This study was conducted in order to review the experience in the reconstruction of postburn head-neck deformities effect in Hµ Néi plastic surgery Centre between 1995 and 1997. 135 procedures were used to reconstruct postburn scar in 55 patients. All the patients had suffered deforming flame and chemical burns in the head and the neck. Some of the reconstructions ware essential procedures, such as eyelid ectropion, neck release by means of Z plastics, skin grafts, expanded flaps, local flaps, and free flaps... Reconstruction of some parts of face, head of aesthetic importance were the late elective procedures which can be performed after scar maturation.
Reconstructive Surgical Procedures, burns

"Survival first" has been the leading rule in burn surgery for a long time. However, the life quality of patients in future should also be emphasized on the strategic level during the early treatment of patients with massive burn. Aesthetics is also extremely important in wound repair, and it should form a clear conception in the mind of the attending surgeons. Therefore, the aesthetic effect of each surgical intervention should be elaborated with all enough attention. Moreover, we should constantly improve our techniques and skills to obtain presentable postoperative appearance. In addition, we should emphasize the application of new techniques and materials in wound repair, with which to improve aesthetic effect. In conclusion, we should pay more attention to promoting the aesthetic effect in the treatment of burns and traumatic wounds to maintain our superior status in burn treatment in the world.
Burns ; surgery ; Esthetics ; Humans ; Reconstructive Surgical Procedures ; methods ; Wound Healing

This article presents the anatomical basis, different kinds of perforator flaps and the distribution regularity of perforator vessels, principle of terminology, range of application, and their advantages and disadvantages. The procedure in harvesting and transplantation of perforator flaps are also discussed, in order to promote clinical application of perforator flaps, and to provide a more efficacious way to reconstruct the deep burn wound.
Burns ; surgery ; Humans ; Perforator Flap ; transplantation ; Reconstructive Surgical Procedures ; methods

Destructive burns and traumas which create composite tissue damages, as well as intractable wounds, usually cause the difficulties or inefficacy in the repair and management through ordinary skin grafting or tissue transplantation owing to the complex defects, unhealthy healing condition, or high requirements for the function and appearance reconstruction of the injured local tissues. The advantages of free tissue transplantation with microsurgical techniques in the tissue repair and reconstruction have been demonstrated as meeting the composite tissues restoration, improving blood supply, avoiding further damage to the wound surrounding tissues, and simplifying the distant tissue transplantation procedure, and therefore significantly decreasing the deformities with good functional and morphological outcomes, and dramatically reducing the hospitalization duration with less complications and faster restitution. In the present discussion, basing on the general literature review and the summary of our long-time clinical application of microsurgical techniques in dealing with serious injuries, we put forward the view that the microsurgical techniques should be considered as the first option for the treatment of destructive burns and traumas, and intractable wounds. And in some cases, only microsurgical techniques can be used, otherwise amputation would be unavoidable, or the optimal treatment would be abandoned or delayed. Meanwhile, it should be emphasized that the risk and the failure rate of performing microsurgical operation can be overcome through strictly hard training.
Burns ; surgery ; Humans ; Microsurgery ; Reconstructive Surgical Procedures ; methods

With the advances in resuscitation, infection control, and metabolic management, the treatment strategies for burn patients have improved remarkably in the last half century. As a result, more patients with deep burn wound survived, and how to optimize the burn wound care aiming at recovery of the normal appearance and physiologic function of patients has been investigated and discussed widely through both the whole treatment strategy making and the new techniques performing. In the present discussion, early tissue reconstruction as well as early wound covering and repair are emphasized by summarizing the improved aesthetic and functional effects obtained by applying the principles of plastic surgery in early burn wound repair, the use of composite skin grafting, the grafting with split-thickness autografts on the preserved denatured dermis or on the preserved healthy fat tissue, etc. Besides these, more attention should be given to the repair and reconstruction in specialized functional parts of the body, such as head and face, neck, hand, female breast, perineum, and joint areas, after a deep burn. The role of rehabilitation during and after the burn wound treatment process is elucidated by demonstrating its potential biophysical mechanism and preventing scar deformity. Adequate treatment of deep burn wound demands a number of important measures including the timing of surgery, adoption of essential techniques, suitable types of wound covering materials, motivated rehabilitation, and necessary psychological therapy. The optimal recovery of damaged part of body after burn should depend on the similarity of rebuild tissue structure to simulate the nature of the original tissue in the cellular, histological, anatomic characteristics, which is the aim of all burn wound care and the basis of the appearance and function repair or reconstruction.
Burns ; rehabilitation ; surgery ; Humans ; Reconstructive Surgical Procedures ; Wound Healing

Individualized therapy denotes that a suitable treatment project is chosen according to specific conditions of the patients with full benefit and minimal damage, and it is one of the contemporary surgical procedures that surgeons are looking for. But certain difficulties still exist in the treatment of burn patients, as well as repair of refractory or chronic wound as performed by burn surgeons. In this issue of the journal, application of individualized therapy in burn wound was discussed from various angles. For instance, through using Meek skin grafting technique, large sheets of skin graft could be saved for repair of wound on special body part of patients with severe burn, and combined flaps surgery could be applied to repair skin and soft tissue defects.
Burns ; therapy ; Humans ; Precision Medicine ; Reconstructive Surgical Procedures ; Skin Transplantation ; Surgical Flaps ; Wound Healing

With the development of modern society, the range of disease spectrum is changing, and risk factors leading to human trauma and damage are also in the shift. In addition to the extraordinary burns in the traditional sense, we also call extraordinary injury as damage induced by some of extraordinary insults in the past. In recent years, damage to skin and soft tissue caused by an extraordinary injury showed a gradually increasing trend. Manifestations of the wound of an extraordinary injury are various and its clinical treatment is very difficult, often requiring exceptional systemic comprehensive treatments. Currently, it is the duty of colleagues in the burn unit to actively deliberate about their realities regarding the following aspects: to accurately define the concept and scope of extraordinary injury, to include it into the range of clinical research and treatment of burns, to fully use professional skills of burn surgeons in dealing with wounds, and to effectively treat the patients through learning and mastering treatment skills of other clinical disciplines for treatment of extraordinary injury.
Burn Units ; Burns ; surgery ; Humans ; Reconstructive Surgical Procedures ; methods ; Risk Factors ; Skin Transplantation ; methods ; Surgical Flaps

Treatment of "extraordinary injuries" is a major challenge for surgeons major in burn care and plastic surgery, though they are experts in wound treatment and repair. The "extraordinary injuries" is very complicated, and its treatment needs multidisciplinary cooperation. Surgeons not only have to master the relevant knowledge, but also should have the expertise to choose the appropriate treatment targeting the special pathological characteristics of the extraordinary wounds. Therefore, surgeons should learn and aggregate more knowledge regarding extraordinary injuries, strengthen muture communication, and encourage research work.
Burns ; surgery ; Humans ; Patient Care Team ; Reconstructive Surgical Procedures ; methods ; Surgery, Plastic ; Wound Healing

This article summarizes methods of repair of massive and deep wounds, elucidates how to improve wound healing quality and avoid scar deformity after deep burn. A part of denatured dermis (non-necrotic) in deep partial-thickness burn, "mixed degree" burn, even in full-thickness burn wounds before forming eschar can be preserved and covered with autologous skin, thereby to avoid secondary damage to the structure of subcutaneous tissue and the junction of dermis-adipose, thus to result in good functions, appearance, and survival rate. After skin grafting, wound healing quality and appearance are improved, joint function and elasticity of skin are enhanced, the degree of scar contracture is relieved due to preservation of normal adipose tissue after escharectomy. The study of composite artificial skin will be actively developed in the future. Tissue-engineering skin and stem cells can be successfully used in patients with deep burns for scarless healing with restoration of physiological functions in a short period.
Adipose Tissue ; transplantation ; Burns ; surgery ; therapy ; Humans ; Reconstructive Surgical Procedures ; Skin Transplantation ; Tissue Engineering ; Wound Healing

It has been an essential trend to understand and solve the difficult problems arising in the treatment process of burn with views of holistic theory. Recent researches have indicated that the driven factors and the termination signals of repair system engineering in treatment of burn are the unity of two opposite rather than two independent bodies with chronological order. Repair driven factors are germinated at the cost of systemic inflammatory response and even multiple organ damage. Inflammatory response is both a necessary procedure of burn repair and the pathological basis of multiple system dysfunction after burn. A comprehensive burn therapy nominated sequential cytoprotection (SCP) strategy has emerged in which the knowledge derived from basic research is translated to clinical practice stepwise, and it might play an important role in treatment of severe burn. Further multi-center randomized controlled clinical trials should be conducted in order to raise the level of SCP strategy in guideline of evidence-based medicine.
Burns ; therapy ; Cytoprotection ; Evidence-Based Medicine ; Humans ; Reconstructive Surgical Procedures ; Wound Healing