Burn Wound
Skin Burn
Treatment
Burns can be caused by different mechanisms by different modes. For example, burn can be flame burn caused by direct heat of fire.
Burns can be caused by different mechanisms by different modes. For example, burn can be flame burn caused by direct heat of fire, scald burn caused by hot liquids, steam burn caused by hot steam coming in contact with skin, electric burn due to electric current passing through body and chemical burn due fall of chemicals over skin surface.
Each kind of burn needs special care and attention to decide the treatment. Apart from type of burn, we always look for the depth of burn and the percentage of surface area of body covered by the burn injury.
The time taken in healing and the need for surgical or medical treatment is different in different degrees of burn.
First-degree burns require only application of topical soothing agents and pain killers, if needed.
Second-degree burns need dressings with topical antibiotic creams and ointments. They usually heal by dressings only within 2 to 3 weeks without leaving much scar. Specialised dressings for burn wounds are available which are impregnated with nanocrystalline silver, collagen protein or antibiotics which help in preventing wound infection and hasten the healing process. Advanced dressings are now used to initiate early healing process. Deeper second-degree burns form a raw area after regular dressings in few cases which would require skin grafting.
Third-degree and fourth degree burns require surgical procedures for cleaning of wound, removal of dead skin followed by cover age with skin graft or flap.
Points to remember in management of Burn wounds
- In a patient with thermal burn or flame burn, depending on the time of contact with fire-few areas are superficial, few are deep and of third degree. This distinction between superficial and deep burn is never visible immediately and is usually seen after 3-4 days of burn. The superficial areas heal with regular dressing and deeper areas require regular dressings for longer duration and may be grafting or flap at joints in future.
- In cases of thermal burn of third degree or deep second-degree burn, where it is known and anticipated that the areas would definitely require grafting in future, early primary excision of the area and coverage of the area with skin graft can prevent a lot of complications like septicaemia, infection and help in faster recovery of the patient and earlier discharge from the hospital.
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If the burn area which does not heal on its own or within a month should ideally be grafted with skin. These raw areas if not grafted lead to-
- Unstable area formation (recurrent breakdown, itchy skin)
- Recurrent ulcers even after healing
- Development of white patches over the area
- Quality of skin is not good.
- Development of contractures if across joints
- Tendency for hypertrophic scars and keloid over such raw areas
Skin Grafting
Skin grafting is the transfer of thin skin sheet, usually taken from thigh, to cover the raw areas of the burn. Once the wound is healthy, skin grafting may be done if defect is not much deep and vitals structures are embedded in granulation tissue. In such cases, dressing is done every alternate day after surgery. Patient may be discharged after 5-6 days, and regular follow-up is required. The area gradually heals and need compression garment later to avoid hypertrophy of scars and to reduce the swelling.
Thermal burns usually require skin graft only for healing and would require flaps in exceptional cases. Cases of electric burn require flaps as the area of burn is quite deep.
Local Flaps
Local flap is the transfer of flap of skin from the surrounding areas to the defect site. It is done when defect is deep and surrounding area is normal and sufficient enough to cover the defect. If not, or local flap fails, then a distant free flap is used to cover the defect through microvascular reconstruction.
Microvascular Free Flaps
If defect is deep, any vital structures are visible, like blood vessels, nerve, bone or tendons exposed and no local tissue is available or patient does not want 2 stage procedure or any flap harvest from the abdomen groin and chest region, then transfer of skin flap, muscle flap from a distant area as a free flap is done to cover the defect using microsurgical techniques. It needs surgical expertise and a good working team. Dr Amit Agarwal specializes in microsurgical reconstruction and has resurface innumerable burn patients. Flaps harvested from the outer aspect of the thigh, back and leg region are used commonly by Dr Amit Agarwal. He also harvests flap from the inner aspect of the foot (medial plantar artery flap) and transfer it to the palmer aspect of the defect to exactly match the kind of tissue loss.
The flap should be monitored frequently post-surgery. Hospital stay is increased, with respect to skin grafting or local flap procedures, but it is the best modality to cover the defects in patients who want a single stage procedure. Dressing is done every alternate day and patient is admitted for at least 7-8 days and discharged once the flap is settled.
Shaping dreams through
Know your surgeon better
Best plastic surgeon, Dr. Amit Agarwal is an American Board Certified, extensively trained, and best Plastic & Aesthetic surgeon in Lucknow. He is the Chief Plastic Surgeon heading the Department of Plastic, Microvascular, and Craniofacial surgery at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, U.P, India. He maintains a busy practice at Avadh and Nishat Hospital and his own center - Kayakriti Plastic Surgery & Dental Center. He was formerly a Consultant in the Department of Plastic Surgery and Burns at the prestigious SGPGI, Lucknow.
MS, DNB (General Surgery) MCh, DNB (Plastic Surgery),
MNAMS, FACS, FICS, FRCS (Edinburgh, UK)
His Credentials
Three pillars of kayakriti
Privacy
We believe your experience with us should be comfortable and hassle-free to make it one of your best lifetime experiences for yours. We, here at the clinic, take full precautions to maintain your privacy in any manner. We also provide a staff who will receive you from the gate and take you to the chamber directly if you demand.
Trust
Our Surgeon is highly qualified and internationally certified with a team of skilled staff to perform any surgical or non-surgical treatment on your body.
Safety
When you plan to undergo any surgery you should always keep in mind that it's your body and it's a surgery. We, here always keep your safety a priority and will never recommend you to undergo any such procedure which is not safe for you. We also provide you with a detailed description of the complications which may occur after the surgery during the consultation as it's a surgical procedure so there may be some complications depending on the way your body reacts.
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Frequently Asked Questions
If you have flat or small breast and you want to improve your breast and hip contour ratio then you are a good candidate for it. The answer will be best provided after the first consultation with Dr Amit Agarwal.
Acute pain will be there for almost a week which gradually reduces and there will be soreness and swelling which may take up to 3 weeks to subside.
You can join your work and daily routines after a week of the procedure and can start exercising after 3 weeks of it.
Yes, you have to wear it round the clock unless we suggest you to remove it.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
Kayakriti Plastic Surgery & Dental Center
D-43, Near Punjab National Bank, Rajajipuram, Lucknow, Uttar Pradesh - 226017, India
Phone No. +919695940009, +919695940006
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