Post Burn Deformities

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Post Burn Deformities

Introduction:

Burn deformities could occur after exposure to any sort of high grade burn. A burn is basically an injury to the skin which is caused by exposure to chemicals, fire or extreme heat like steam. Minor burns could be healed with or without medication, but some severe burns require hospitalization and could prove life threatening.

Degrees of Burns:

Based on severity, burns are classified into following three:
  • First degree burn: Outer layer of skin is affected
  • Second degree burn: First two layers of skin are involved
  • Third degree burn: Deeper layers of skin, fat, muscle or bone are affected

What are Post Burn Deformities?

Normally burns heal and new skin grows which replaces the damaged skin. But, when large amount of tissue is damaged due to a very severe burn, the surrounding normal skin pulls together in an attempt to heal and cover affected region. This tightening of skin is called contracture and it is a type of most common post burn deformity. When a contracture is formed close to or across muscles, ligaments, joints and tendons, it could cause stiffness and restrict the function and motion of injured area.

Surgical Options for Post Burn Deformity:

Plastic or reconstructive surgery is required for correcting post burn deformities. Some of the surgical treatment options may include:

  • Skin Grafting: Skin grafting involved transferring and removing healthy skin from a donor site and grafting it on the burned area in order to restore function of the affected part. Donor site and burned area is covered with a bandage, once the healthy skin is transferred. There are two types of skin grafts depending on the amount of donor tissue transplanted:
    1. Split thickness skin graft: Only outermost layers of the skin are harvested
    2. Full thickness skin graft: All layers of the skin are harvested
  • Scar Release Surgery: For large burns, this surgery is done. It helps reducing scar contracture and for improving mobility. During surgery, surgeon will cut away the scar tissue to release tightness of skin between muscles and joints. Burned area is reopened and then your surgeon will further perform either flap surgery or skin graft.
  • Flap Surgery: This procedure is similar to skin grafting but involves the transfer of underlying blood vessels and muscle tissue, along with skin from donor site to affected area. Flap surgery helps in restoring function of the affected area that has no skin, fat, blood vessels, bone or muscle.
  • Z-Plasty: For treating small burns, this procedure is used. A small triangle shaped flaps of skin are cut around the scar, rotated and sutured to cover the scar and relieve the tension created by post burn contracture. This results in Z-shaped scar pattern which is less noticeable as it aligns with the natural skin folds.
  • Tissue Expansion: Growth of extra skin by stretching surrounding tissue is promoted by using this procedure. An inflatable balloon called tissue expander is surgically inserted under the skin close to burn site and is slowly filled with saline solution. The expansion of the balloon stretches the skin, enabling extra skin growth. When skin is grown, tissue expander is removed.

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