Closure of the Burn Wound

Closure of the burn wound is the ultimate goal of treatment of burns. Closure can be achieved by spontaneous epithelialization or by grafting. Based on analyses of our series from the Burns Unit in Copenhagen from 1962–1971 (2,460 patients with acute burns) and from 1972–1975 (660 patients with acute burns), the exposure method of burn wound treatment produced the best results in cases of partial‐thickness burns, and this same method usually gave the best results in cases of deep burns seen up to 14 days postburn. Furthermore, our studies show that surgical excision is permissible at the earliest possible time after the burn accident (during the shock phase) in both small and very extensive burns. In cases of deep partial‐thickness burns, the cosmetically best results are achieved by tangential excision. The question as to when surgical intervention should take place, whether acutely in the shock phase or 14 days postburn, so as to yield the best results in terms of lowest mortality and morbidity, and best cosmetic results, cannot be answered on the basis of our series at this moment. In order to solve this important problem, we have set up a randomized, controlled trial which started on May 1, 1976.