Does early excision of burn wounds change the pattern of mortality?

Ninety-five patients died at the University of Washington Burn Center from 1980 to 1985. Fifty-seven patients (60%) survived more than 3 days. Thirty-five of these patients underwent excision and grafting. The major causes of death were pneumonia, burn wound sepsis, and sepsis from multiple sources. Thus infection was the cause of death in 26 (74%) of these 35 patients. The other 22 patients who survived longer than 3 days did not undergo excision and grafting before death. The primary cause of death was pneumonia. Infection was the cause of death in 12 patients of this group (55%) and thus was the major cause of death in 62% of all patients who survived more than 3 days. Although early wound closure may affect overall mortality, it does not appear to materially change the pattern of the causes of death in those that die after 3 days of hospitalization.