Objective To observe the clinical efficacy and inflammation of tangential excision within 24 hours after burn with massive deep Ⅱdegree burn wounds for elderly patients. Methods From Jan. 2010 to Dec. 2013, a total of 82 elderly patients with massive deepⅡdegree burn wounds were divided into the observation group ( giveing tangential excision within 24 hours after burn) and the control group ( giveing tangential excision within 3~5 d after burn) according the time of tangential excision treatment. The amount of infused fluid, u-rine, levels of serum inflammatory factors, survival rate of skin grafts, wound healing time, hospitalization time and the complications were compared between the two groups. Results There was no significant difference in the amount of infused fluid, plasma and urine between the two groups in the first day and fifth day (P>0. 05). The levels of TNF-αsignificantly decreased after 3 days of therapy compared with the control group (P<0. 05). The levels of IL-6 significantly decreased and IL-10 significantly increased from the first day of therapy in the ob-servation group compared with the control group (P<0. 05). The survival rate of skin grafts in the observation group was significantly higher than that in the control group, and time of wound healing and hospitalization in the observation group was significantly shorter than that in the control group (P<0. 05). The complication rate of the observation group was 11. 1% which was significantly lower than that in the control group 29. 7% (P<0. 05). Conclusion To treat burn with massive deepⅡdegree burn wounds for elderly patients with tangential excision within 24 hours which can effectively reduce the inflammatory, reduce wound infection and improve the success rate of skin grafting.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.