What to do with an acute burn injury?
Any hot or burned clothing or jewelry should be removed immediately to prevent further injury and to enable accurate assessment of the extent of burns. Burned areas should be cooled immediately using cool water or saline soaked gauze for 30 minutes. For small and moderate sized burns, cooling can minimize the zone of injury.
What is the role of the Plastic Surgeon?
Major burns will be transferred to a burn center. The remaining 90% of minor burns can be safely managed in primary care. Most of these burns will heal regardless of treatment, but the initial care can have a considerable influence on the cosmetic and functional outcome.
Much of the cosmetic outcome depends on the proper diagnosis of burn depth, initial cleaning and the choice of modern silver dressings or artificial skin. Deeper burns need removal of the dead tissue under anaesthesia to stop infection. This is followed by the coverage with skin grafts or artificial skin.
Patients with burns of limbs involving joints may need physiotherapy. It is important to identify these patients early and start therapy. Hypertrophic scars may benefit from scar therapy such as pressure garments or silicone dressing.
Many burn patients can not lead a normal life because of the inevitable post-burn scars, contractures and deformities which have negative aesthetic and functional considerations. These may be immature, atrophic, hypertrophic, keloid, stable/unstable, depigmented (vitiligo) or hyperpigmented. The scars may turn malignant as well.
Scars will not become invisible but Plastic Surgery can offer excellent improvement of scar quality and size. Dr. Reuter, with his experience as former Head of the National Burn Center, will explain the options in detail.
Here is a short overview:
Laser resurfacing on hyperpigmented or elevated burn scars is best performed after 12 month from the injury.
Tissue expansion is a medical procedure that enables your body to "grow" extra skin for use in reconstructive procedures. This is done by inserting an instrument known as a "skin expander" under the skin near the area in need of repair. Over time, this balloon will be gradually filled with salt water, slowly causing the skin to stretch and grow. Once enough extra skin has been grown, it is then used to correct or reconstruct a damaged body part.
Skin graft or flap surgery for severe burn scar contractures. Scars are very strong and can limit joint movement, bone growth or the development of a normal breast when affecting the chest. In the face scars can pull mouth or eyelids into an abnormal position. Every individual problem will need a tailored solution which might require more than one operation over the years to achieve the best results.