title: The early management of the burn wound and observations on hypertrophic scarring. With special reference to the deep dermal level and hypertrophic scarring.
abstract: Much confusion about the management of the burn wound still exists in many a clinician's mind. This is an attempt to clarify the problem and create a better understanding of the importance of assessing the various depths of penetration of the thermal agent. The treatment varies from the use of minimal bland dressings left undisturbed to aggressive early tangential excision and skin grafting. This is discussed together with the rationale for this approach and some problems associated with it. A 'critical depth' of penetration at the deep dermal level, which spares the acini of the sweat glands, is suggested as the factor initiating later development of hypertrophic scarring. This can be prevented by early excision and skin grafting.
authors.forename: S J
authors.initials: SJ
authors.lastname: Hersch
mesh_terms: D001458:Bandages; D002056:Burns / Q000145:classification / Q000150:complications* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D017439:Cicatrix, Hypertrophic / Q000209:etiology*; D003646:Debridement / Q000379:methods; D006801:Humans; D017592:Skin Care / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods; D013545:Sweat Glands / Q000293:injuries; D014945:Wound Healing