The effect of complete burn wound excision and closure on postburn oxygen consumption. 1987

C Lalonde, and R H Demling
Longwood Area Trauma Center at Brigham and Women Hospital, Boston, Mass. 02115.

We determined the effect of complete excision and closure of the burn wound on the postburn increase in oxygen consumption. Twelve sheep were given a 15% of total body surface full-thickness burn and were monitored for 7 days. By the third day, a 50% increase in O2 consumption, VO2, was noted, as was a significant increase in cardiac index and decrease in mixed venous PO2, compared to baseline. The hypermetabolic process persisted for the 7-day pre-excision period. On the seventh postburn day all sheep were anesthetized for 2 hours with halothane and placed on positive pressure ventilation, and then one half of these sheep underwent excision and closure. During anesthesia, VO2 decreased to 76 +/- 15 ml/min/M2, a value significantly lower than even the preburn awake baseline of 122 +/- 14 ml/min/M2 and the 7-day postburn value of 180 +/- 18 ml/min/M2. Quantitative cultures, before excision, revealed the wounds to be noninfected (less than 10(5) organisms per gram). In six animals, the burns were totally excised to fascia and closed with full-thickness defatted hide from other sheep obtained at the same time under sterile conditions. In these animals, the VO2 returned to preburn baseline by 24 hours postexcision and remained there for the 3-day postexcision study period. In the other six burned sheep, the 15% full-thickness burns remained. The hypermetabolic state returned to the 7-day postburn level on return to the awake state and persisted for the remainder of the study. We conclude that complete excision and wound closure can reverse the postburn increase in O2 consumption.

UI MeSH Term Description Entries
D008196 Lymph The interstitial fluid that is in the LYMPHATIC SYSTEM. Lymphs
D010101 Oxygen Consumption The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346) Consumption, Oxygen,Consumptions, Oxygen,Oxygen Consumptions
D010313 Partial Pressure The pressure that would be exerted by one component of a mixture of gases if it were present alone in a container. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Partial Pressures,Pressure, Partial,Pressures, Partial
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D001831 Body Temperature The measure of the level of heat of a human or animal. Organ Temperature,Body Temperatures,Organ Temperatures,Temperature, Body,Temperature, Organ,Temperatures, Body,Temperatures, Organ
D002056 Burns Injuries to tissues caused by contact with heat, steam, chemicals (BURNS, CHEMICAL), electricity (BURNS, ELECTRIC), or the like. Burn
D002452 Cell Count The number of CELLS of a specific kind, usually measured per unit volume or area of sample. Cell Density,Cell Number,Cell Counts,Cell Densities,Cell Numbers,Count, Cell,Counts, Cell,Densities, Cell,Density, Cell,Number, Cell,Numbers, Cell
D000758 Anesthesia A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D012756 Sheep Any of the ruminant mammals with curved horns in the genus Ovis, family Bovidae. They possess lachrymal grooves and interdigital glands, which are absent in GOATS. Ovis,Sheep, Dall,Dall Sheep,Ovis dalli

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