title: Experience in the treatment of patients with burns covering more than 90% TBSA and full-thickness burns exceeding 70% TBSA.
abstract: OBJECTIVE
  The objective of this study was to explore our experience in the treatment of serious burn patients (total burn surface area [TBSA] > 90% and full thickness burns > 70% TBSA).
  
  
  METHODS
  Thirty patients who were admitted to our unit over a period of 12 years were analyzed retrospectively; 23 cases (76.7%) were successfully treated.
  
  
  RESULTS
  There were seven out of 12 cases (58.3%) in the first 5 years and 16 out of 18 cases (88.9%) in the latter 7 years of the study period.
  
  
  CONCLUSIONS
  It is concluded that: 1) giving electrolyte-free fluids (around 3700 ml) and the maintenance of hourly urine output at 70 ml or more appear to be beneficial in resuscitation therapy; 2) the first operative procedure should be undertaken early, at about the third day after injury; 3) a higher percentage area of eschar to be excised in the first operation is encouraged and eschar excision of up to 40% or more is preferable; 4) controlling the area of exposed wound under 5% in the entire therapeutic course is essential in the prevention of burn infection; 5) emphasis should be placed on the vital role of a dehumidifier in reducing the incidence of fungal infection; and 6) early enteral nutrition with the use of growth hormone in correcting the nutritional state of the patient is also emphasized.
authors.affiliation: Burn Unit, Nanfang Hospital, First Military Medical University, Mei Hwa Yuan, Guangzhou 510515, Peoples Republic of China. nfyybu@fimmu.edu.cn
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Zhou
authors.forename: Jia-Liang
authors.initials: JL
authors.lastname: Ren
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Zhou
authors.forename: Lei
authors.initials: L
authors.lastname: Yang
authors.forename: Yong-Heng
authors.initials: YH
authors.lastname: Wu
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Jia-Han
authors.initials: JH
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D001830:Body Surface Area; D002056:Burns / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015599:Trauma Severity Indices