When a patient is admitted to the hospital with acute burns, the burn surgery, or reconstruction, begins. The surgery lasts until the person's expectations are met, or the surgeon has done everything possible to reach their expectations. A realistic approach is required to match the patients' expectations (which are usually very high) with the probable outcomes of this type of reconstructive surgery. Even after the burn surgery is accomplished, the patient-surgeon relationship still continues, and may last for a lifetime.



Reconstructive burn procedures typically require flap reconstruction or skin grafting, which involves removing skin from unburned places on the body (donor sites) and then grafted, or placed, on the burn wound. This grafted skin attaches to the wound and closes it effectively.

There are unfortunate consequences of burn surgery. One of those is scar contracture, which permanently shortens the muscle or scar tissue that can produce deformity or distortion. This happens as a result of the skin grafting.

Contractures usually inhibit normal body movement. In these reconstruction procedures, a surgeon removes an existing scar and puts a graft on the site where the removed scar is located.

When to Know if the Burn Surgery Has Been Effective

When new blood vessels and tissue form the graft is considered successful. There are times when skin grafts do not take due to early complications like infection, shearing, or fluid that collects underneath the graft. Grafting is an effective and proven treatment, though it is important to know that all grafts will leave some remaining scarring.

During the procedures, the surgical team has to pay close attention to the donor site, in addition to the injured area, since that can result in inadequately healed tissue. Full-thickness and thick split-thickness skin grafts result in deeper donor site wounds, which demand longer healing time and could result in hypertrophic scarring and contraction.

With these types of skin grafts, dermal tissue has the potential to be permanently lost at the donor site. The skin layer does not grow back by itself and usually creates scar formation. Most split-thickness skin grafts require a healing time of approximately 10 to 20 days. A longer 21 to 90 day period is required for most full-thickness skin grafts. Therefore, medium-thickness split grafts are used more often to offer improved graft survival and durability with minimal complications at the donor sites.

Over 100,000 hospital admissions per year are accounted for due to burn injuries. Several specialized burn centers for acute burn injuries have opened, and death rates from acute burns have significantly dropped. Survivors, although, are often left, with impairment of function and a grotesque distortion of their appearance. Of particular concern is in the head and neck regions because this type of impairment results in neck contracture, drooling, corneal exposure, lip incompetence, nasal airway blockage and an inability to make facial expressions, among many other issues.

Specialists in reconstruction and burn rehabilitation?burn surgery?are a critical part of the care a burn team provides for patients.

Take your time finding someone you can trust, and feel comfortable with, to perform this procedure for you. Make sure it's a highly qualified health professional with expertise in the specialty you are interested in.