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June 20, 1925


Author Affiliations

San Antonio, Texas

JAMA. 1925;84(25):1917. doi:10.1001/jama.1925.26620510003011c

The treatment of extensive second and third degree burns has taken on a new turn since the work of Cannon2 and Willis.3 The new procedures are destined to reduce mortality, reduce damage to internal viscera due to absorption of protein toxin of slough, alleviate pain, shorten convalescence, reduce the necessity of doing skin grafts, and prevent contractures.

The primary procedure is to remove the entire burned area with a sharp knife, the débridement extending down to healthy tissue. All bleeding points are stopped by ligature, and the oozing is stopped by applying a saturated alcoholic solution of picric acid to the surface. In addition to the hemostatic effect, the picric acid combats any skin infection that may be present. The entire procedure is done under gas anesthesia, this causing less shock, and no preliminary morphin is given. The latter is avoided because it has a deleterious and depressing