chapter  12
9 Pages

Daily Work

Rounds with the burn team are made daily at 7:00 AM. All burn wounds are inspected unless there was a recent operation. In general, the operative dressings are removed on postoperative day 3 down to the fine mesh gauze. Clinical cir­ cumstances may dictate that the wounds be inspected earlier at the discretion of the senior physician. All wounds are completely exposed on postoperative day 4. Donor sites are exposed on the day of the operation after arrival to the hospital room or on postoperative day 1, and are available for daily inspection thereafter. Wounds that are treated conservatively should be seen daily to inspect for signs of invasive infection. Ominous signs include a surface appearance of fungus or black spots. Increasing edema and erythema around wounds also increase suspicion. If there is any question, the wound should be biopsied and sent to pathology and microbiology. The pathologists do rapid sections to look for organisms invading into viable tissue. The microbiologists identify the organism, and the quantitative counts. The wounds are then dressed until the following day.