Mechanical Debridement
This is a procedure where loose tissue and blisters are removed. You will be medicated to help decrease the pain, but some amount of discomfort may be unavoidable. It is necessary to remove the loose or blistered tissue in order to check the depth of the wound; decrease the risk of infection; and allow medications to reach the deeper burned areas.
Grafting
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| Burn Center doctors attend to a patient in the Burn Center operating room. |
The surgical procedure for treating third degree (full thickness) burns is called skin grafting. The area of damaged skin will not heal on its own and must be surgically removed. This is also called surgical debridement. An anesthesiologist will review your medical history and chart and discuss the type of anesthesia to be given for each procedure. General anesthesia is preferred, which means you will be put completely to sleep and will have no pain or memory of the surgery. If your burn wounds are over large areas it is usually not safe to graft all burned areas at once, and several trips to the operating room for grafting may be needed.
After you are completely asleep in the operating room the burned tissue will be removed. The exposed healthy tissue underneath may be covered with one or a combination of the following:
- Autograft: skin obtained from a non-burned area of your body.
- Allograft: skin obtained from a human donor.
- Xenograft: skin obtained from animal sources (usually pig or cow). This type of skin is rarely used.
- Cultured Epithelial Cells (CEA): skin that has been grown in a laboratory from a small sample of your own skin.
- Integra Artificial Skin: this is a two-layered skin covering. The top layer serves as a temporary synthetic epidermis and the bottom layer serves as a foundation for the re-growth of dermal tissue.
The grafted area is covered with multiple layers of dressings and usually kept damp with an antibiotic solution. The dressing stays in place for 3-5 days. After that time, the dressings will be “taken down” to be observed by the doctors and nurses to determine how well the graft has healed. If you have a donor site from an autograft procedure, a protective dressing will be placed over this area. The donor site will heal in about 10-14 days, but may require dressing changes on a daily basis.
Fourth degree burns may require different and more intense surgical procedures.
These options will be discussed with you on an individual basis.
