Housinger T A, Hills J, Warden G D
Department of Surgery, University of Cincinnati, OH.
J Burn Care Rehabil. 1994 Sep-Oct;15(5):408-11.
The acute management of pediatric facial burns is not uniform. Many surgeons prefer to wait until primary wound separation occurs before grafting. Concerns over early excision are accentuated in small pediatric patients. The possible benefits of early excision results have led to adoption of this technique at our facility. This study presents our recent experience with early excision and grafting. Sixty-six patients with a mean age of 6.2 years underwent early excision and grafting of facial burns. Patients underwent grafting a mean 12.7 days after burn. Procedures were done in two stages. All grafts were dressed open. There were no episodes of acute airway decompensation. No patient required regrafting. Patients wore pressure masks a mean of 15.5 months after grafting. Thirteen patients had releases (10 eyelids, three lips/commissures) in the first postoperative year. These results demonstrate that early excision and grafting of facial burns can be carried out safely in pediatric patients with burns. The benefits of early wound coverage can thus be applied to facial burns in this population of patients.
小儿面部烧伤的急性处理并不统一。许多外科医生倾向于等到创面初步分离后再进行植皮。小儿患者早期切除的问题更为突出。早期切除带来的潜在益处促使我们机构采用了这项技术。本研究介绍了我们近期在早期切除和植皮方面的经验。66例平均年龄6.2岁的患者接受了面部烧伤的早期切除和植皮。患者烧伤后平均12.7天接受植皮。手术分两个阶段进行。所有植皮均采用开放包扎。未发生急性气道失代偿情况。没有患者需要再次植皮。患者在植皮后平均佩戴压力面罩15.5个月。13例患者在术后第一年进行了松解手术（10例眼睑，3例嘴唇/口角）。这些结果表明，小儿面部烧伤患者可以安全地进行早期切除和植皮。早期创面覆盖的益处因此可应用于这类患者的面部烧伤。
