Burn reconstruction with skin grafting is a reconstructive operation that treats the after-effects of burns, such as thick scars and contractures that tighten the skin and limit movement of the joints, face or hands. Its goal is to restore movement and function and improve the appearance of the affected area as far as possible.
The surgeon removes scar tissue or releases the contracture with planned incisions, then covers the area with skin taken from a healthy part of the patient's own body, usually the thigh, buttock or behind the ear. The graft may be split- or full-thickness depending on the site, and the operation is usually done under general anaesthesia.
Surgery takes about one to four hours depending on the size of the area. The graft is held still under dressings for five to seven days while it takes, the donor site heals in about two weeks, and pressure garments and physiotherapy follow for several months. The final result appears after about one to two years as the scars mature.
The final cost is set after a medical consultant reviews your case and photos.
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It can release contractures and restore joint movement, ease tightness, itching and pain in old scars, and improve the look of the skin. These changes often improve quality of life and self-confidence.
Anyone with burn scars or contractures that limit movement or cause functional or cosmetic problems, and whose health allows anaesthesia. Surgery is usually delayed until scars mature, around a year after the burn, unless a contracture is impairing function.
You will have blood tests and an assessment of the scarred area and donor site, and you should stop smoking at least two weeks before, as smoking harms graft survival. Some medicines are stopped under medical supervision, and you fast before anaesthesia.
Scar tissue is removed or the contracture is released, then a skin graft is taken from a healthy area and fixed in place with stitches or surgical staples and a pressure dressing. The donor site is covered with a special dressing until it heals.
The grafted area is kept still for about five to seven days and checked at the first dressing change to confirm the graft has taken. The donor site heals in about two weeks, after which pressure garments and physiotherapy are needed for several months.
Appearance and movement improve gradually over the first months, and the final result is seen after about one to two years as scars mature. Results are usually permanent, although children may need further surgery as they grow.
Risks include partial or complete graft loss, infection, bleeding, colour mismatch with the surrounding skin, recurrence of contracture and scarring at the donor site. Many of these are reduced by following aftercare instructions carefully.
There will be scars around the edges of the graft and at the donor site, which improve gradually with time, pressure garments and skin care. The graft may also differ slightly in colour and texture from the surrounding skin.
Staying about ten to fourteen days is usually advised to confirm the graft has taken and to complete the first dressing changes. A longer stay may be needed for large areas or grafts near a joint.
For extensive or long-standing burns, reconstruction is often divided into several stages a few months apart to allow each stage to heal. The surgeon decides the number of stages after examining you.
