One of the most difficult problems in the care of the burn wound begins with the first change in dressing. At this time, the surgeon is faced with the problem of deciding the method for debridement of the burn wound. This eschar is composed of necrotic skin destroyed by the burn, coagulated protein from the exudated plasma, and bacterial exudates which have begun developing. Normally the eschar loosens about the second or third week, and underneath the eschar the granulation base appears. However, the sooner this granulation base develops, the earlier a graft can be applied.
The surgeon has three alternatives in the debridement of the eschar. He may wait until normal separation of the eschar occurs, application of dry dressings, or he may decide on surgical (mechanical) debridement. The third method is applying wet saline soaks. The disadvantages to the first drydressing method is the length of time necessary