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Acute Care Facial Burns
Acute Care Facial Burns
In some circumstances, a
portion of an aesthetic unit will clearly not heal in 3
weeks, but the area is small enough to be reconstructed
.later by excision and closure or with tissue expanders
In this situation, excision and grafting either are not
performed or are done with routine grafts
The
allograft is carefully inspected to determine
whether it is adherent to the bed underneath. If
the allograft is loose, it may mean that the excision was
not deep enough, in which case the excision and allografting
.must be repeated
It is usually O.OI8 to 0.021 inch in thickness in adults and
0.008 to 0.0 12 inch in children and obtained from
the scalp if graft color must be matched with the color
of healed or unburned areas. If the entire face is to be
grafted, the scalp is insufficient,and the harvesting must
.be done elsewhere
It is
important that the donor site
be planned shortly after
admission, before all donor
sites have been used to
.resurface other body parts
Each area of scalp is then infiltrated with large
volumes of saline
containing I : 500,000 epinephrine to make it flat or
nearly so. To achieve this, more solution is injected
around the perimeter of the site to be harvested than
in the center. This is done just before harvesting
because the fluid leaves the scalp rapidly
.Duplicast mold
Bubble and elastome
.Plaster reinforcement