ABSTRACT
In this therapeutic approach, all deep dermal and full-thickness burns are excised after admission, ideally within 24 h of injury. Resuscitation is started and carried on during surgery, and urine output and other hemodynamic parameters govern it. Operative losses are replaced with reconstituted whole blood (one unit of fresh frozen plasma + one unit of packed red cells) calculated to replace a blood loss of 0.5 nil/cm2 excised. Blood gas analysis and measurement of blood count and electrolytes are repeated every 30 min during surgery to determine the adequacy of fluid resuscitation and operative blood loss replacement. Patients receive perioperative antibiotics to prevent postoperative sepsis due to bacterial translocation from the gut.
