ABSTRACT

Preop The surgeon must assess and manage (A)irway, (B)reathing, and (C)irculation, as

with any form of trauma. Estimate the total body surface area (TBS A) burn using the rule of nines. Intravenous fluid replacement is done using the Parkland formula, 4 ml lactated Ringers/kg body wt/%TBS A burn, given over the first 24 hours: one-half in

I the first 8 hours. Continue IV fluids to maintain a urine output of 0.5 ml/kg wt/hours. Avoid systemic antibiotics. Topical antimicrobial agents-silvadene, sulfamyalon, or

I silver nitrate-are used liberally. Silvadene is the agent of first choice; silver nitrate is used in patients with sulfa allergy; and sulfamyalon is used for patients who require | eschar penetration. Treat associated trauma.