[The effects of escharectomy during burn shock stage on metabolic rate alterations].

OBJECTIVE

To determine whether early massive eschar excision and skin grafting may decrease the hypermetabolic response that characterizes burn injury.

METHOD

Twenty-one adult men with burns over 30% of the total body surface area were assigned to one of two treatment groups. Resting energy expenditures (REEs) were obtained by means of cardiorespiratory diagnostic systems (made by Medical Graphics Corporation in USA) at the patients' bedsides.

RESULTS

The clinical conditions and non-operative management in two groups were comparable [(311 +/- 15) J.h-1.m-2 vs (345 +/- 16) J.h-1.m-2], but different in time of eschar excision and skin grafting. Although REEs increased sharply in all patients, the patients in group 1 with escharectomy during burn shock stage had lower REEs than those in group 2 with escharectomy after burn shock stage.

CONCLUSION

Escharectomy during burn shock stage contribute to decreasing the hypermetabolic response to burn injury.