Regular Article| Volume 52, ISSUE 6, P480-481, September 1999

Subcutaneous adrenaline infiltration in paediatric burn surgery

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      Paediatric burn surgery may be associated with significant blood loss and postoperative pain. To investigate methods of reducing these symptoms, we studied a prospective series of 29 children with small to medium sized burns. Presurgically both the burn wound and split skin graft donor sites were injected with a 1:500 000 adrenaline solution, to which bupivicaine had been added. No patient required blood transfusion and no patient developed systemic side effects from the injected solution. Four patients required parenteral analgesia, two in the immediate postoperative period and two at first dressing change. In all other patients pain was controlled with oral analgesia alone. Mean graft take in our series was 95%, indicating that this technique does not compromise burn depth assessment, nor impair graft survival.




        • Heimbach D.M.
        • Engrav L.H.
        Surgical management of the burn wound.
        New York: Raven Press,. 1984; : 17-18
        • Brezel B.S.
        • McGeever K.E.
        • Stein J.M.
        Epinephrine v thrombin for split-thickness donor site hemostasis.
        J Burn Care Rehabil. 1987; 8: 132-134
        • Kiser A.C.
        • Lentz C.W.
        • Peterson H.D.
        Subcutaneous injection of donor sites for split-thickness skin grafts.
        J Am Coll Surg. 1996; 182: 265-267
        • Janezic T.
        • Prezelj B.
        • Brcic A.
        • Arnez Z.
        • Zaletelj-Kragelj L.
        Intraoperative blood loss after tangential excision of burn wounds treated by subeschar infiltration of epinephrine.
        Scand J Plast Reconstr Surg Hand Surg. 1997; 31: 245-250
        • Hughes W.B.
        • DeClement F.A.
        • Hensell D.O.
        Intradermal injection of epinephrine to decrease blood loss during split-thickness skin grafting.
        J Burn Care Rehabil. 1996; 17: 243-245
        • DeBono R.
        • Rao G.S.
        Vasoconstrictor infiltration in breast reduction surgery: is it harmful?.
        Br J Plast Surg. 1997; 50: 260-262
      1. Wolfort, S. Rohrich, R. J. Handren, J. May JW Jr The effect of epinephrine in local anaesthesia on the survival of full- and split-thickness skin grafts: an experimental study. Plast Reconstr Surg 1990; 86: 535–40.