Pietsch J B, Netscher D T, Nagaraj H S, Groff D B
J Pediatr Surg. 1985 Dec;20(6):754-7. doi: 10.1016/s0022-3468(85)80039-7.
The advantage of early excision and grafting in the treatment of limited full-thickness burns has been clearly established. The goal of the present study was to evaluate the role of early burn wound excision in major pediatric burns. Of the 470 pediatric burn admissions between 1979 and 1984 that were reviewed, 53 patients met the criteria of deep second or third degree burns greater than 25% total body surface area (TBSA). Of these, 20 had burn wound excision within 7 days (Early) and 33 had delayed excision and grafting (Late). The Early group, despite having greater transfusion requirements (69.4 v 36.2 cc/kg), had shorter hospital stays (35.3 v 49.1 d, P less than 0.05), fewer metabolic complications (20% v 79%, P less than 0.001), and less burn wound contamination (55% v 90%, P less than 0.01) than the Late group. Mortality was lower in the Early group (0% v 12%), but this was not statistically significant. Early excision and grafting are therefore recommended in the care of major burns in children.
早期切除并植皮治疗局限性全层烧伤的优势已得到明确证实。本研究的目的是评估早期烧伤创面切除在小儿大面积烧伤治疗中的作用。在回顾的1979年至1984年间收治的470例小儿烧伤患者中，53例符合深二度或三度烧伤面积大于25%体表面积（TBSA）的标准。其中，20例在7天内进行了烧伤创面切除（早期组），33例进行了延迟切除并植皮（晚期组）。早期组尽管输血需求量更大（69.4对36.2 cc/kg），但住院时间更短（35.3对49.1天，P<0.05），代谢并发症更少（20%对79%，P<0.001），烧伤创面污染也更少（55%对90%，P<0.01）。早期组的死亡率更低（0%对12%），但差异无统计学意义。因此，建议对小儿大面积烧伤进行早期切除并植皮治疗。
