Objective: To evaluate the effects of massive escharectomy on the resuscitation of burn shock in the early stage after severe burn.
Methods: Mongrel dog inflicted with 40% TBSA III degree scalding were employed as the model. The dogs were randomly divided into two groups ------ escharectomy (E) and non -- escharectomy (C) groups. All the dogs received balanced salt solution according to Parkland formula from 1 postburn hour (PBH). The dogs in E group underwent escharectomy en masse at 3 PBH with immediate grafting of fresh alloskin. The dynamic indices of hemodynamics, blood rheology, oxygen supply, oxygen consumption and blood lactic acid content were monitored.
Results: Severe shock occurred in all the dogs 30 min after burn. The were evident decreased cardiac output (CO), cardiac index (CI) and left ventricular work index (LVWI) in all the dogs. But the viscosity of whole blood and plasma, the erythrocytic agglutination index and plasma lactic acid content increased significantly. The dogs in E group were operated with massive escharectomy at 3 PBH. In this group, CO, CI, blood rheologic indices and plasma lactic acid content were obviously improved when compared with those in the preoperational period and to those in the C group.
Conclusion: Simple fluid resuscitation couldn't correct burn shock quickly. Massive escharectomy during shock stage was safe, feasible and effective in the correction of burn shock.