Cuenca-Pardo J, Álvarez-Díaz CJ, Luján-Olivar F

Language: Spanish
References: 18
Page: 18-24
PDF size: 210.93 Kb.

ABSTRACT

A control study to compare the clinical evolution of patients with burns on the hand, who were treated at an early stage compared to those treated in the traditional manner was carried out. It included 68 patients that suffered deep burns by fire that involved one or both hands, excluding in lesions with charred fingers. Two groups were formed at random: group I had 34 patients with an extension average of 12.8%, these patients were operated on between the third and fifth day post-burn, by means of tangential excision and thin deep skin grafts. Group II had 34 patients with an average extension of 12.5%; the patients were operated on between the 14th and 18th day, with excision of the damaged tissue and local conditions allowing, skin grafts; in the event of loss of skin grafts with residual bloody areas, they were programmed for new skin grafts. A very hospitalization stay for group I was 7 days and 19.1 for group II (p ‹ 0.001); the average numbers of surgeries was of 1.1 for group I, and 2.2 for group II (p ‹ 0.01). There were eight complications in group I and none presented sequels; in group II there were 24 complications and 20 patients evolved with scars and contractures. Precocious surgical treatment of burn patients avoids complications and sequels, reduces the care costs and favors the quick patient’s return to their work activities.

REFERENCES

1. Nguyen TT, Gilpin DA, Meyer NA, Herndon DN. Current treatment burned patients. Ann Surg 1996; 225: 14-25.

2. Cuenca-Pardo JA, Alvarez-Díaz CJ. Quemaduras en la mujer embarazada. Cir Plast 1999; 9:18-22.

3. Arturson G. Cambios fisiopatológicos. En: Bendlin A, Linares HA, Benaim F. Tratado de quemaduras. México: Interamericana 1993: pp. 127-144.

4. Salisbury RE. Thermal Burns. In: McCarthy JG. Plastic Surgery. Philadelphia: WB Saunders Co 1990: pp. 787-984.

5. Cuenca-Pardo J, Alvarez-Díaz CJ. Fase inflamatoria del paciente quemado. Cir Plast 2001; 11: 90-97.

6. Still JM, Law EJ. Primary excision of the burn wound. Clin Plast Surg 2000; 27: 23-47.

7. Luce EA. The acute and subacute management of the burned hand. Clin Plast Surg 2000; 27: 49-63.

8. Salisbury RE. Reconstruction of the burned hand. Clin Plast Surg 2000; 27: 65-69.

9. Donetan MB. Reconstruction of the burned Hand and upper Extremity. In: McCarthy JG. Plastic Surgery. Philadelphia: WB Saunders Co 1990: pp. 5452-5482.

10. Kara M, Peters WJ, Douglas LG, Morris SF. An early surgical approach to burns in the elderly. J Trauma 1990; 30: 429-432.

11. Artz-Moncrief. Tratado de quemaduras. México: Interamericana, 2ª ed. 1969. pp. 139-164, 178-206.

12. Kirn DS, Luce EA. Early excision and grafting versus conservative management of burns in the elderly. Plast Reconstr Surg 1998; 102: 1013-1017.

13. Prassana N, Singh K. Early burn wound excision in major burns with pregnancy: a preliminary report. Burns 1996; 22: 234-237.

14. Chamania S, Patidar GP, Dembani B, Baxi M. A retrospective analysis of early excision and skin grafting from 1993-1995. Burns 1998; 24: 177-180.

15. Jansekovic Z. A new concept in early excision and immediate grafting of burns. J Trauma 1970; 15: 42-67.

16. Burke JF, Boudoc CC, Quinby WC. Primary burn excision and immediate grafting: a method shorting illness. J Trauma 1974; 14: 389-395.

17. Engrav LH, Heimbach DM, Reus JL et Al. Early excision and grafting vs nonoperative treatment of burn of indeterminate depth: a the randomized prospective study. J Trauma 1983; 23: 1001-1007.

18. Saffle JR, Davis B, Williams P et al. Recent outcomes in the treatment of burn injury in the United States: A report from the American Burn Association Patient registry. J Trauma 1996: 219-236.