Skin grafting of full thickness burns under local anaesthesia with EMLA cream.

Two elderly patients with 6 and 4 per cent total body surface area (TBSA) full thickness burns were entirely skin grafted solely under topical anaesthesia with EMLA cream. Both patients had several concurrent illnesses. The risk of general or regional anaesthesia for their general condition was much greater than the risk of unhealed burn wounds which substantially impaired the patients' quality of life. The surgical procedures were painless to both patients. The taking of the skin grafts and the healing of the donor sites were uneventful. It seems that the late skin grafting of full thickness burns up to 10 per cent TBSA may be accomplished solely under the topical anaesthesia with EMLA cream and thus avoiding the general or spinal anaesthesia in a high risk group of thermally injured patients.