Burns Surgery is the treatment of burn wounds. Plastic surgeons are specially trained to treat acute burns as well as late post-burn reconstructive surgeries. Reconstructive burn surgery takes place after the burn wounds have healed and include skin grafting, contracture release and various flaps or procedures to improve the appearance of burn scars.
Depending on the severity of the burn and the age of the patient, a burn injury survivor may require – or may elect – several different types of surgeries. Some surgeries occur almost immediately after the burn incident, whereas other types of surgeries come into play down the road during rehabilitation.
Sadly, children with serious burn injuries often face the most surgeries of all types of burn victims. Because they are still growing, they require surgeries to correct scarring and allow for proper growth throughout their lives.
Patients with serious burn injuries will undergo a surgical procedure called debridement before any other surgeries are contemplated. Debridement involves cleaning the entire burn area and removing dead or infected skin cells and vascularized bone. Debridement is an essential procedure in the beginning of a burn patient’s treatment and usually occurs before other surgeries.
Skin grafts are performed for two reasons.
A temporary skin graft is performed to provide a temporary cover for burned skin to preserve sterility, protect the skin from further damage and provide pain relief. Temporary skin grafts are sometimes performed with a procedure called xenografting, in which a medical product made of sterilized pig skin is used as the temporary covering.
Permanent skin grafts are often required for burn survivors with deep partial thickness burns or full thickness burns. Skin grafts promote healing and help minimize scarring. Depending on the size of the burn, a patient may require more than one skin graft operation while hospitalized.
Permanent skin grafts almost always use skin from another part of the burn victim’s body (called the donor site). After the skin graft operation, the donor site must also receive treatment to minimize scarring. Immediately after a permanent skin graft operation, the patient must undergo an immobilization period of about five days, so that the blood vessels may begin to grow from the tissue below the graft into the donor skin
This surgical technique has been around for more than 100 years. Dermabrasion uses either a laser or a sterile wire brush or diamond wheel to remove raised scars. A scar can never be erased, but its appearance can be changed. Dermabrasion is an extremely useful tool to lessen the appearance of scars from a burn injury. Dermabrasion will be performed on an in-patient or out-patient basis by a dermatological surgeon.
Plastic surgery is often not an elective procedure for burn victims. Plastic surgery procedures such as z-plasty or w-plasty may be a necessary part of scar management.
For some patients with extremely severe burns to their legs, arms, hands or feet, amputation may become a necessary surgery. Whether amputation will be necessary depends on the extent and depth of the burn, as well as on how well the burn responds to other surgical treatments.
Patients with burn injuries to areas of the body such as the ears, face or breasts may be recommended for reconstructive surgery.
The healing time will depend on case-to-case basis and type of surgery is performed.