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August 1962

Treatment of Burns by Early DebridementA Controlled Study

Author Affiliations

Chief, Department of Surgery, Ancker Hospital, Markle Scholar (Dr. MacLean), Present Address, Royal Victoria Hospital, Montreal Canada; Resident Surgeon, Ancker Hospital. (Dr. Rayner).; From Department of Surgery, Ancker Hospital, St. Paul, and University of Minnesota, Minneapolis.

Arch Surg. 1962;85(2):297-304. doi:10.1001/archsurg.1962.01310020127024

Introduction and Rationale  The major cause of death after full-thickness skin loss due to burning is infection. The initial treatment phase has been extensively studied, and the value of fluid and electrolytes, particularly saline, in the first 48-72 hours is well established. The careful regulation of fluid therapy and the institution of other measures to combat shock have prolonged life so that death before 72 hours is now rare even in a patient with total body burn. The management of the second treatment phase, which has as a goal early wound closure, has been less vigorously investigated. It is during this period, from the time of burning to the time of complete healing of grafts, that death from sepsis is an everpresent hazard.The reasonable assumption was made that any measure which might shorten this hazardous and painful period would have the advantage of decreasing the chance of death from

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