Burns & Burn Contractures

Our Approach in Burns & Burn Contractures

From emergency to recovery ; every stage, under one roof.

Burns are classified by depth and surface area, and no two injuries are identical. Our team uses a staged, evidence-based approach that prioritises life, then limb function, then appearance without ever losing sight of the person behind the injury.

1.Initial Assessment & Burn Classification

Accurate classification determines the entire treatment pathway:

• • TBSA (Total Body Surface Area) estimation using the Rule of Nines or Lund-Browder chart
  • Depth assessment ; superficial epidermal, superficial partial, deep partial, or full-thickness burns
  • Inhalation injury screening ; hoarseness, singed nasal hairs, carbonaceous sputum
  • Circulatory assessment of extremities ; escharotomy planned if circumferential deep burns are present
    

2. Acute Burn Wound Management
   The first 72 hours are critical for wound and systemic outcomes

• Fluid resuscitation using Parkland formula ,essential to prevent burn shock
• Wound cooling (15–20 minutes with cool running water if within 3 hours of injury)
• Silver sulphadiazine or advanced wound dressing application based on burn depth
• Tetanus prophylaxis and systemic analgesia protocol initiated at admission

3. Early Surgical Excision & Skin GraftingFor deep partial-thickness and full-thickness burns, early surgery significantly reduces mortality and scarring:

• Tangential or fascial excision of non-viable burned tissue within 48–72 hours
• Skin graft surgery for burns Mumbai : split-thickness skin graft (STSG) harvested from unburned donor sites
• Sheet grafts used on face and hands for superior aesthetic and functional outcomes
• Meshed grafts for large surface area burns to maximise coverage from available donor skin
  

4. Wound Coverage for Large Burns

When donor skin is insufficient for immediate grafting:

• Biological dressings ; cadaveric allograft or xenograft for temporary wound cover
• Dermal substitutes (Integra, Matriderm) for deep burns requiring a two-stage reconstruction
• Vacuum Assisted Closure (VAC) therapy to prepare wound bed for definitive grafting
• Staged reconstruction planned from admission based on wound mapping

5.Burn Contracture Release & Reconstruction

Scar contracture release is among the most functionally important reconstructive procedures we perform:

• Z-plasty and multiple Z-plasty for linear contractures across joint lines
• W-plasty for contractures in aesthetically sensitive areas
• Full-thickness skin grafts (FTSG) or flap coverage for deep, recurrent contractures
• Tissue expansion for scalp, face, and neck contractures  gradual skin generation before reconstruction
  

6.Hypertrophic Scar & Keloid Management

Burn scars frequently become hypertrophic or keloidal without active management:

• Pressure garment therapy initiated from the time of wound healing  worn 23 hours per day for 12–18 months
• Silicone gel sheeting and topical scar treatment alongside compression
• Intralesional corticosteroid injections (triamcinolone) for early hypertrophic scars
• Laser therapy  fractional CO₂ and pulsed dye laser  for mature, raised burn scars