Partial excision of residual burn lesions.
Most burn victims have unattractive residual lesions, which may include hypertrophic donor sites, unsightly skin grafts, hypertrophic scars, and mature scars with altered pigmentation or texture. Some of these lesions can be treated by total excision in one or more stages or they can be reconstructed utilizing grafts, flaps, Z-plasties, or tissue expansion. But frequently these procedures are either not indicated or not elected by the patient. In such a situation, the only surgical option is partial excision, with the goal of making the lesion less conspicuous and more easily concealed by clothing. Whether or not such partial excisions are worthwhile is the obvious question. We could not find an answer in the literature and therefore decided to review our own experience. Between 6/30/81 and 3/12/86, 92 such procedures were performed and followed in 25 patients. Partial excision of hypertrophic donor sites, unsightly skin grafts, and hypertrophic scars did yield improved appearance in most patients. However, partial excision of mature scars, ie, areas of altered pigmentation or texture, did not have the same success. We continue to treat the first three types of lesions in this fashion but no longer include the latter.
Engrav
L H
LH
Division of Plastic Surgery, University of Washington, Seattle 98195.
Gottlieb
J R
JR
Millard
S P
SP
Walkinshaw
M D
MD
Heimbach
D M
DM
Marvin
J A
JA
D000293:Adolescent; D000328:Adult; D002056:Burns / Q000150:complications / Q000601:surgery*; D002648:Child; D002921:Cicatrix / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006984:Hypertrophy / Q000601:surgery; D008875:Middle Aged; D012086:Reoperation; D012867:Skin / Q000473:pathology; D016038:Skin Transplantation