Plastic Surgery for Burns

What are burns?

A ‘burn’ refers to an injury to the skin or tissue caused by direct or close contact to heat. As the skin touches a hot pan or gets overexposed to certain chemicals, the cells underneath die, causing damage to the skin.

As a result, the injured skin will produce collagen (a type of protein) to facilitate tissue repair. Over time, the burned area will gradually heal itself, forming a thickened wound called scars.

Burn scars are the result of the wound healing following a partial or full-thickness thermal injury. Thermal injury can frequently result in extensive scarring, which may have a profound psychological impact on the victim, serving as a visible reminder of a traumatic event.

Most of us have suffered a burn at some point in our lives, most often a thermal burn (read below to find out about other types of burn). However, fortunately, we do not usually require medical attention. For more serious burns, first aid is needed, plus potentially plastic surgery to reduce any scarring.

Luckily, Dr. Zaydon can help you feel and look more physically appealing and regain that confidence that you once had. Keep reading to find out more about burns, their treatment, and how plastic surgery can help you recover from your burn injury and scars.

What are the different classifications of burn scars?

Did you know that there are over 500,000 burn-related ER visits each year? (Source: American Burn Association). Studies also revealed that the most common cause of burn injuries in adults are smoking and an open flame. Of course, not all burn accidents leave permanent scars. It will depend on multiple factors, which are also how burns and burn scars are categorized.

Burns are typically classified in three different ways: based on the source of the heat energy, the depth or severity of the burn, and scar appearance and how it affects the skin.

Types of burns according to the source of heat

One way to classify burn injuries is to identify the heat energy source or the main cause of the burn. It’s important to note that regardless of the circumstances, all five of them can be serious and indeed life-threatening. Here are some of the most common causes of burns:

Thermal burns

Thermal burns refer to skin injuries caused by contact with any external heat source. The increased temperature of such objects can result in tissue and cell death or charring. Some possible sources of thermal burns include hot oil, grease, steam, open flame from a fireplace, and house fire.

Electrical burns

Electrical burn injuries happen when a high-energy electric current comes into contact or travels through the body. It may also occur when high voltage electricity causes clothing and other materials to catch fire, causing burn injuries.

Some common instances that may cause electrical burns include touching an exposed electrical cord, a hair dryer falling into the water, a or lightning strike.

Mild electrical burns may result in painful superficial skin injury and may exhibit blistering or fluid leakage. On the other hand, severe burns from high electric current not only cause dermal damage; it can also affect the victim’s internal organs (e.g., heart, kidney, nervous system) and may even cause death.

Chemical burns

Chemical burns occur when the skin, eyes, or mouth gets overexposed with corrosive materials. Some examples of harsh substances that can damage the tissues include detergents, strong acids, pesticides, drain cleaners, and fertilizers.

In the span of 10 years, chemical burns only accounted for about 3% of all adults who visited burn centers exhibiting chemical burn injury. Although rare, this type of burn can still cause permanent damage to the skin or, worse, vision loss.

Radiation burns

Radiation burn refers to a skin injury that happens as an adverse effect of radiation therapy. This burn commonly affects cancer patients who are undergoing radiation therapy regularly.

Friction burns

A friction burn occurs when the skin comes into contact with a hard surface while moving at high speed. This type of skin injury is a product of physical trauma and heat, resulting in thermal burns and skin abrasions.

Some of the most common causes of friction burns include motorcycle accidents, treadmills at home, sports, and outdoor activities.

According to studies, friction burns have a high prevalence rate for both children and adults. However, there is little to no record of friction burns in medical facilities as patients do not seek treatment because most injuries are only mild in nature.

Types of burns according to the severity

Burns are described as serious skin damage that causes the skin cells of the affected area to die. They can occur due to accidents brought by hot liquids, hot solids or flames. The three classifications of burns based on their severity are:

A first-degree burn is the least severe of the three since it mostly occurs in the outermost layer of the skin. It may result in redness, tenderness, swelling and pain. This would usually take a week to heal completely.
A second-degree burn involves damage to the second layer of the skin. The burnt area would look pink, moist, and soft and feel very painful. It would usually take 2-6 weeks to heal, depending on the extent of the damage to the dermis.
A Third-degree burn damages the third layer of the skin, which is the full thickness of the skin. Fat, nerves, muscles and bones will most likely be affected and would leave the patient in agony. The healing process of this type of burn is incredibly slow and results in contractures, keloid scars or hypertrophic scars. Fortunately, these scars may be permanently removed from your skin through plastic surgery for 3rd-degree burns.

Image source: https://www.buoyhealth.com/learn/burns#types

Types of burns according to the appearance of the scar

Mild or first-degree burns only result in temporary scar tissues that can fade over time. However, if the injury affects the deeper layers of the skin, then that may lead to more permanent scarring. Such burn scars may be classified into three types according to their appearance.

- Hypertrophic burn scars appear as thick, pink to red, raised scars that often develop one to two months after the injury. They are notoriously difficult to treat because of their extensive tissue involvement and tendency to worsen with hypertrophy and contracture formation. Various therapies have been advocated in the past, including surgical excision and grafting, dermabrasion, and corticosteroids.
- Contracture scars refer to abnormal scarring after a burn injury characterized by a thickened tissue that tightens as the skin starts to pull together.
- Keloid scars are raised, shiny, hairless bumps that may extend beyond the original burn injury. Most keloidal scars are painless, but some may become itchy and tender.

Hypertrophic, contracture and keloidal burn scars are not life-threatening. However, they can sometimes impair one’s mobility, especially if they occur near the joints or affect the deeper layers of the muscles. So, it’s vital to seek the help of an expert burns plastic surgeon to reconstruct your skin appearance and bring back optimal mobility.

How to treat burns?

Burn treatment depends on the severity, wound size, and wound depth. Most mild or first-degree burns can be treated at home using first aid techniques and natural remedies. But for second and third-degree burns, immediate medical assistance is needed to avoid any complications.

Treating burns goes beyond pain management, removal of dead tissue, grafting and other surgical procedures. It extends to the body or facial reconstruction and burns rehabilitation program that may be needed by the patient to fully recover from their injury.

Here are the three main stages of a patient’s comprehensive treatment plan for burns.

First aid for burns

Standard first aid for burns is to cool the burn with running cold water. There are several other first aid steps to take. Read the full list (provided by the Red Cross).

Plastic surgery of burned skin (reconstruction)

In the event that your burn is more serious, you may be left with scarring. The good news is that plastic surgery can help reduce the appearance of scarring. There are many different procedures available, depending on the exact condition of your injury. Your expert plastic surgeon burns specialist will know the right treatment option and plan of care for you. Read more about plastic surgery for scars.

Burn rehabilitation

Post-burn rehabilitation plays a vital role in a patient’s full recovery. The program entails different modalities (e.g., physical and occupational therapy) that will help improve the patient’s mobility and functional independence. Additionally, rehabilitation can decrease the likelihood of developing post-traumatic burn effects.

(Source: Red Cross).

Plastic Surgeon For Barbecue Burn in Miami

Barbeque (B-B-Q) burns

Accidents with gasoline, which is used while barbecuing or grilling, are a major cause of thermal burns in the U.S. It has been reported that gasoline-related burns account for 13,000 – 15,000 ER visits per year.

Barbecue Safety

Every year, there are thousands of barbecue burn injuries in Miami from the careless or unlucky use of lighter/starter fluids and/or gas. Here are a few safety tips for around the barbecue.

NEVER EVER use gasoline as a starter fluid or accelerant for charcoal grills.
Always use an approved lighter/starter fluid for charcoal grills.
After soaking your coals with lighter/starter fluid, wait for a minute for the heavy concentrations of explosive vapors to disperse.
When using lighter/starter fluid, place the container well away from the barbecue before attempting to light the coals.
Be very careful not to spill any fluid on your clothing, or in the surrounding area of the barbecue.
Wear an insulated fire retardant barbecue mitten when lighting your presoaked coals.
Never add lighter/starter fluid to hot or even warm coals. An explosion can happen causing serious injury.

Plastic surgery for boiling water burns

Burn injuries caused by a liquid material (e.g., boiling water) are called scald burns. This type of burn can bring immediate and severe pain, as well as serious scarring, depending on the severity. Scalding can happen anywhere, but it is commonly seen in the food and restaurant industry.

A boiling water burn can cause a variety of symptoms, from superficial epidermal burn to full-thickness burn injury. Unfortunately, a third-degree burn caused by boiling water can bring lasting damage to the tissues and may even endanger the victim’s life.

Plastic surgery for work-related burns

Work-related burns are skin injuries that happen during or in the workplace. It can either be thermal, electrical, chemical, radiation, or scalding.

Although they are technically not part of any burn classification, work-related burns should be given attention since they account for the majority of all burn cases. In fact, studies stated that work-related burns happen twice as much as non-work-related burn injuries.

Fortunately, if you incurred your burn at work or while performing work-related tasks, then the cost of medical treatment may be covered by your employer or their workers’ compensation insurance plan. Navigating the complexities of a work-related injury can add complexity to the issue, so working with a plastic surgeon who accepts workers’ compensation can make the process easier.

How to get rid of burn scars?

After the initial treatment of your burn injury, your skin will start healing the wound, leaving a noticeable scar behind. Fortunately, several non-surgical options exist to remove burn scars and even mitigate unpleasant scar appearance. This includes the following:

Silicone gel application

The use of silicone gel to eliminate scars has been a common non-invasive technique for over 30 years. Studies suggest that applying medical-grade silicone gel to burn scars can reduce its texture, color, and height. It works by:

Hydrating the scar, thus promoting fibroblast stimulation and reducing collagen production. This also helps soften and flatten the scar tissues over time.
Preventing bacteria, especially collagen-producing bacteria, from entering the scar tissue.
Increasing the production of collagenases helps break down collagen in the tissues, thus allowing faster scar removal.
Decreasing itchiness to prevent scratching and further damage to the scar.

Applying moisturizers and emollients

A burn injury damages the oil glands of the skin, causing the skin to become dry and itchy. As a result, the patient may experience discomfort, which, in turn, may cause them to scratch or rub the scarred area.

To avoid this, you can apply moisturizers or emollients to prevent skin irritation. However, you should consult your doctor or plastic surgeon first before using anything.

Avoiding sun exposure

Burn injuries and scars have a higher risk of sustaining more damage from sun exposure as they contain harmful ultraviolet rays. Overexposure to UV rays can also make the scar more noticeable and turn a darker color.

Massage or pressure therapy

Burn centers are known to use specific massaging techniques (e.g., kneading, skin rolling) to help reduce the height and unpleasant appearance of the scar. Moreover, it can aid in decreasing the pain, irritation, itchiness, and sensitivity of the burn scar.

An occupational therapist may also perform such methods during burn rehabilitation programs.

Things you should know about plastic surgery for burn scars

According to data from the American Burn Association, about 96.7% of all burn victims survive, but most burn patients are left with serious disabilities and scarring.

Plastic surgeons who treat burns play an important role in making the lives of burn injury patients better by giving them the hope to improve their quality of life. Plastic surgeons are now providing a number of procedures that assist patients with physical and cosmetic limitations caused by burn-damaged skin.

Dr Zaydon, as a burns expert in Miami, has listed below the things you need to know about plastic surgery for burns. More specifically, he will explain the types of burns that can occur, the benefits of contemporary treatments, what to expect during and after surgery, and advice for post-surgical care.

Benefits of scar burns treatment

Reconstruction. The tissue or affected body part can be reconstructed to a near pre-injury state (depending, of course, upon the severity of the burn).
Aesthetic purposes. Scars from burns, particularly those on visible parts of the body such as the face or hands, can have psychosocial effects on the patient. Therefore, plastic surgery for burns on the face can help reduce the visibility of such scars, thus assisting victims in regaining their confidence and self-worth.
Improved function of the affected part. If the function is lost due to the burn, then an intended goal of surgery may be to recover function.

What to expect during scar surgery?

As a local burns expert, Dr Zaydon advises that the type of procedure will depend on the kind of scar. So, for example, the procedure selected may vary between burn scars, deformities or contractures.

All procedures which aim to reduce the severity of scars are referred to as scar revision and are usually performed under local or general anesthesia. Scar revision procedure involves:

Removal of keloid tissue – this procedure is done by directly removing the keloid tissue; after that, a skin graft will be used to cover the area. Skin grafting is the process of taking a piece of healthy skin and attaching it to the affected area of the body.
Laser surgery – the laser treatment is done to smooth out, flatten or remove abnormal discoloration of the skin with a burn scar.
Skin grafting – this procedure involves grafting the healthy skin from the other parts of the body and using it to replace the damaged area.
Skin flap surgery – this procedure is the process of moving the healthy skin along with the underlying fat, blood vessels and muscles to the injured site.
Dermabrasion – this procedure is done to improve the appearance of scars over a period of time. The process involves shaving or scraping off the superficial skin to smooth out the scar tissue.
Tissue expansion – this procedure is mainly for reconstructive purposes. It increases the amount of existing tissue and is used in conjunction with skin flap surgery.
Z-Plasty – this process involves a Z-shaped incision to decrease skin pull due to contracture. This is also used to blend the scar into the natural creases and folds surrounding the skin.

Post-surgery care:

After the surgery, you may experience soreness, tenderness, tingling, numbness and itching around the incision area. Mild oozing and bruising may also be visible, and a small lump may also be formed. All these are normal and should not be a cause for your concern.

Tips to prevent post-surgery infection:

Be proactive about asking your doctor how long you need to keep the affected area dry. It’s important to follow your doctor’s instructions.
Check the incision every day for a possible infection build-up.
Always clean the surgery area in the way your doctor recommends.

Remember not to:

Rub or scrub the affected area
Take off the tape strips from the incisions unless your doctor instructs you to
Use products such as powder or lotion
Expose the incision to sunlight
Take a shower unless you can make the incision dry. In the meantime, while you are recovering, you can take sponge baths. Before doing so, cover the incision with a plastic bag to keep it dry.

Post-surgical complications

Signs of infection include:

Increasing yellow or green discharge
Discharge developing an odor
Change of size in the incision area
Redness or hardening of the surrounding area of the incision
Area becoming hot to the touch
Fever
Experiencing unusual pain
Excessive blood gathering on the dressing

IF YOU NOTICE ANY OF THE ABOVE SIGNS OF INFECTIONS, IMMEDIATELY CONTACT YOUR DOCTOR.

As a plastic surgeon for burns in Miami, Dr Zaydon treats a variety of burns. He has many years of experience helping burn victims through face reconstruction and removing and reducing the appearance of scars brought by burns. Read more about Thomas Zaydon, M.D.

Thomas Zaydon, M.D. is a Board Certified Plastic Surgeon who specializes in reconstructive surgery, including the treatment of burns. In addition to treating burns, he also frequently serves as a Plastic Surgery Consultant, Expert Witness, and Expert Medical Advisor and provides IMEs and Peer Reviews.

If you have suffered a burn and require a burns expert in Miami, please contact us. We’ll answer any questions you might have. Alternatively, you can make an appointment.

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.

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Plastic Surgery for Burns

What are burns?

What are the different classifications of burn scars?