[Clinical guidelines for timing of escharectomy and skin grafting during burn shock stage in extensively burned patients].

OBJECTIVE

To provide practical clinical guidelines to doctors who have no hemodynamic monitoring facilities in performing escharectomy during the shock period in extensively burned patients.

METHODS

We analyzed our clinical experiences in 60 patients with extensive burn.

RESULTS

Puting forward several clinical indexes for timing of escharectomy during burn shock stage: 1. Amount of fluids in the first 24 h postburn 2.6-3.0 ml.kg-1.1% TBSA-1; 2. Output of urine 80-100 ml/h; 3. Mentally fully conscious; 4. Thirst significantly alleviated and there is no nausea and vomiting; 5. Pulse 100/min; 6. Hb < or = 150 g/L; 7. Hct < or = 0.50.

CONCLUSIONS

With the clinical indexes as guidelines, we assume that escharectomy could be performed during burn shock stage with reasonable safety.