Surgical management of burn injuries: current concepts and advancements in reconstructive strategies
DOI:
https://doi.org/10.18203/2349-2902.isj20251550Keywords:
Burn surgery, Early excision, Skin grafting, Burn reconstruction, Dermal substitutes, Functional recoveryAbstract
Severe burn injuries pose complex clinical challenges requiring multidisciplinary management. Surgical intervention remains a cornerstone in the treatment of deep partial-thickness and full-thickness burns, aiming to achieve early wound closure, minimize infection risk, and restore function and aesthetics. This manuscript reviews the principles, timing, and techniques of surgical management of burn injuries, including early excision and grafting, reconstructive options, and recent advancements in surgical care aimed at improving patient outcomes. A comprehensive literature review was conducted using PubMed, Embase, and Scopus, analyzing clinical trials, meta-analyses, and consensus guidelines related to burn surgery. Key aspects such as timing of surgery, excision methods, grafting techniques, and reconstructive innovations were explored. Early excision and grafting within the first 72 hours post-injury significantly reduce mortality, infection rates, and hospital length of stay. Autologous split-thickness skin grafts remain the gold standard, but alternatives such as dermal substitutes, allografts, and bioengineered skin have shown promising results in large surface area burns. Recent developments in spray-on skin cells and meshed grafts have further improved functional and aesthetic outcomes. The surgical approach to burn management has evolved significantly, emphasizing early excision, optimized grafting strategies, and advanced reconstructive techniques. A patient-centered, staged surgical plan tailored to burn severity and anatomical location ensures optimal recovery and rehabilitation.
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