Early tangential excision and skin grafting as a routine method of burn wound management: an experience from a developing country

This study assessed the feasibility of performing early tangential excision and skin grafting for burn wounds 'routinely' in a developing country. An analysis of mortality, morbidity and hospital stay was carried out for 90 burns patients with deep partial skin loss burns out of 202 admissions, who underwent 'early' tangential excision and skin grafting. Overall survival rate was 86.5 per cent. Children below 14 years of age with burns ≤ 40 per cent TBSA (total body surface area) had no mortality, 93.5 per cent of adult patients with burns ≤ 60 per cent TBSA survived in contrast to those with burns of > 60 TBSA per cent who all died. Morbidity for contractures and hypertrophic scars was nil to minimal. The mean hospital stay for adult patients with major burns was 30 days, with minor burns it was 18.7 days. We conclude that in developing countries, early tangential excision and skin grafting can and should be done routinely for all minor burns and for the major burns who are admitted to a well-equipped burns centre, but not for very 'extensive burns', until biological skin substitutes are more readily available.