What is post burn reconstructive surgery?
Plastic and reconstructive surgeons often play a critical role in transforming the lives of the patients. Those patients who have been victims of unfortunate accidents, such as burn injuries, etc benefit from cosmetic surgery or plastic surgery for burns.
There are some reconstructive surgery surgeons who repair burnt or damaged skin through skin transplant or burn surgeries to improve the patient’s life.
Being a burn victim may have a significant impact on your overall health. Not only do burn patients have to live with certain emotional and physical limitations but also social and situational challenges.
This worsens when they have highly visible scars that affect their physical appearance.
Burn patients face a wide range of barriers or limitations that includes being self-conscious, rejection related fear, embarrassment, humiliation, and having to deal with frequent comments and questions from people.
As a consequence, a patients social and interpersonal connections end up being impacted or limited.
Due to various limitations, it may not be possible to eliminate the burn scars from a visual appearance by various cosmetic surgical and non-surgical ways.
A surgeon can modify or alter scar tissue or use skin grafts to achieve both cosmetic and functional improvements with minimum visible.
Type of Burns treated with reconstructive surgery.
Skin burns can happen due to various reasons such as accidents. When the skin is subjected to excessive heat, it burns off. The burn usually depends on the flame size which is more severe in their depth and size if the flame penetrates the skin.
Acute Burn Care
Most deep burns or second-degree and third-degree burns require reconstructive surgery procedures. Acute burn care procedures involve split-thickness skin grafting or full thickness skin grafting depending on the burnt area. Burn resuscitation just after a burn surgery period is critical.
A Split Thickness Skin Graft
Appropriate resuscitation of the burn patient with required fluid management can prevent burn wounds from increasing.
With proper hydration, a patient can prevent a superficial second-degree burn wound from getting a deep second-degree burn wound. This would save the patient from surgical reconstruction.
During the initial post-burn surgery period, the tissue adjacent to the most damaged areas of the skin is considered to be in a state of flux.
With Proper management, these burnt skin area is prevented from deteriorating further and converting into deeper burn levels. With quick, effective, and efficient burn surgery management, the burn surgeon can stop the spreading of the injury further lessening the total surface area that requires reconstructive efforts.
Initial Burn Interventions
Burn scars often leave a patient with a permanent deformity but they are treated in a stage-wise pattern. Just after the initial burn wounds get healed, silicone sheeting, as it’s proven to improve a long-term scar appearance.
Non-surgical burn procedures are normally considered within the initial year.
If the following measures fail or a functional limitation develops, reconstructive burn surgery is considered. The type of burn surgery procedure chosen will depend upon the area and type of burn.
Need for Reconstructive Burn Surgery
Post a burn scar is fully healed, reconstructive surgery procedures may be required for a cosmetic or day to day functional purpose. Burn scar surgery is required for approximately 13% of the burn patients.
Whereas facial reconstructive surgery procedures are performed in approximately 5.3% of patients.
Most burn scars require 6months to a year time before they completely heal. Through this process scars will follow a predictable pattern, appearing red and raised before eventually fading.
Patients are advised to avoid sun exposure and wear sunscreen during this period to minimize the risk of hyperpigmentation. Often, the passage of time allows the scar appearance to improve sufficiently to avoid or reduce the need for surgery.
In general, little scar fading needs to take place to assess if reconstructive surgery is in fact needed. The risk of scar issues is also low if the surgery is performed after scar diminished.
For most burn reconstructive surgery patients, the average time until the first reconstructive procedure is approximately 1.5 years.
Check If you need reconstructive burn treatment
The first step is to schedule a consultation with a cosmetic surgeon. Communication is very crucial to achieving your goals. Your expectations from the burn surgery can be discussed during the consultation to get a clear picture if you will actually get what you want.
Together, you and your plastic surgeon can reach a point or an understanding of the procedures and the long-term benefits you will experience. Every burn victim or patient is different, and your burn surgeon will only choose the surgical technique and treatment plan that is right for you.
During your first consultation, you should do the following:
- Provide your complete medical history such as information about previous surgical procedures. Medical conditions you have had or have right now. Whether you are on certain medications or you are consuming herbal supplements.
- Allow your surgeon to conduct a complete physical examination.
- discuss all possible risks and complications of the plastic burn surgery procedure.
The majority of these plastic burn surgery procedures are completed on a day to day basis. Your plastic surgeon will give you specific instructions on how to prepare for burn reconstructive surgery that includes guidelines on preoperative skin cleansing, eating and drinking, smoking, and taking or avoiding certain vitamins and medications.
After your burn reconstruction surgery is done you should arrange for someone to drive you home. You may also need help to move around for a day or two after you leave the hospital.
After post burn reconstructive surgery
Following post-burn reconstructive surgery, instructions are important for your wound to heal and obtain the best possible outcome. Both function and physical appearance take time.
You will need to follow up with your appointments so that your cosmetic surgeon can assess your long-term results and answer all your questions or concerns that you may have. Post operative instructions may vary from patient and type of procedures selected.
In general, skin graft procedure needs a kind of bolster dressing to hold them in place for a few days without any movement of the skin graft. The bolster helps the skin graft stick to the wound and begin to heal.
Minor burn surgery may require only a small and soft dressing afterwards. After scar appears on the hand, your cosmetic surgeon may place you in a larger dressing that incorporates a plaster splint for support post burn surgery.
Most follow-up visits are scheduled within first two weeks of burn reconstructive surgery, and there can be a few stitches to remove at that time.
However, physical therapy or occupational therapies may be required after burn reconstructive surgery to ensure a complete recovery of body function.
This may involve splints or casts, as well as exercises you perform at your treatment visits and at home. Your cosmetic surgeon and therapists will work together to develop a plan that is best suited for you.
Possible Complications Associated with post-burn Reconstructive Plastic Surgery
Any surgery carries some risk. Patients differ in their anatomy and their ability to heal. Some complications associated with burn reconstructive plastic surgery may include, but are not limited to, the following:
- Infection due to exposure to various elements
- Excessive bleeding
- Bruising due to various reasons
- Difficulty or late in wound healing
- Anesthesia problems
- Surgery problems
Risk of complications may increase if a patient:
- Smokes very often
- Patient has a connective-tissue damage.
- Undergone radiation therapy and has skin damage.
- Blood circulation at surgery site is decreased.
- If a patient has HIV (human immunodeficiency virus).
- If the patient has an impaired immune system.
- The patient eats unhealthy food or has poor nutritional habits.
Choosing a surgeon for post-burn reconstructive surgery.
Choosing a burn reconstructive surgeon who is well trained, skilled and ethical requires careful attention. A surgeon’s reputation for burn treatment results, happy patients, and ethical standards are most important.
Not every cosmetic surgeon is well trained and experienced in carrying out burn reconstructive surgery procedures. The best cosmetic surgeon may also have limited skills as a burn reconstructive surgeon.
Safety should be your priority
Most surgeons know that skin grafting or burn reconstructive surgery has its own limitations. There is also a limit on the maximum area that can be skin grafted or treat with burn surgery.
When choosing a surgeon for burn reconstructive surgery, it is recommended that you consider the surgeon’s philosophy about safety.
Is the Surgeon Board Certified in a Surgical Specialty?
A surgeon who failed at certain exams that are necessary for post burn- reconstructive should not be your first choice. Similarly, board certification in a non-surgical speciality might not provide evidence of adequate training in using various surgical technique nor in managing an acute surgical emergency.
Is the Surgeon Well Trained?
Is the surgeon well trained in preventing and taking care of surgical emergencies? If you had to choose between two equally qualified burn reconstruction surgery plastic surgeons, would you prefer a surgeon who never had to take care of a burn surgery emergency, or would you prefer the surgeon who has had to take care of many surgery emergencies?
What to Avoid?
Avoid using home remedies or anything not prescribed by a burn specialist. Do not google or try self medicating in any way, as it may harm or deteriorate your condition further. Virtually all deaths associated with burn plastic surgery have occurred when there was an excessive burn or worsening of the condition.
Avoid Marketing Hype
No burn plastic surgery technique is more superior or inferior to each other they are just different. There may be a slight difference in skin grafting surgery and other post burn reconstruction techniques, but all of them show almost similar results.
Do not get mislead by any advertising agency’s hyperbole. Do not consider marketing hyperbole as the base of surgical skills and integrity of the surgeon.
Arrogant Surgeons Are Dangerous
It is natural for a surgeon to believe that his speciality is the best. However, a surgeon becomes dangerous when he begins to believe that he is the best or he cannot go wrong with his procedures.
Such arrogant surgeons are more likely to attempt not just post burn reconstruction surgery but also any surgery without considering the complications involved.
You are exposed to greater risks and serious surgical complications. Avoid overconfident surgeons who believe their training permits them to attempt complicated burn plastic surgery or skin grafting procedures.
The expertise of a surgeon in emergency management of post burn reconstructive surgical and medical complications is important.
It is reasonable to demand that all burn plastic surgery experts be trained in the diagnosis and emergency management of potential burn surgery related complications especially in the smaller areas of the body like the chin etc.
Hands-on Training in skin grafting and other burn plastic surgery
A good number of years of experience with in-the-operating-room, hands-on burn treatment and skin grafting is important. Individualized hands-on training is considered best.
In the process of choosing a burn plastic surgery expert or surgeon, you must be well prepared with a list of does and don’ts to look for when choosing a surgeon.
Patients need to be hospitalized post their burn reconstructive plastic surgery. It is mostly done when the clinic does not have an overnight stay facility to look after the patient for the next 24hrs post burn plastic surgery to avoid any problems. Hospitalization is not necessarily a bad indicator.
It might be very desirable to choose a burn surgery expert or surgeon who is attentive to potential problems and does not hesitate to hospitalize a patient for further observation purpose. A surgeon who is reluctant to hospitalize a patient because he fears it might affect his reputation, might not be a good option for you to be considered for your post burn ronstructive surgery.
Does the surgeon you are considering for your post burn reconstructive surgery have a good reputation among other surgeons and patients?. Ask various other patients and few other surgeons what they know about the surgeon you are considering for your burn plastic surgery.
How Many burn surgery Patients?
The number of patients your cosmetic surgeon has treated in the past is the point to be considered while selecting a surgeon for your spot burn reconstructive surgery. It is not advisable to only go with the words of the surgeon when he/she is describing his/her own experience with a burnt plastic surgery.
A surgeon who does only a few post burn plastic surgery per year might not be as good as it compared to a surgeon who does 3 or more skin grafting and other burn-related surgeries per week.
Is the Surgeon Well Trained?
The experience your surgeon has in burn reconstructive surgery is important; it is the first thing you should consider when choosing a surgeon. Training in preventing complications is more important than experience in taking care of complications post-burn reconstructive surgery.
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