Burns are skin and surrounding tissues caused by heat, chemicals, electricity or erosion damage.
Degrees of severity of burns
Burns can be classified according to the severity of their aggression on the skin:
- First - degree burn: it is an injury to the epidermis, and the typical example is sunburn. Presents with redness without blistering and heals quickly.
- Second - degree burn: the epidermis and dermis injured. They are deeper burns and can be divided into:
- Superficial, if the injury affects the epidermis and dermis is exposed reddened. Heal in 2-3 weeks without scarring, unless the alteration in skin color, which disappears in a short time.
- Deep, which they can not epithelialize (uncured) alone. Below the blister that forms a coloration it appears in white patches. These lesions require review by a surgeon, because sometimes surgery is necessary.
- Third degree burn: they are affected all layers of the skin. This injury can not heal by itself and always require surgical interdiction.
Healing in burns
In any burn healing requires time: it is not considered that a scar is mature until it has been a year after the attack.
Hydration and pressure therapy, which involves applying pressure on injuries patches or as garments made: to facilitate the healing process and minimize the effects of the burn two therapeutic measures are recommended.
Pulsed laser ablative fractional and can also improve scar remodeling.
Burns 2nd degree intermediate and deep 3rd degree and sometimes require surgical intervention. The indication depends on the depth, location. The extent and morphology of lesions.
The surgery involves the removal of burned skin surface and replacing it with healthy skin (graft / flap) or skin substitutes.
Skin substitutes help healing burn. Its main advantage is that not leave scars in other areas and to be used for superficial burns, scar sequels are better aesthetic quality.
Skin grafts are pieces of skin (epidermis and dermis) taken from healthy zone and covering the operated area of the burn.
Flaps are vascularized tissue segments themselves, also taken from healthy area and cover the surgical site. They are used when the burns are deep and expose tendons, vessels, bone or joints, which can not be placed graft.
Surgery for burn scars
In general, surgery on the scars did not arise until 12 or 18 months after the injury, since the remodeling phase of scars does not end until after the first year.
There is a caveat and retractile scars are those that affect the function because the skin has been reduced and just stretching.
Surgical possibilities range from small operations to remove scars sequentially to large surgeries in which fibroids are removed and coverage of skin grafts or flaps defects is performed.
The need for one or the other technique is based on the severity of the sequel, the involvement of the deep tissues and produces retraction.
Given the variability of injuries, indications of treatment should be individualized by a specialist in Plastic Surgery .