Modern concepts in the treatment of burns

During the past 10 years significant advances have been made in the treatment of burns. Modern concepts of therapy are based on a more thorough understanding of the physiological derangements that occur after burning. APPRAISAL OF THE BURNED PATIENT The magnitude of injury is based upon two principal factors, extent of injury and depth of burn. The extent of burn is usually expressed as the percentage of the total body surface area. For many years, Berkow's table was used as a guide for estimating the percentage of body surface burned. A modification of this table by Tennison and Pulaski into the "rule of nines" has been employed recently (see figure).1 For children, the extent of burn should be increased for the head and trunk and decreased for the extremities. Burns are usually divided into three categories based on depth: first degree, second degree, and third degree. A first degree burn