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European and Turkish Board Certified Plastic Surgeons
Turkish Plastic, Reconstructive and Aesthetic Surgery Association Certificate of Competence
Before Late-Period Sequel Correction
Burn sequelae may require treatment due to aesthetic anxiety, loss of function or a combination of both.
During Late-Period Sequel Correction
Even if the burns heal with wound care, scars may remain even if the tissue patch (graft) is required. These scars are typically darker than the rest of the skin, they are in the form of hard tissues raised from the skin.
In today’s conditions, the best medical treatment that can be applied for these and similar scars is silicone. Silicone-containing creams or, in more severe cases, silicone sheet covers are recommended. Regular use of silicone both reduces this swelling and lightens the color of the scar tissue.
If the burn is in a region containing the movable joints such as fingers, elbows, knees, ankles, then a treatment should be planned accordingly in the early period, and the patient should follow the recommended exercises.
Sequelae may occur in these areas in the future, particularly in the pediatric age group and in patient groups who are incompatible with treatment. The skin on the inner side of the joint may shorten, and not allow the entire joint opening. It is necessary to intervene in these cases as early as possible.
Because following the shortening of the skin, the muscles will shorten, perhaps the joint will become calcified, and the treatment will be much more complicated and often insufficient. In these patients, the short tissues are opened, and the wounds are closed with tissues that are brought from another part of the body.
Another problem that occurs after burns is “cicatricial allopia”. In other words, it is the absence of hair due to scarring. In full-thickness burns on the scalp, bald areas will occur because the hair follicles are no longer present, even though this area is treated. Hair transplantation in these areas will not be successful either. Particularly in this group of patients, “expander” applications that are known as “balloon therapy” ensure very successful results. It is a treatment that requires at least two sessions of surgery, with a period of 2 months between them.
Another sequela of burns that should not be missed is “Marjolin’s ulcer”. Although it is very rare, it is a very aggressive skin cancer. Typically it develops on old burns and wounds. The time between burn trauma and Marjolin’s ulcer can be 30-50 years. It is necessary to consult a physician as soon as possible for any type of wound that develops on the burn or old wound floor and a diagnosis is made by taking a biopsy from this area.
After Late-Period Sequel Correction
Burn patients should be followed up for a long time due to both physical and psychological sequelae. Functional and aesthetic losses due to burns will often require gradual reconstruction procedures.
The patient-physician relationship should not be disrupted in order to both follow up the reconstructions and detect malignant lesions that may occur.