Burns

What is burn surgery?

There are two main categories of burn surgery: acute and reconstructive. Acute burn care occurs immediately after the injury. Complex burns often require consultation with plastic surgeons, who assist with the inpatient and outpatient management of these cases. Large burns, or burns of critical body areas, should be treated at a verified burn center. Many smaller burns can be treated with outpatient options. Some patients may need reconstructive burn surgery after the initial burn wounds have healed. This type of care is usually provided by a plastic surgeon. The goals of reconstructive burn surgery are to improve both the function and the cosmetic appearance of burn scars. This involves altering scar tissue, with both non-operative and operative treatment. The relationship between the burn patient and the reconstructive burn surgeon often lasts many years. Treatments for scar tissue often take several months to be effective, and new scar contractures can appear long after these injuries, especially in young patients who are still growing.

What are the benefits of reconstructive burn surgery?

Surgery will not be able to remove a patient’s burn scars entirely, but it will help improve basic functions and make scars less noticeable. Scarring can limit the normal motion of the neck, shoulder, hands, or legs. Often surgery to help release this contracture can help a patient regain range of motion. Facial scarring that leads to problems with the eyelids, lips, nose, or hair loss can also be helped with reconstructive burn surgery. Scars that are abnormally thick, wide, or discolored might also be improved by a variety of operative and non-operative methods.

What are the options for reconstructive burn treatment?

Non-operative therapies might involve scar massage, application of pressure garments, or other topical therapies. Surgical options consist mainly of scar release procedures. The tight scar tissue is released and the open area closed by a plastic surgeon. There are a variety of ways to close these wounds depending on a patient’s needs. Skin grafts, skin rearrangement (sometimes called Z-plasty), and more complex skin donor flaps could be used, depending on the location of the scar and a patient’s personal goals. Most minor procedures are performed as outpatient surgery, but the larger grafts and flaps would likely require an inpatient stay. Tissue expansion can also be used as an alternative to skin grafting. Excellent results are commonly attained when performing tissue expansion to regions of the face, neck, arms, hands, and legs.