Burn reconstruction is planned according to the location of the injury, the condition of the scar and the patient’s functional needs.
Some burn scars become raised, firm, itchy or uncomfortable during healing. Depending on the scar type and symptoms, treatment may involve non-surgical scar management, surgery or a combination of approaches. Hypertrophic scars remain within the boundaries of the original injury, while keloids extend beyond them. These scar types may require different treatment strategies.
A burn contracture develops when scar tissue tightens and restricts the movement of nearby skin or joints. Contractures can affect the neck, shoulders, elbows, wrists, fingers and other areas.
Contracture release surgery may help reduce this tightness and improve movement when appropriate. The technique depends on the location, severity and available surrounding tissue.
Burn scars on the face can affect skin movement, facial contour and, in some cases, the position of the eyelids or lips. Treatment requires careful assessment because facial reconstruction must consider both appearance and function.
If a scar affects eye closure, breathing, eating or another important function, prompt specialist assessment may be necessary.
Tight scars across the neck or near a joint can interfere with everyday activities. Depending on the anatomy, surgery may release the scar and allow the area to move more freely.
The amount of improvement depends on the severity of the contracture, the condition of the surrounding tissues and postoperative rehabilitation.
Burn scars affecting the hands, fingers or arms can limit grip, bending or other movements. Treatment planning considers the scar, the affected structures and the functional goals of reconstruction.
Hand therapy or physiotherapy may be recommended alongside surgery to support recovery and help maintain movement.
The appropriate procedure depends on whether the goal is to close a wound, release a contracture, improve scar quality or reconstruct damaged tissue.
Burn scar revision aims to improve selected features of a scar, such as its position, contour or effect on nearby skin. It may involve removing or repositioning scar tissue and closing the area using an appropriate technique.
Scar revision does not remove every trace of a scar. The final appearance depends on the original injury, skin characteristics, the surgical approach and healing.
Contracture release is considered when scar tissue restricts movement or pulls on nearby structures. The surgeon releases the tight tissue and determines how the resulting area should be closed or reconstructed.
Depending on the location and size of the defect, options may include direct closure, local tissue rearrangement, skin grafting or flap reconstruction.
The purpose is to improve the affected area’s function and reduce the restriction caused by the scar.
A skin graft involves taking skin from a donor site and placing it over a prepared wound or defect. Skin grafting may be considered when the area cannot be closed appropriately with the surrounding skin alone.
The suitability of a graft depends on the wound, the recipient site, the available donor skin and the expected functional and cosmetic outcome.
A graft can heal differently from surrounding skin and may not match its colour, texture or flexibility.
Flap reconstruction uses tissue that retains its own blood supply or is transferred with its blood supply to cover or reconstruct a damaged area. Depending on the defect, the flap may include skin and other tissues.
Flap surgery may be considered for selected complex defects where the available tissue and functional requirements make it appropriate. The technique is chosen according to the patient’s anatomy and reconstructive needs.
Not every patient needs grafting or flap surgery. The surgeon will explain which options are relevant to the individual case.
The timing of reconstructive surgery depends on the condition being treated.
A fresh burn may require urgent medical assessment and treatment rather than elective scar surgery. Once the wound has healed, the patient may be assessed for scar management or reconstruction if tightness, deformity or functional problems develop.
Some reconstructive procedures are considered after the scar has matured, while others may be needed earlier when a contracture interferes with movement or essential function. The decision depends on the patient’s needs and the surgeon’s assessment.
There is no single waiting period that is appropriate for every burn injury. Patients should seek advice if a scar is becoming tighter, movement is worsening or the scar affects the eyes, mouth, neck or another important area.
Burn reconstruction may be appropriate for patients who have healed burn scars, contractures or tissue defects that cause functional limitations or specific concerns.
Suitability depends on factors such as:
The surgeon may recommend scar care, pressure therapy, silicone products, physiotherapy or other non-surgical measures when appropriate. Surgery is considered when its potential benefits justify the risks.
The procedure depends on the scar or tissue defect being treated.
The surgeon reviews the history of the burn, previous treatment, wound healing and any ongoing symptoms. The affected area is examined to assess scar thickness, flexibility, movement restriction and the condition of surrounding tissue.
The consultation should cover the goals of surgery, available options, possible scars, risks, recovery and the need for rehabilitation.
The treatment plan is tailored to the location and severity of the problem. Some scars may be suitable for revision or contracture release, while more extensive defects may require grafting or flap reconstruction.
The surgeon explains the proposed technique and whether additional procedures may be needed.
Depending on the procedure, scar tissue may be released or removed, and the affected area may be closed directly or reconstructed with a graft or flap. The surgical site is then dressed and monitored according to the treatment plan.
The type of anesthesia, the need for hospital observation and the expected recovery depend on the procedure and the patient’s health.
After surgery, patients receive instructions about wound care, dressing changes, pain management and activity restrictions. Physiotherapy, occupational therapy, splinting or other rehabilitation measures may be recommended, particularly when a joint or hand is affected.
Following the treatment plan is important to support healing and help maintain any improvement in movement.
Recovery varies according to the size and location of the treated area, the procedure performed and the patient’s individual healing.
Keep the surgical site clean and follow the dressing instructions provided by the treating team. Do not apply unprescribed creams or home remedies to the wound.
Attend follow-up appointments so that healing can be assessed and any concerns addressed.
When reconstruction involves a joint, neck or hand, the surgeon may recommend a rehabilitation plan. This may include exercises, splinting or therapy to help maintain movement and reduce the risk of recurrent tightness.
Do not begin strenuous activity or stretching exercises without guidance from the treating team.
Scars continue to change as they heal. Their colour, texture and flexibility may improve over time, but the extent of change varies. Scar management may be recommended after the wound has healed sufficiently.
Seek medical advice if you notice increasing redness, worsening pain, fever, unusual discharge, wound separation or a sudden reduction in movement.
