Engrav L H, Heimbach D M, Walkinshaw M D, Marvin J A
Plast Reconstr Surg. 1986 May;77(5):744-51. doi: 10.1097/00006534-198605000-00007.
Sequential excision of burns is now a common technique. Nevertheless, standard texts, when describing the treatment of facial burns, recommend allowing spontaneous separation of the eschar and then grafting on granulation tissue if healing does not occur. This method yielded disappointing results for us and the reconstructive procedures required were of great magnitude. Therefore, in January of 1979, we began primary excision and grafting of those face burns not essentially healed at 10 days. We have now treated 16 consecutive patients (approximately 5 percent of all face burns) in this manner who are at least 12 months postinjury. Three were lost to follow-up, leaving 13 for evaluation. This method yields better appearance and function than that obtained by allowing spontaneous healing over more than 3 weeks or grafting on granulation tissue and decreases the magnitude of subsequent reconstruction.
烧伤的分期切除如今已是一项常用技术。然而，标准教科书在描述面部烧伤的治疗时，建议让焦痂自然分离，若未愈合则在肉芽组织上进行植皮。这种方法对我们而言效果不尽人意，且所需的重建手术规模巨大。因此，在1979年1月，我们开始对伤后10天仍未基本愈合的面部烧伤进行一期切除和植皮。我们现已采用这种方式连续治疗了16例患者（约占所有面部烧伤患者的5%），这些患者受伤后至少已有12个月。3例失访，其余13例接受评估。与让创面自然愈合超过3周或在肉芽组织上植皮相比，这种方法能产生更好的外观和功能，并减小后续重建手术的规模。
