Covering the massive burn: a case series and review of the literature

Abstract

The term massive burns is used to indicate burns that cannot be covered by the patient’s own skin by a single harvesting. Massive burns therefore are a subclassification of major burns (i.e. burns > 25% TBSA) and are typically managed in a tertiary burns centre. They have been variously defined as burns extending over more than 30%,1,2 35%,3 40%4 and 50%5,6 of the total body surface area (TBSA). As 20% of a patient’s body surface area (such as the face, hand, feet and perineum) is not suited to provide donor sites, a maximum of 40% TBSA can be covered with the patient’s own skin, and therefore it makes most sense to define a massive burn as a burn over 40% TBSA. Massive burns provide a number of treatment challenges.