Introduction:
Burn surgery can be divided into two basic categories: acute and reconstructive. Care for acute burns begins as soon as the injury does. A group of trauma surgeons who focus on providing acute burn care provide it. Plastic surgeons frequently need to meet with patients who have complex burns, as they can help with both inpatient and outpatient management in such cases. A reputable burn center should handle large burns or damage to vital body parts.
What Is Burn Reconstruction Surgery?
Reconstructive burn surgery is a technique carried out by a plastic surgeon once the initial injuries from a burn are completely healed. Surgery is intended to improve skin function and restore skin attractiveness. Patients who are dealing with burns that have negative long-term functional or cosmetic repercussions opt for this treatment. Both non-surgical and operational treatments are used to change the scar tissue in this situation. The patient-reconstructive burn surgeon relationship frequently lasts for many years. Many times, it takes many months for scar tissue treatments to be successful, and new scar contractures can develop years after the initial injury, especially in growing young children.
Why Is Plastic Surgery Performed for Burns?
Restoration of skin and the functionality of specific organs, such as the ears, mouth, and eyes, which may become compromised due to severe burns, is the main goal of plastic surgery for burns. To repair the scarred tissues, plastic surgery may require several months of preparation. Patients who experience the long-term poor functional and esthetic impacts of serious burns particularly need plastic surgery.
How Should One Get Ready for Burn Reconstructive Surgery?
Doctors and patients will address any allergies and drugs that the individual might be using in the weeks leading up to reconstructive burn surgery. Before surgery, the doctor frequently advises individuals to stop smoking, start taking vitamins, and change their pharmaceutical regimen. Lastly, the patient will require help around the house after surgery and must arrange transportation to and from surgery.
What Happens During the Procedure?
This method can be either operative or non-operative. Some treatments include topical therapy, pressure garments, and scar massage. Scar release methods, in which scars are first opened and subsequently treated by a plastic surgeon, are frequently included in the operational techniques. These plastic surgery procedures call for skin grafts in some cases. The surgery is often performed as an outpatient, although more intensive skin graft procedures could necessitate a hospital stay.
What Are the Methods of Reconstruction?
Skin Grafts: Skin grafts are especially beneficial for open wounds that are challenging to close. A skin graft is a portion of healthy skin that is removed from the "donor site" on one portion of the body and applied to another area of the body where the skin is impaired. A split-thickness skin graft, a full-thickness skin graft, and a composite skin graft are the three different types of skin grafts.
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The skin layers closest to the surface are used in split-thickness skin grafts, which are frequently applied to treat burn wounds. The surgeon will pick a less obvious donor site if at all possible.
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A full-thickness skin transplant may be utilized to cover jointed areas when skin flexibility is required or to treat a burn site that is deep and broad. Usually, direct closure of the wound at the donor site leaves a minor scar.
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When underlying support is required for a wound, a composite skin graft is utilized. Lifting every layer of skin, fat, and occasionally underlying cartilage from the donor location is necessary for a composite graft. There will still be a scar at the graft location, but it will eventually disappear.
Tissue Development: The body can 'grow' additional skin through a process known as tissue expansion, which can be used to repair practically any area of the body. A silicone balloon expander is put under the skin close to the area that needs to be corrected as part of the surgery. Over time, the region is slowly filled with saline solution, allowing the skin to stretch and develop. This method, which is most frequently used for breast reconstruction, is also used to fix skin that has been harmed by accidents, surgery, or birth disorders.
Flap Surgery: In flap surgery, tissue is removed from other bodily areas, such as the back, abdomen, or buttocks, and used to create a skin flap. One kind of flap surgery uses tissue that keeps its blood supply by remaining anchored to its original place. The flap is made up of muscle, fat, and skin. A different flap method makes use of tissue that has been surgically taken from the buttocks, thighs, or abdomen. By re-connecting the blood vessels, the tissue is transplanted to the region. Proficiency in microvascular surgery is necessary for this treatment. Skin expansion is simpler than flap surgery. There will be scars on the restored area as well as the tissue site.
Microvascular Surgery: Microvascular surgery is moving bone, muscle, or skin together with an artery and vein to a location that requires restoration. This kind of surgery reconnects the small blood arteries and restores circulation to reattach fingers, hands, arms, and other severed parts of the body. Microvascular surgery can also be utilized to repair soft tissue abnormalities brought on by tumor surgery or reconstructive surgery.
What Are the Benefits of Burn Reconstruction Surgery?
The advantages of burn reconstruction surgery include the following:
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Burn sufferers' confidence and self-esteem can be raised via reconstructive surgery. The cheeks, mouth, ears, or even the eyes might sustain a severe burn injury. Disfigurement and frustration may result from this. Reconstructive surgery can therefore restore those parts, which can increase the patient's self-confidence.
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In people whose nose or nasal cavity has been injured by burns, reconstructive surgery can improve sleep. Better breathing and sleep are made possible by plastic surgery's assistance in restoring the nose.
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Patients with severe burns can experience vision loss as a result of drooping eyelids or a buildup of extra skin and muscle around the eyes. Cosmetic surgery called blepharoplasty aids in the recovery of vision by correcting the eyes.
What Are the Complications of Burn Reconstruction Surgery?
The complications of burn reconstruction surgery are as follows:
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Unwanted scarring.
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Painkillers might not be able to ease discomfort at the surgical site.
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Blisters, redness, swelling, or soreness at the surgical site are signs of infection at the site of plastic surgery. A temperature increase may also occur if you have an infection.
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body's rejection of skin grafts.
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Sensation loss at the site of the operation.
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There may be yellow-colored drainage coming from the surgery site, which needs to be immediately reported to the doctor.
Conclusion:
The goals of post-burn rehabilitation include aesthetic improvement, reduced contraction and functional constraints, infection prevention, ensuring wound healing, and restoring tissue loss.
The extent of the lost tissue and the impacted structures must be considered while choosing the best reconstruction technique. Beginning with a straightforward operation like split skin grafts as the first stage and ending with a complex tissue transfer through microvascular surgery at the opposite extreme.
