Acute burns and burn scars

Acute burns and burn scars are two different phases of the same disease that are often related depending on the severity of the initial damage.

Acute burns are treated with daily dressings after cleansing with chlorhexidine and silver sulfadiazine creams and non-adherent paraffin gauze. Once the acute phase has passed, the body slowly begins a repair phase without regeneration (restitutio ad Integrum is said not to occur)

The skin reacts to the loss of substance, generating a tissue equivalent to a kind of ‘patch’, but lacking in its peculiar characteristics: the hair bulbs, sweat glands, sebaceous glands and pigmentary adnexa, as well as skin lines – dermatoglyphs – that determine the uniqueness of the skin, as in fingerprints.

In order to intervene on the skin damage caused by an acute burn, it is necessary to carry out scar treatments and therapies ranging from massages, application of creams or foils or silicone-based and compression sheaths that are shaped to be worn to attenuate the thickness of newly formed scars.

The scars that form can be hypertrophic, i.e. raised, or keloid when they develop almost monstrously outside the margins of the initial damage. This new tissue generated by skin scarring creates aesthetic and often also functional problems such as retracting bridges or cords that may impede certain movements… Of course, this can vary greatly depending on the extent of the burn and its location, the age of the patient, whether it is superficial or deep, and numerous other factors.

Generally, an attempt is made to remove scars by direct excision to remove the blemishes leaving less new scarring. However, there may be cases of very serious burns (e.g. to the face) where it is essential to proceed with skin grafts in order to restore not only the features, but also the functionality of the mouth or eyes and facial expression.

In milder cases or in less dramatic localisation situations, it is possible to proceed with techniques such as lipofilling associated with fractioned CO2 ablative laser.

Dr. Tommaso Savoia has specific experience and expertise in the treatment of these serious pathologies, having attended Large Burn Centres in Paris (Hopital Cochin) and Milan Niguarda.