Diagnosis & Indications
 
 
Diagnosis Principles :

Burns are systemic complex injuries following skin exposure to thermal energy. In many textbooks, the method of diagnosis of burn depth is described. It is mainly based on naked eyes observation and the doctor's experience, therefore it is often difficult to differentiate between full-thickness burns and deep partial-thickness injuries. As a result, the whole skin tissues may be excised no matter they are alive or not. After surgical excision, the wounds are worsened and the mortality and disablement rates are raised.

It is really necessary to determine whether the burn wound needs to be subjected to surgical excision or not. If the wound has the following aspects:
1) there are surviving skin tissues in the deep layer of the wound with appearance of exudates within six hours after injury;
2) the subcutaneous tissues are viable with functional microcirculation. The wound of this kind is actually indication of Burns RegenerativeTherapy (BRT) and should not be subjected to excision. After treated with this therapy, white exudates will appear on the wound surface. The more of the exudates, the more superficial of the wound. If the wound has no exudates after three days post burn, surgical operation can be considered. If the wound without hemorrhage of subcutaneous tissue after the fasciotomy, it can be excised. But this should not include the wound where the exudates disappeared after treated with dry therapy.

Pathological diagnosis is used to diagnose the depth of burn wound without exudates and to determine whether the wound needs to be excised. Wound with exudates does not need pathological diagnosis. Pathological diagnosis is easy without pain and misdiagnosis. Histological examination of a small piece of biopsy sample should be performed. If most of the subcutaneous tissues are necrosis, the wound can be excised and treated with skin grafting. If the subcutaneous tissues still have the structural vitality, the wound should not be excised, and Burns RegenerativeTherapy (BRT) should be applied. Pathological diagnosis can avoid the misdiagnosis with naked eyes and mistakes of treatment.

Indications :

1. Burns Regenerative Therapy (BRT) is an independent method for treating superficial II-degree and deep II-degree burn and scald wounds of various causes and different areas.
2. In coordination with cultivating and relieving technique, Burns RegenerativeTherapy (BRT) can be used for treating full-thickness dermis burn and scald wounds with viable subcutaneous tissue of various causes and different areas.
3. For treating burn wound deep to muscular layer with diameter less than 20 cm.
4. For treating wounds of skin donor site.
5. For treating granulation wound deep to muscular layer, for promoting regeneration of granulation tissue in burned bone after debridement and to create a physiological environment of receive site for skin grafting.
6. For treating all kinds of surface wounds.
7. For treating hemorrhoid, leg ulcer, bedsore, chronic ulcer, infected wound, chilblain, etc.

Note : Indications for Burn surgical therapy with excision and skin grafting

1. Full-thickness degree burn wounds reaching lower layer of subcutaneous tissue of different areas and different causes.
2. Skin grafting technique is used for treating granulation tissue wound without epithelial regeneration and for plastic surgery.
3.The hospitals should be qualified to conduct surgical operation and the operation should be conducted by surgeons specialized in Burns RegenerativeTherapy (BRT) and/or burn surgery.