Bach C-A, Richard P, Constant I, Vazquez M-P, Conti E
Unité de chirurgie, centre de traitement des brûlés, hôpital d'enfants Armand-Trousseau, AP-HP, Paris, France.
Ann Chir Plast Esthet. 2013 Aug;58(4):373-8. doi: 10.1016/j.anplas.2011.09.002. Epub 2011 Nov 15.
Acute burn is a more or less profound destruction of the skin envelope. The depth of the injury determines the severity of functional and aesthetic sequelae. Local care prevents the infection, factor of deepening of the burn. Currently the dressing used in most Burns centers is a bandage covering a bacterial product applied to the burn. The advantage of this dressing is to prevent the occurrence of local infection. In contrast, open-air method of treatment is based on the notions that the wound is infected. His purpose is to reduce the effects of infection by creating an unfavourable environment to the growth and multiplication of bacteria. The principle of this method is the formation over the burned area of an eschar. The eschar acts as a natural dressing to protect the injured area against infection. The residual skin islets are preserved. The surgical cleavage of the eschar is easy; the deep surface of the crust defines the surgical plan. Deep tangential excisions are not necessary. The implementation of this technique is easy and it is particularly well suited to pediatrics. Treatment is not painful and the child's activities are not hampered by bandages. Respect of the children's quality of life and medical-economic efficiency of this method give it a prominent place in the treatment of burns in children.
急性烧伤是皮肤表层或多或少的深度破坏。损伤深度决定了功能和美观后遗症的严重程度。局部护理可预防感染，而感染是烧伤加深的因素。目前大多数烧伤中心使用的敷料是一种覆盖在涂于烧伤处的细菌制品上的绷带。这种敷料的优点是可预防局部感染的发生。相比之下，暴露疗法基于伤口已被感染的观念。其目的是通过营造不利于细菌生长和繁殖的环境来减轻感染的影响。该方法的原理是在烧伤区域形成焦痂。焦痂可作为天然敷料保护受伤区域免受感染。残留的皮肤小岛得以保留。焦痂的手术切除很容易；痂皮的深层表面确定了手术方案。不需要进行深部削痂术。该技术实施起来很容易，尤其适用于儿科。治疗过程不痛苦，孩子的活动也不会因绷带而受限。这种方法对儿童生活质量的尊重以及医疗经济效益使其在儿童烧伤治疗中占据重要地位。
