[Surgery of burns]

The surgical treatment of burns must provide the best conditions that assure re-epidermalisation of the burn. Two imperatives must be respected during the initial management: encourage rapid scarring of the burn as the loss of the protection of the cutaneous barrier leads to a significant risk of contamination of the burn and of generalised infection, and the quality of the burn scar (minimal retraction or hypertrophic reaction) is directly related to the duration of the scarring process; utilisation of the technique that will give the best aesthetic and functional results in treating firstly the exposed zones (face and hands) and the functional zones (flexural folds, articular regions). The surgical treatment should respect the areas that can spontaneously re-epidermalise (superficial or intermediate burns), however in the deeper lesions (second-degree or third-degree burns) the destruction of the basal layer capable of providing keratinisation and re-epidermalisation renders the recourse to skin transplantation indispensable, which must be performed before the fifteenth day in order to best avoid complications.