Burns

At all universities, in Aachen, Zurich and in Vienna burn centers are part of the departments of plastic and reconstructive surgery. Therefore I have continuously been involved in treatment of burns and in secondary corrections of burn sequelae.

Scarring is often particularly strong after burn injuries, frequently leading to the formation of conspicuous, thick, but also unstable and painful scars. As a secondary consequence, these scars can also lead to a deformation and distortion of the soft tissue mantle, particularly in the face and neck area, but also in the area of the breast. Above joints, this situation will lead to restrictions in the movement, and ultimately a stiffening of the joints if no correction is performed on time. At exposed parts of the body, but also in regions subject to particular mechanical strain, burn scars tend to be unstable, forming a chronically open wound and hence posing the risk of the soft tissue becoming inflamed.

Most of these scars will have reached their full maturity after approximately one year, so that corrective surgery should also be aimed for after this period. Exceptions are provided by functionally problematic scars, for example in the area of the eyelids or at the extremities, particularly the hands. Their correction can be more urgent, and the necessity of their operation definitively expected in any case. Once the scars have matured, their aesthetically undesirable or functionally restrictive parts are jointly defined with the person concerned, and the available correction options and/or techniques discussed. This leads to an operative and also time schedule that usually involves several operations. The development of an overall strategy is also of great importance for the correct selection of individual operation techniques (e.g. considering reliance on tissue expansion). And it is just as crucial to see which parts of the scar can be corrected and which parts need to be replaced by better tissue. What is vital besides the surgical treatment is long-term follow-up treatment involving elastic compression garments and skin care, with the corresponding regular check-ups. If the burn injury has led to a loss of important functions, the options provided by functional reconstruction methods need to be discussed.