[Prevention of complications in reconstructive surgery of burn injuries]

On the basis of treatment of more than 5,000 patients with postburn cicatricial contractures of the joints, deformities and defects of the soft tissues the authors studied the complications and their causes. Suppuration of the operative wounds, necrosis of grafts and the edges of the wound, and hematomas are the main complications. The character of the complications and their sequelae are connected directly with the specific features of the surgical intervention and type of plastics (free, flap, microsurgical, dermatotensia), as well as with the anatomical features of the tissues and vessels damaged by the burn, which reduce the resistance to infection and facilitate the appearance of circulatory disorders. Preventive measures are suggested which excluded purulent complications and reduced tissue necrosis to minimum. Therapeutic measures reducing sharply the sequelae of the complications are discussed. Preeminence of preventive measures over therapeutic measures is emphasized. Their timely application helps in attaining good outcomes of restorative and reconstructive operations in patients who had suffered from burns.