Herndon D N, Parks D H
J Trauma. 1986 Feb;26(2):149-52. doi: 10.1097/00005373-198602000-00009.
Thirty-two children admitted from 1977 through 1981 were treated by serial debridement of their burn wounds with 1:1.5 to 3:1 meshed autografting of granulating tissue as it became available. Thirty-two burned children treated from 1981 to 1984 were treated by early total excision to fascia with application of 4:1 expanded autograft and cadaver skin for complete closure. The ages (6.8 +/- 0.6 years), sex distribution, and mean per cent third-degree burn (64 +/- 1%) were the same in both groups. There were seven deaths in each group. Overall operating time (10.3 +/- 0.8 hours) and units of blood loss (28.3 +/- 3.5) were indistinguishable in the survivors of both groups. The survivors of the early excision group underwent fewer operative procedures, (5.8 +/- 0.5 vs. 7.6 +/- 0.5) and had a greatly decreased length of hospital stay (57 +/- 5 vs. 97 +/- 8). The ultimate functional and aesthetic consequences of the two techniques must be compared.
1977年至1981年间收治的32名儿童，在肉芽组织形成后，采用1:1.5至3:1的网状自体皮移植对烧伤创面进行系列清创处理。1981年至1984年间收治的32名烧伤儿童，采用早期彻底切除至筋膜，并应用4:1的扩张自体皮和尸体皮进行完全闭合治疗。两组患儿的年龄（6.8±0.6岁）、性别分布以及平均三度烧伤百分比（64±1%）相同。两组各有7例死亡。两组幸存者的总手术时间（10.3±0.8小时）和失血量单位（28.3±3.5）无明显差异。早期切除组的幸存者接受的手术次数较少（5.8±0.5次对7.6±0.5次），住院时间大幅缩短（57±5天对97±8天）。必须对这两种技术的最终功能和美学效果进行比较。
