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 | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Article 11, Volume 43, Issue 2, July 2019, Page 221-226 PDF (8.82 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejprs.2019.64978 | ||||
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| Authors | ||||
| Tarek Elmenoufy1; Osama Taha2; Mohamed Kamal3; Mostafa Elsonbaty3 | ||||
| 1The Department of Plastic and Reconstructive Surgery, El-Hylmia Armed Forces Hospital, Cairo** | ||||
| 2The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Assiut University | ||||
| 3The 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 | ||||
| Early excision and grafting – Delayed skin; grafting – Burn eschar – Primary burn surgery; – Surgical management of burn | ||||
| References | ||||
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