[Long-term strategy of the initial management of facial burns: About 3 cases]

The management of facial burns in their acute stage determines most of the sequelae aspect. An initial treatment of good quality should reduce and even prevent scar ransom and should not compromise potential future corrections. This treatment is based on the respect of facial surgery standards and on the use of some particular technical points.

We described our surgical protocol through three case reports. We are performing a surgical excision of the unhealed lesions between the 12th and 15th postburn day. This excision is followed by a dermoepidermal skin graft in the same operative time. This graft must be harvested from the scalp every time it is possible and must be manually perforated. All the aesthetic units junctions are necessarily respected. Flaps can be necessary at this stage.

The long-term functional and cosmetic results observed in patients with facial burns vary a lot depending on the initial treatment. Patients with severe burns that benefited from an appropriate initial treatment may thus present better results than patients with less severe burns who were badly treated.