Initial Excision and Closure of Acute Burns
Learning Objectives
Describe the rationale for early burn wound excision and closure and its role in reducing sepsis and organ dysfunction in pediatric burn patients
Explain how burn size, depth, circumferential involvement, and patient physiology influence the timing and extent of surgical excision
Apply principles of hemostatic burn excision, including layered excision, tourniquet use, and dilute epinephrine clysis, to minimize blood loss
Analyze indications for staged excision, delayed surgery, or fascial excision based on patient stability, nutritional status, and infectious risk
Evaluate donor site management and graft fixation strategies to optimize wound healing while minimizing morbidity and postoperative complications
Author(s)
Robert Sheridan, MD
Burn Service Medical Director | Shriners Hospital for Children
Interim Chief of Staff | Shriners Hospital for Children
Attending surgeon | Mass General burn unit
Traci Wolbrink, MD, MPH
Co-Director, OPENPediatrics; Co-Director, Center for Educational Excellence and Innovation; Program Director, Pediatric Critical Care Medicine Fellowship; Senior Associate in Critical Care Medicine | Boston Children’s Hospital
Associate Professor of Anaesthesia | Harvard Medical School
Citation
Sheridan R, Wolbrink TA. Initial Excision and Closure of Acute Burns. 11/2017. Online Video. OPENPediatrics. https://learn.openpediatrics.org/learn/course/internal/view/elearning/3300/initial-excision-and-closure-of-acute-burns.