A problem of major proportions in the treatment of the secondary aspects of the deeper burns is the presence in the burned area of devitalized or injured tissues. The tissues involved depend on the site and depth of the burn, but for practical purposes the chief component for consideration consists of a mass of interlacing collagen fibers which extend throughout the dermis to connect with like material in the subcutaneous tissue and between the muscle fibers. The material, whether treated with severe coagulatory agents, simple ointments or wet dressings, forms a strongly adherent layer which separates but slowly from the tissues beneath. This layer constitutes a serious impediment to management of the case. Infection is liable to develop within the material or beneath it. Further, even if infection does not occur, the layer may impede healing and preparation of the area for skin grafting. It would appear that occasions might
COOPER GR, HODGE GB, BEARD JW. ENZYMATIC DEBRIDEMENT IN THE LOCAL TREATMENT OF BURNS: A PRELIMINARY REPORT. Am J Dis Child. 1943;65(6):909–911. doi:10.1001/archpedi.1943.02010180085011
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