Once upon a time and the timing of surgery in burns.

摘要

The depth of injury is the major determinant in the management of the burn wound.1 The superficial partial thickness burn will invariably heal without surgery, the full-thickness wound, of any significant size, will invariably not heal without surgery. The intermediate depth burn can heal without scarring if cleaned and dressed with biological dressings.2 It is the deep partial thickness, or deep dermal burn that still causes some debate. There is the potential for such injuries to heal but the process can take several weeks during which time the patient is at risk of infection developing in the wound. Another very important consideration is the outcome as the risk of hypertrophic scarring does increase with delayed wound closure. Accordingly, in children and adults with functionally or aesthetically critical sites of injury the surgical management of deep dermal burns is to be strongly encouraged.