Dr. Stephen Milner, director of the Johns
Hopkins Burn Center, comforts a patient.
For children or adults who have suffered from burns, wounds, such as bedsores, or conditions and injuries that have left scars, reconstructive surgery can be exactly what they need to restore their bodies to good health and former appearance. In some cases, such as bedsores, not having reconstructive surgery may make the wound worse.
Even relatively minor burns can leave scars and people who have been burned over large parts of their bodies often must deal with scarring that is disfiguring. Reconstructive surgery can reduce scarring and restore appearance to the affected area.
The reconstructive surgeons at Johns Hopkins work with the patients, their families, doctors at the Johns Hopkins Burn Center, and other medical staff to determine what kind of surgery is needed and how it will be done to restore the patient’s appearance. Surgery can provide a range of benefits, from better mobility and health to increased self-confidence.
Immediately following the injury, a surgeon may do a temporary skin graft to protect the skin from more damage and to keep the area clean as well to provide some pain relief.
After the wounds have healed, further plastic surgery may be necessary depending on the severity and area of the burn. Some patients will need skin grafts to promote healing and keep scarring to a minimum. In other cases, tissue transfer—moving skin, arteries, muscle, and nerves—may be necessary. When the face or head is involved, other types of reconstructive surgery may be called for to repair parts of the body, such as the ear.
Later, many patients opt to minimize the appearance of scars. The plastic surgeons at Johns Hopkins can use a number of techniques to decrease the size and appearance of scarring, including dermabrasion, surgical revision and laster treatment.
Bedsores, sometimes called pressure sores or decubitus ulcers, can develop in people who have been confined to bed for long periods of time, are unable to move for short periods of time, or who use a wheelchair or sit in one spot for long periods of time. Other complications, such as aging, circulation and decreased sensation, can increase the likelihood that a person will develop bedsores. Hospital patients and nursing home residents, as well as those who are being cared for at home and who are confined to bed are most at risk to develop bedsores.
In their early stages, bedsores can be treated non-surgically. Left untreated they can lead to dangerous medical complications like bone and blood infections or bacterial infections in a joint.
If the pressure sore has progressed to the point that the ulcer has gone deeper than the skin surface and is affecting bone and tendon, surgery may be the best treatment. The reconstructive surgeons at Johns Hopkins can diagnose the problem and recommend appropriate reconstruction.
In many cases, scars are not noticeable and people simply live with them. In other cases, they are noticeable in appearance or even disfiguring, covering a large part of the body. In those cases, a person may choose to treat the scars using plastic surgery techniques.
The type of treatment a plastic surgeon recommends will vary depending on the scar and the goals the patient has for the treatment. It may be possible that a single treatment will provide satisfactory results or the patient may need several treatments to minimize the scar’s appearance. These are the types of treatments the plastic surgeon may recommend:
- Topical treatments, which include compression bandages and gels.
- Injectable treatments, which are used with concave scars. Several injections may be required over the course of time.
- Surface treatments, which can decrease the appearance of the scar. They may include dermabrasion, laser therapy, chemical peels, or skin bleaching. Learn more about skin treatments.
Keloid scars develop at the site of a healed skin injury, and are the result of an overgrowth of collagen. They can appear as firm lesions or shiny nodules and vary in color from pink to dark brown. While benign and non-contagious, they are unsightly and sometimes painful and itchy.
The plastic surgeons at Johns Hopkins can treat keloid scars to reduce their appearance. A number of treatments can be used, including:
- Cortisone injections
- Laser treatments
- Silicone sheets
At Johns Hopkins, our plastic surgeons have done thousands of reconstructive and plastic surgeries to restore appearance and functionality. They have learned about and, in many cases, taught the latest and most effective surgical techniques. In addition, because they work at Johns Hopkins, they can call on any other kind of medical expertise needed right at the facility, from orthopedists and oncologists to pediatricians and dermatologists.
Our reconstructive surgeons in the Plastic and Reconstructive Surgery Department, located in Baltimore, Maryland, are devoted to their profession and that includes consultation with the patients, their families, and others as needed. From the first consultation to the final check-up, they make themselves available and accessible to patients.