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 discoloured 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. 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.
Following post-surgery instructions are important to heal and obtain the best possible outcome, both in terms of function and physical appearance. You will have to follow up appointments so your surgeon can assess your long-term results and answer any questions or concerns you may have. Since a variety of procedures can be performed, your individual postoperative instructions may vary. In general, skin grafts require kind of "bolster" dressing to keep them in place for 3-5 days without any movement of the skin graft. The bolster helps the skin graft “stick” to the wound and begins to heal. Smaller operations (scar revisions, Z-plasties) might require only a small, soft dressing afterwards. After scar releases on the hand, your surgeon may place you in a larger dressing that incorporates a plaster splint for support after surgery. Additional physical therapy or occupational therapy may be required in the weeks and months following surgery to ensure a complete recovery of function. This may involve splints or casts, as well as exercises you perform at your treatment visits and on your own at home. Your surgeon and therapists will work together to develop the plan that is best for you.