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Principles of burn reconstruction: Overview of surgical procedures

Jorge Leon-Villapalos, MD, FRCS
Peter Dziewulski, MD, FRCS
Section Editor
Marc G Jeschke, MD, PhD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS


Following resuscitation and stabilization in the acute period, management of the burn wounds and potential scarring becomes the next priority. The goals of reconstructive surgery for the burn patient are first to restore function, then to restore aesthetic appearances. Both objectives are usually pursued together. The later effects of burns, which are related to loss of normal tissue and abnormal scarring, include limitation of movement, pain, disfigurement, and psychosocial embarrassment.

An overview of the surgical techniques used for burn reconstruction is reviewed here. Emergent care of patients with moderate-to-severe burns and the local topical antimicrobial agents and dressings for burns are discussed elsewhere. (See "Emergency care of moderate and severe thermal burns in adults" and "Emergency care of moderate and severe thermal burns in children" and "Topical agents and dressings for local burn wound care".)


Several challenges related to tissue loss and scarring must be met to reconstruct burns [1]. The key to longer-term local burn care is scar management, which can be achieved through surgical and nonsurgical methods combined with physical therapy. A balance needs to be attained between periods of rest and immobilization to allow skin grafts to take, or tissue flaps to heal and mobilization of the burned area to restore function.

Successful reconstruction needs to be complemented with the integration of the patient in the multidisciplinary burns team and specifically with the early intervention of the therapy and rehabilitation teams to restore the patient to society as an active and functional member.

The specific challenges for reconstruction of patients with burns include:

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Literature review current through: Nov 2017. | This topic last updated: Sep 12, 2017.
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