Reconstructive surgery for burn patients

Reconstructive surgery in burn patients is difficult because of the intense scarring and the necessity to carry out multiple operative procedures for different reconstructive needs in a single patient. The primary aim of the surgeon is to prevent hypertrophic scar by early wound closure, and proper postburn treatment using a combination of silicone gel, splinting, and pressure therapy. Reconstructive procedures should be deferred until the wounds have matured. Accurate preoperative assessment and appreciation of the true tissue deficiency, appropriate application of different reconstructive options, and the establishment of the priorities of reconstruction in relation to individual requirements are essential for a successful outcome. In general, functional needs have to be met before attending to aesthetic concerns and priority should be given to restore active before passive function. Different reconstructive options using direct closure, skin grafts, flaps, free tissue transfer, and tissue expansion are discussed.