Burn Wound Closure,
Abstract
Wound closure should be carried out at the earliest possible stage. In suitable cases it can be done almost immediately, i.e., at day 2 or 3, with some form of excision being followed by the immediate application of autograft. If necessary, further staged excisions can follow at 2-4 day intervals. Wound closure becomes a problem in the extensive deep burn of over 60% where there is a shortage of the patient's own skin for grafting. It should be noted that over 90% of burn cases in the U.S. population involve less than 60% of the body surface area. It is an unfortunate paradox of transplantation biology that the tissue grafts which are technically easy, skin, bone marrow, pancreatic islets for example - are immunologically difficult. In closing large burn wounds we are thus in the business of time-borrowing, by such expedients as temporary biological coverings and artificial coverage of the wound. History records a wide variety of burn wound coverings, ranging from tannic acid in both old and recent times, to the so-called artificial skins of modern investigative technology. The recent clinical use of biological skin scaffolds is an exciting development. This concept provides a biogradable template as a deep layer, acting as a scaffold for a neodermis, together with a temporary silastic covering which is replaced in stages by this autograft. Initial reports have been good, and we await their further experience with interest.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 21, 1983
- Accession Number
- ADP004414
Entities
People
- J. H. Heslop
Organizations
- University of Otago