Plastic surgery procedure that functionally rebuilds scars, contractures and tissue loss developing after a burn.
Indication
- Burn contractures restricting joint motion (especially the hand, neck and axilla)
- Pain, itching and functional loss due to hypertrophic or keloid scars
- Tissue loss of the scalp, eyebrow or eyelid after a burn
- Skin adherence and loss of skin elasticity due to burn sequelae
- Chronic open wounds or non-healing burn areas
- Wide scar areas affecting body integrity after healing
Preparation
- Planning during the stable period after burn healing is complete (generally 6-12 months later)
- Physical examination and photography to assess scar maturity
- Blood tests and imaging if needed
- Smoking cessation before the procedure
- Review of medications with the physician
How it's performed
- General or regional anesthesia is administered
- Scar tissue is excised and tension-relieving incisions are made (Z-plasty, W-plasty)
- Skin grafts or local tissue flaps are used for missing tissue
- In wide areas, a staged approach with tissue expanders may be planned
- Careful closure and drainage after tissue placement
- The procedure is completed with dressings and a splint
Post-procedure
- First-day hospital or outpatient follow-up; 1-3 day admission depending on the area's size
- Regular dressing and suture checks (1-2 weeks)
- Scar care: moisturizers, silicone gel/sheets, pressure garments
- Physiotherapy and joint mobilization are started early
- Scar maturation follow-up for 6-12 months
Risks
- Infection, bleeding, hematoma
- Partial graft or flap loss
- Scar recurrence or hypertrophy
- Color mismatch and sensory changes
- Anesthesia reactions
FAQ
When is the right time for burn reconstruction?
It is planned after burn healing is complete and the scar has matured (generally 6-12 months). Earlier intervention may be needed for function-limiting contractures.
Is it completed in a single session?
More than one session may be needed depending on the size of the burn area and tissue loss. A staged approach is common.
Will a scar remain after the procedure?
Scars do not disappear completely; however, their size, appearance and functional impact can be significantly improved.
Why is physiotherapy important?
It prevents the scar tissue from re-contracting and helps preserve joint range of motion.
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