Basic techniques for optimizing burn wound healing: insights from clinical practice

Abstract

The purpose of this paper is to provide the author’s view on basic techniques to optimize burn wound healing. For burns that are partial thickness, the goal is to optimize re-epithelialization to reduce the chance of hypertrophic scarring. For deeper burns, there are principles that lead to better outcomes. For very small burns, such as on the hand, full-thickness skin grafts can be performed in the outpatient setting. For burns requiring split-thickness skin grafts, thicker grafts tend to contract less than thinner ones. Using wider skin grafts or breaking up straight seams with darts also leads to improved results. Choosing donor sites that either minimize scarring or can be hidden should also be considered. For the massive burn, one must still prioritize better grafts for more functional or cosmetic areas (face, hands). Early excision and coverage should reduce scarring. Despite the availability of newer technologies, simple strategies to treat the burn wound still lead to excellent results.