[Principles of the local treatment: Surgical processing]

Area of Science:

• Burn surgery
• Wound healing
• Regenerative medicine

Background:

• Deep burns necessitate surgical intervention to manage necrotic tissue and prevent complications.
• Third-degree circular burns may require escharotomies and fasciotomies to prevent vascular compromise.

Purpose of the Study:

• To review current surgical treatments for deep burns.
• To explore advanced and future therapeutic strategies for burn wound management.

Main Methods:

• Discussion of surgical techniques including escharotomy, fasciotomy, and early burn wound excision.
• Review of wound coverage methods: autologous skin grafting, homografts, keratinocyte culture, and artificial dermal substitutes.
• Consideration of tissue engineering as a future treatment modality.

Main Results:

• Early burn wound excision and autologous split-thickness skin grafting are considered the gold standard for optimal scar quality.
• Homografts serve as a temporary measure in severe burns with limited donor sites, despite secondary rejection.
• Keratinocyte culture is exceptional for life-saving but yields poor cosmetic results; artificial dermal substitutes may improve outcomes.

Conclusions:

• While current gold standards exist, ongoing research in tissue engineering promises advancements in surgical burn treatment.
• Future strategies aim to improve both survival rates and cosmetic results in severe burn patients.