Research Article| Volume 1, ISSUE 4, P261-270, 1970

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Observations on the early excision of burns and the surgical management of crush injuries using an intravenous dye injection technique to assess tissue viability

  • M.N. Tempest
    Requests for reprints should be addressed to:—M. N. Tempest, Esq., M.D., Ch.M., F.R.C.S. (Edin.), St. Lawrence Hospital, Chepstow, Monmouthshire NP6 5YX.
    Welsh Regional Plastic Surgery, Burns, and Jaw Injuries Centre, St. Lawrence Hospital, Chepstow, UK
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      There are occasions in the clinical management of burns suitable for early excision when the accurate diagnosis of burn depth may be extremely difficult. In the initial treatment of crush wounds, ‘degloving’ injuries, and ‘closed’ avulsion injuries, there may be also serious doubt about the viability of the skin which cannot be resolved by conventional means. In both types of case, provided there is no interference with the arterial or capillary inflow, the intravenous injection of a suitable dye can resolve this diagnostic dilemma. Although the use of a 20 per cent solution of fluorescein given intravenously is a most useful ‘screening’ test, the injection of Disulphine Blue gives a pattern of skin staining which is clear to the naked eye, easily photographed for record purposes, and which can be used in the operating theatre. The technique has been proved to be without any toxic or untoward effects in man.
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