Early Excision and Skin Graft versus Delayed Skin Grafting for Patients with Deep Thermal Burn Up to 15% of the Body Surface Area: A Prospective Comparative Study

Document Type : Original Article

Authors

1 The Department of Plastic and Reconstructive Surgery, El-Hylmia Armed Forces Hospital, Cairo**

2 The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Assiut University

3 The Department of Plastic and Reconstructive Surgery Faculty of Medicine, Assiut University

Abstract

Background: The innovation of early burn surgery takes
very long time to be well established may be due to improper
explanations of burn pathophysiology and unpredicted complications
of such surgery [1]. Janzekovic work in the 1970s
early allows early surgery of burns to achieve greater acceptance
through tangential excision [2]. Delayed skin grafting
technique include its relative selectivity and the fact that it
is not based on diagnosis, usually involves less surgical
intervention, and is simple to practice [3].
Objective: The outcomes of the two modalities of deep
thermal burn management up to 15% of the body surface area
were compared.
Patients and Methods: A prospective study was performed
on 30 patients with recent burn who were divided into two
groups; group of early surgery: 15 patients were operated
using early excision and skin grafts and group of delayed
surgery: 15 patients were operated using delayed skin grafts.
Patients were evaluated during preoperative period for (fever,
WBCs count, hemoglobin level, albumin level, blood and
plasma transfusion), intraoperative blood transfusion and
post-operative (graft take, numbers of the operations, functional
deformity, psychotherapy drug needs, nosocomial infection,
weight deficit and hospital stays).
Results: It was found that the incidence of fever and
transfusion requirements were significantly higher in group
of delayed surgery. There were no significant difference
regarding intraoperative blood transfusion and graft take. As
regarding the numbers of operations, the functional deformity,
the need for psychotherapy drugs, the incidence of nosocomial
infection, the incidence of weight loss and hospital stay were
significantly less in group of early surgery.
Conclusion: Early excision and skin grafting in patients
with thermal burn up to 15% of body surface area was associated
with decreasing incidence of fever, nosocomial infection,
decrease transfusion requirements, improve functional outcome,
decrease rate of burn associated major psychological
stress, decrease incidence of weight loss, decrease numbers
of operations and decrease hospital stay.

Keywords

Main Subjects

References

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