Related Experiment Videos
Early excision of major burns in children: effect on morbidity and mortality
Insights
Early surgical treatment for major pediatric burns significantly reduces hospital stays and complications. Prompt excision and grafting in children with extensive burns improve outcomes and decrease metabolic issues.
Area of Science:
- Pediatric Surgery
- Burn Management
- Wound Healing
Background:
- Early excision and grafting are proven beneficial for limited full-thickness burns.
- The efficacy in major pediatric burns requires further evaluation.
Purpose of the Study:
- To assess the impact of early versus delayed burn wound excision in pediatric patients with major burns.
- To compare outcomes based on the timing of surgical intervention.
Main Methods:
- Retrospective review of 53 pediatric burn admissions (1979-1984) with >25% TBSA deep second or third-degree burns.
- Categorization into 'Early' (excision within 7 days) and 'Late' (delayed excision) groups.
- Comparison of hospital stay, metabolic complications, wound contamination, and mortality.
Main Results:
- The 'Early' group experienced shorter hospital stays (35.3 vs. 49.1 days) and fewer metabolic complications (20% vs. 79%) compared to the 'Late' group.
- Burn wound contamination was significantly lower in the 'Early' group (55% vs. 90%).
- While mortality was lower in the 'Early' group (0% vs. 12%), this difference was not statistically significant.
Conclusions:
- Early burn wound excision and grafting are recommended for managing major pediatric burns.
- This approach leads to improved patient outcomes, including reduced complications and shorter hospitalizations.
- Further research may explore optimizing transfusion strategies in early excision protocols.
Abstract:
The advantage of early excision and grafting in the treatment of limited full-thickness burns has been clearly established. The goal of the present study was to evaluate the role of early burn wound excision in major pediatric burns. Of the 470 pediatric burn admissions between 1979 and 1984 that were reviewed, 53 patients met the criteria of deep second or third degree burns greater than 25% total body surface area (TBSA). Of these, 20 had burn wound excision within 7 days (Early) and 33 had delayed excision and grafting (Late). The Early group, despite having greater transfusion requirements (69.4 v 36.2 cc/kg), had shorter hospital stays (35.3 v 49.1 d, P less than 0.05), fewer metabolic complications (20% v 79%, P less than 0.001), and less burn wound contamination (55% v 90%, P less than 0.01) than the Late group. Mortality was lower in the Early group (0% v 12%), but this was not statistically significant. Early excision and grafting are therefore recommended in the care of major burns in children.