Burn survivors are often left with disabling injuries and skin and soft tissue damage that keep them from getting their lives back on track. This reconstructive surgery complements the range of therapeutic care burn patients receive by restoring aesthetic balance and function to injured areas, often the face and hands.
Tissue from other parts of the body, for example, can be used to help repair scars and to rebuild delicate features, which are easily harmed by fire.
Reasons for Burn Reconstruction and Care
Scars become less noticeable with time. This is why many surgeons wait as long as a year or more after an injury or burn before deciding to perform revision. Scar revision is not covered by insurance; however, if the scar was a result of a burn or traumatic injury, and it minimizes your ability to function, it may be covered by your insurance. Large burn scars or complicated scars that pull the edges of the skin together, known as contractures, may affect the adjacent muscles and tendons, thus restricting their normal movement and decreasing function.
As one of the first burn facilities in the nation, the UCI Plastic Surgery Regional Burn Center continues to encourage physical and emotional healing of each patient. Treatment programs are offered for all types of burns, and recovery programs are individually tailored to specific injuries. The nation’s most respected and highly trained physicians, nurses, and burn rehabilitation experts work together as a multidisciplinary team to assist burn victims in their recovery.
The physicians of the UCI Plastic Surgery participate first hand in the treatment of acute burn injuries, as well as in the treatment of long-term problems that may occur. Working together at the Burn Center, co-director Dr. Michael Sundine and the other doctors give UCI Plastic Surgery a unique dimension on helping burn patients with their difficult problems.
FAQ About Burn Reconstruction in Orange County
Here are answers to some of the common questions about burn care and reconstruction at UCI Plastic Surgery in Southern California. Call or email our plastic surgery offices in Orange County for additional information, or read more about the UCI Plastic Surgery regional burn center.
How do I prepare for burn reconstruction at UCI Plastic Surgery?
Your surgeon will examine your scar type and the likelihood for both aesthetic and functional improvement, depending on the site of injury. You may require only a few injections of steroids for improvement, or you may need multiple operations to rearrange tissue in order to regain full function. Scar types include burn, keloid, and hypertrophic scars along with contractures.
What happens during burn reconstruction?
Scar reconstruction is usually done either as an outpatient procedure (under local anesthesia) or inpatient if it involves placing grafts or flaps for further monitoring. The surgery can take anywhere from a few minutes for injection to six hours if a flap is required for a complex defect. The complex and inpatient operations are performed under general anesthesia.
While no scar can be removed completely, it can be improved in appearance through injection of steroid medications or by surgical scar revisions. Hypertrophic and some keloid scars fall into this category.
Scar contractures need to be released, and the large defects are replaced with skin grafts or a flap (fresh tissue from another part of the body transferred to the problematic area). In some cases, tissue rearrangement, such as Z-plasty, may be used to release the tension from burn or traumatic scars. Tissue expansion of the neighboring healthy tissue in certain parts of the body can be performed to replace scar tissue eventually.
What should I expect after burn reconstruction?
For the first few days, the area may be swollen. Dressings should remain dry and intact and any exposed suture line (especially on the face) will be treated with antimicrobial ointment. Pain or discomfort can be controlled by medication. The revised scar will be sutured, and, if non-absorbable sutures were used, they will be removed within one to three weeks after the operation. Areas of scar release may be splinted to prevent immediate contracture, and the splint may be removed after the first week or may be changed to nighttime splints, depending on the location and type of scar.
What are the risks?
There is always a possibility of complications, such as infection, bleeding, a reaction to anesthesia, or recurrence of the scar. Ulceration and separation of the scar is also a possibility. Due to the large size and severity of some scars, multiple operations may be necessary to achieve an acceptable appearance and function. When using skin grafts or flaps, the donated tissue may not match the color or texture of the recipient site or the scarred area. In these cases, partial or total graft or flap loss is possible, though unlikely, which may require revisional surgery.
For additional information about burn care and reconstruction in Southern California, please contact the Orange County plastic surgery offices of UCI Plastic Surgery. We are located in the city of Orange, and convenient for patients in Los Angeles, Anaheim, Garden Grove, Santa Ana, and more.