The treatment of deep dermal burns by abrasion

Deep dermal burns usually heal by a combination of epithelialisation and granulation tissue formation, and may form hypertrophic scars. Sometimes, however, they heal spontaneously and early with no hypertrophy. Early tangential excision and grafting is practised by many surgeons for these burn wounds, but, because of the problems of diagnosis and therefore the risks of unnecessary surgery, we have practised a policy of abrasion of burn wounds unhealed at two weeks after injury. The wounds were over-grafted or not depending on the appearance of the remaining dermis. Healing was generally rapid. Long term results show good scar formation with few problems from scar hypertrophy or contracture.