EXTENSIVE WOUND EXCISION IN SHOCK STAGE IN PATIENTS WITH MAJOR BURNS

To stop excessive plasma loss, alleviate noxious effects of devitalize d tissues on the body and shorten the hospitalization time, rye perfor med extensive escharectomy during the shock period in extensively burn ed patients. Group A consisted of 21 patients aged 9-45 years (26.1+/- 7.9 years), with a mean total burn area of 63.2%+/-18.1% TBSA, and ful l-thickness injury involving 35.9%+/-19.6% TBSA, The first escharectom y was done at 24.1+/-13.9 hours postburn, and excision area averaged 3 2.3%+/-6.7% TBSA (24%-46%), In 15 of them, Swan-Ganz catheter was intr oduced to monitor the hemodynamic changes. It was found that RAP, PAP, PAWP, ABP, IIR, CO and CI were all stable during and after the operat ion. Group B consisted of 29 patients aged 11-50 years (30.4+/-11.7 ye ars), in whom escharectomy was begun 4-5 days postburn. The mean heali ng time of the patients in group A was 33.1 days, shorter than that of group B patients (40.1 days). The duration of hemoconcentration was s horter in group A, The amount of blood transfusion was almost 700 ml l ess in group A during the first two weeks. Less antibiotics were used with fewer visceral complications in group A, We believe that escharec tomy during the burn shock stage is feasible.