author rendered treatment from the initial stages, in the period from January 1981 to December 1985. In these cases, the burn area was more than 10 per cent of the body surface area (BSA) in infants and children, and more than 20 per cent BSA in adults. Both superficial dermal thickness burn and deep dermal thickness burn were coexisting. The treatments and results of examination after convalescence are as follows. 1. In conservative local treatment, impregnated ointment gauze, L(D)PS and silver sulfadiazine were used, with wet-to-dry dressing, and hydrotherapy or skeletal suspension used jointly in some cases. 2. Of 41 cases, 38 received grafting during the treatment process. Patch autograft was applied to all cases, and allograft was jointly applied to 5 cases. 3. From post-convalescence examination, most cases showed hypertrophic scar when grafting was provided at a later stage and with the younger age of the patient. From this, it can be emphasized that earlier grafting will cause reduction in treatment period, with better functional and esthetic results, even in deep dermal thickness burn.