Primary Excision and Grafting of Large Burns

Jackson, Douglas; Topley, Elizabeth; Cason, J.S.; Lowbury, E. J. L.

doi:10.1097/00000658-196008000-00001

Cited by 124 publications

(31 citation statements)

References 6 publications

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“…In scenarios where the STSG has been placed on granulation tissue, Jackson et al 17 and others have shown a lower success rate (80 -85%). In contrast, we have shown that the application of an STSG to granulation tissue can have an excellent rate of success but does not provide a statistically significant benefit when compared with other graft beds.…”

Section: Split-thickness Skin Grafts In the Modern Burn Unitmentioning

confidence: 98%

Factors Affecting Success of Split-Thickness Skin Grafts in the Modern Burn Unit

Thourani

Ingram

Feliciano

2003

The Journal of Trauma: Injury, Infection, and Critical Care

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In the hands of an experienced burn surgeon, the recipient bed has no significant impact on the success rate of STSGs at 14 days postgrafting, except in those patients 18 years or younger, in which the mean STSG success rate was significantly greater on granulation tissue compared with fat. TBSA burned > 35%, age > 55 years, and the presence of diabetes mellitus continue to have an adverse impact on the success rate of STSGs at 14 days.

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Section: Split-thickness Skin Grafts In the Modern Burn Unitmentioning

confidence: 98%

Factors Affecting Success of Split-Thickness Skin Grafts in the Modern Burn Unit

Thourani

Ingram

Feliciano

2003

The Journal of Trauma: Injury, Infection, and Critical Care

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“…Primary excision and grafting of large fullthickness and deep dermal burns is standard management in most burn centers today [3,4].…”

Section: Introductionmentioning

confidence: 99%

Pulsed carbon dioxide laser ablation of burned skin: In vitro and in vivo analysis

1990

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Pulsed lasers produce efficient and precise tissue ablation with limited residual thermal damage. In this study, the efficiency of pulsed CO2 laser ablation of burned and normal swine skin was studied in vitro with a mass loss technique. The heats of ablation for normal and burned skin were 2,706 and 2,416 J/cm3 of tissue ablated, respectively. The mean threshold radiant exposures for ablating normal skin and eschar were 2.6 J/cm2 and 3.0 J/cm2, respectively. Radiant exposures greater than 19 J/cm2 produced a plasma, which decreased the efficiency of laser ablation. Thus the radiant exposures for efficient ablation range from 4 to 19 J/cm2, and within this radiant exposure range 20-40 microns of tissue are ablated per pulse. We also examined, on a gross and histopathologic basis, in vivo burn eschar excision with a pulsed CO2 laser. The laser allowed bloodless excisions of full thickness burns on the backs of male hairless rats. The zone of thermal damage was approximately 85 microns over the subjacent fascia. The pulsed CO2 laser can ablate burn eschar efficiently, precisely, and bloodlessly and may prove valuable for the excision of burned and necrotic tissue.

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“…In case of isolated success following debridement of necrotic tissues covering 50-60% of the body surface, reduced mortality or shorter healing period were not observed, as compared to conservative management. The comparison of the excision with early skin grafting and delayed skin grafting showed no differences considering mortality (28). Jackson preferred the excision of deep burn wounds, considering 20% of the body surface.…”

mentioning

confidence: 95%

“…At the turn of the sixties of the past century MacMillan and co-authors presented data concerning the excision of 10-30% of the body surface, including even more extensive surfaces (26,27,28).…”

mentioning

confidence: 99%