Core warming of a burn patient during excision to prevent hypothermia.

Staged excision and grafting remains the mainstay of the surgical treatment of large burn injuries since Jackson and colleagues demonstrated a decreased mortality with excisions of 20% or less in 1960 [1]. The major factors limiting these excisions are blood loss and hypothermia. Despite these known limitations, little progress had been made in combating the hypothermia that comes with a large excision. The current re-warming strategies include: increasing ambient room temperature, infusing warm intravenous fluids, and using hot air technologies such as the Bair Hugger, but no single solution or combination of solutions has proven adequate [2]. Recently at our institution, a new intravascular warming catheter was used to perform a large burn excision with excellent results.