Debridement and Skin Grafting - Hospital Treatment

Debridement and Skin Grafting are required for deep 2nd degree wounds that do not heal by approximately 2-3 weeks and 3rd degree wounds.

The timing of surgery depends on a number of factors. In general, debridement and grafting are desirable in those situations where the wound has demarcated and is full thickness (usually within 5-10 days or earlier). In smaller %BSA burns, if there are areas of varying depth of injury, one can delay surgery in expectation of decreasing the area requiring grafting.

Note: Burn wound invasion indicates a need for urgent debridement.

Debriding is usually done by tangentially excising the wound until the bed is viable with evidence of punctate bleeding. Grafting can be done by either open or closed method depending on the involved area.

Once an area has been grafted it is IMMOBILIZED FOR FIVE (5) DAYS to allow for graft adherence and vascularization.

Donor sites are treated in several ways:

• Op-site - applied in OR and removed when area under it is dry and healed (usually by 14 days post-op).

• Jelonet Gauze - applied in OR; covered with compresses which are removed when the patient returns to the ward. Leave the gauze open to air and trim the edges as they dry and separate (over the next 14 days). It lifts around 14 days post-op.

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