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Current Methods of Burn Reconstruction

Orgill, Dennis P. M.D., Ph.D.; Ogawa, Rei M.D., Ph.D.

Plastic and Reconstructive Surgery: May 2013 - Volume 131 - Issue 5 - p 827e–836e
doi: 10.1097/PRS.0b013e31828e2138
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Learning Objectives: After reading this article, the participant should be able to: 1. Explain the present challenges in reconstructive burn surgery. 2. Describe the most appropriate treatment methods and techniques for specific burn injury types, including skin grafts, dermal substitutes, and a variety of flap options. 3. Identify the appropriate use, advantages, and disadvantages of specific flaps in the treatment of burn injuries, including local, regional, superthin, prefabricated, prelaminated, and free flaps.

Summary: Victims of thermal burns often form heavy scars and develop contractures around joints, inhibiting movement. As burns can occur in all cutaneous areas of the body, a wide range of reconstructive options have been utilized. Each method has advantages and disadvantages that must be considered by both patients and surgeons. The authors reviewed the literature for burn reconstruction and focused their discussion on areas that have been recently developed. They reviewed the mechanism of burn injury and discussed how this relates to the pathophysiology of the burn injury. Surgeons now have a wide array of plastic surgical techniques that can be used to treat burn victims. These range from skin grafts and local flaps to free flaps, prefabricated flaps, superthin flaps, and dermal scaffolds. Recent advances in burn reconstruction provide methods to decrease scar tissue and joint contractures. In the future, the authors hope that further developments in burn treatment will foster the development of new technologies that will allow site-specific reconstruction with minimal donor-site morbidity.

Boston, Mass.; and Tokyo, Japan

From the Division of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School, and the Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School.

Received for publication February 22, 2012; accepted August 13, 2012.

Disclosure: Dr. Orgill has consulting and program services/training agreements with Integra LifeSciences, Inc. He has also received research funding from Integra LifeSciences, Inc. Dr. Ogawa has no financial interests to declare.

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Harvard Medical School, Brigham and Women’s Hospital, 75 Francis Street, Boston, Mass. 02115-6110

©2013American Society of Plastic Surgeons