Burn Healing Treatments

Burns are injuries to the skin and adjacent tissues caused by heat, chemicals, electricity or erosion.

Degrees of severity of burns

Burns can be classified according to the severity of their aggression on the skin:

  • First-degree burn: this is an injury to the epidermis, and the typical example is sunburn. It presents with redness without blisters and heals quickly.
  • Second degree burn: the epidermis and dermis are injured. They are deeper burns and can be divided into:

– Superficial, if the injury affects the epidermis and the reddened dermis is exposed. They heal in 2-3 weeks without scarring, except for the alteration in skin color, which disappears in a short period of time.

– Deep, which cannot epithelialize (heal) on their own. A whitish patchy discoloration appears under the blister that forms. These lesions require revision by a surgeon, as surgery is sometimes necessary.

  • Third-degree burn: all layers of the skin are affected. This lesion cannot heal on its own and will always require surgical interdiction.

Healing process in burns

The healing of any burn requires time: a scar is not considered to be mature until one year after the aggression.

To facilitate the healing process and minimize the effects of the burn, two therapeutic measures are recommended: hydration and pressure therapy, which consists of applying pressure to the lesions with patches or custom-made garments.

Pulsed laser and fractional ablative can also improve scar remodeling.

Burn surgery

Intermediate 2nd degree burns, deep burns and 3rd degree burns sometimes require surgical intervention. The indication depends on the depth, location, extent and morphology of the lesions. The extension and morphology of the lesions.

Surgery consists in the removal of the burned skin surface and its replacement by healthy skin (graft / flap) or by skin substitutes.

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Skin substitutes help the burn to heal. Their main advantage is that they do not leave scars in other areas and when used for more superficial burns, the scar sequelae are of better esthetic quality.

Skin grafts are skin segments (epidermis and dermis) that are taken from a healthy area and cover the operated surface of the burn.

Flaps are segments of vascularized tissue by themselves, which are also taken from the healthy area and cover the operated area. They are used when burns are very deep and expose tendons, vessels, bone or joints, on which a graft cannot be placed.

Surgery for burn scars

In general, surgery on scars is not considered until 12 to 18 months after the injury, since the remodeling phase of the scars does not end until after the first year.

There is one exception and that are those retractable scars that affect the function since the skin has been reduced and ends up stretching.

The surgical possibilities range from small interventions to remove the scars sequentially to large surgeries in which fibrosis is removed and the skin defects are covered with grafts or flaps.

The need for one technique or another is based on the severity of the sequela, the deep tissue involvement and the retraction it produces.

Given the variability of the lesions, treatment indications should be made on an individual basis by a specialist in Plastic Surgery.