The burn wound from the surgical point of view.
The surgical approach cannot, and should not, be different for a mechanical wound and for a burn wound. Thin autografts applied over an excised burn wound act as the best antibiotic and the best analgetic, and at the same time provide a definite cover. The removal of thin skin grafts does not represent any additional danger to the burned patient. Homografts applied on excised dermal surfaces act as the best protection for potentially damaged layers of dermis, assuring spontaneous epithelization after their rejection. The clinical results obtained by primary necrectomies in extensive deep burns justify the conclusion that more of our effects should be concentrated towards an earlier and more adequate treatment in the early postburn phase. I am sure that the only chance of survival of critically burned patients depends on efficient action. Like Evans, I do believe in the value of whole blood transfusion in badly burned patients. We have to try to save their lives by changing their blood, as we do without hesitation in cases of badly matched blood transfusions.