The practical procedure of tumescent technique in burn surgery for excision of burn eschar.

The tumescent technique, which involves injection of large volumes of dilute epinephrine solution into subcutaneous fat, has been shown to markedly increase the safety of liposuction surgery, which is associated with risks of blood loss. The authors use this technique during burn surgery and developed a practical method of determining the amount of solution injected. The authors have applied the tumescent technique consisting of subeschar infiltration of dilute epinephrine (1 mg/L) in thermoneutral (37 degrees C) saline. Preoperatively, a 5 x 5 cm square grid pattern is drawn on the burn wound, which facilitates estimation of the amount of infiltrated solution. The authors injected 20 ml of solution per square in the grid. Ten consecutive patients underwent 15 surgical procedures for tangential excision and split-thickness skin grafting. There were no complications during the intraoperative or postoperative period. Their method using a grid pattern drawn on the tissue being treated by the tumescent technique in burn surgery facilitates the excision of burn eschar.