The Management of Extensive Cutaneous Burns

The prognosis in cases of cutaneous burns should be guarded because many patients in the older age group still die after relatively minor burns. Shock is usually present in varying degrees. Diagnostic methods here described are essential for preventing shock and for estimating the patient's needs for water and electrolytes. The hourly urine volume furnishes a good index for adequate fluid therapy and should be maintained at 30 to 50 cc. per hour during the first 24 hours. In treating pain it is important to avoid excessive use of analgesics or hypnotics. The burned area can be treated by the closed method, the exposure method, saline baths, or aerosol sprays. Local infections followed by septicemia must be regarded as an imminent danger. Finally, for optimum results, the general nutrition and psychological state of the patient need to be considered.