Very deep high temperature burns associated with blunt abdomino-thoracic trauma.

A 14-year-old boy with deep burns, blunt abdominal trauma and extensive muscle damage is described. The patient was operated on for a ruptured liver, developed acute tubular necrosis, had 3220 gr of necrotic tissue removed in serial tangential excisions, had an above elbow amputation of the left hand, removal of necrotic ribs and excisions of necrotic spinal processes, developed sepsis twice, empyema of right pleura, had open infected knee joints and was successfully treated until complete healing over a period of four months. The successful outcome seems to be due to early and aggressive surgical treatment, hemodialysis, total parenteral nutrition for over two months, antibiotic therapy, cryoprecipitate and devoted nursing, occupational and physiotherapy.