Burn Surgery

What is Burn Surgery?

Burn surgery also known as burn reconstruction is a surgical procedure performed to treat burn injuries and related complications. 

Types of Burn Surgeries 

Burn surgery is mainly divided into the following categories:

• Acute Burn Surgery: This surgery is performed immediately after the injury to limit the damage caused by the burn to critical parts of the body.
• Reconstructive Burn Surgery: It is performed after the acute burn wounds have healed and are performed to remove some of the scar tissue and restore function.

Indications for Burn Surgery

A burn injury can occur due to exposure to chemicals, heat and cold, electricity, or radiation.  Burns are classified based on the depth of the damage to the tissues from the skin surface:

• First-degree burns: There is redness and pain in the superficial (uppermost) layer of the skin. 
• Second-degree burns: The burn affects the uppermost and middle layer (dermis) of the skin which results in swelling, redness, pain, and the formation of blisters. 
• Third-degree burns: These burns cause severe in-depth injury as they affect three layers (epidermis, dermis, and fat) of the skin. It results in a blackish, white, and leathery appearance on the skin. 
• Fourth-degree burns: This causes severe damage to the muscles, tendons, and bone.
• Burn surgery is usually performed on people suffering from third and fourth-degree burns.

Preparation for Burn Surgery

Preparation for burn surgery includes:

• Avoid eating and drinking from midnight the day before the surgery.
• Your surgeon will provide you with other instructions regarding preparation for the procedure.
• Written consent will be obtained from you after the procedure has been explained in detail.

Procedure of Burn Surgery

Burn surgery procedure is performed by skin graft technique, where healthy tissues (donor) are removed from any other parts of the body and transplanted to the affected area. There are mainly 2 types of skin graft procedures, they include:

• Split-thickness graft: This technique uses a few layers of the outer skin.
• Full-thickness graft: This involves all layers of the skin. 

The procedures involved in burn surgery include:

• Debridement: This is the first important step in burn surgery which involves cleaning the burn area and removal of the dead or infected cells of the skin.
• Graft Harvesting: This is done with a dermatome, an instrument used for removing the skin and underlying tissues from the donor site.  
• Skin Graft Placement: Skin grafts are replaced to cover deep or open burn wounds. The grafts will be held in place with a few stitches and a sterile dressing. Dressings will also be placed on the graft harvesting site.

Post-Operative Instructions for Burn Surgery

Post-operative instructions for burn surgery include:

• After the surgery, you will be taken to the recovery area or burn unit.
• Your vitals will be monitored in the recovery area.
• The dressing will be changed three to five days after the surgery.

Risks and Complications of Burn Surgery

Some of the common risks and complications of burn surgery include:

• Undesirable scarring
• Infection
• Blisters near the incision
• Drainage from the incision
• Pain, swelling, and redness at the graft site
• Severe pain
• Rejection of skin graft