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.