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Johns Hopkins Children’s Center

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Surgery

Mechanical Debridement

Surgical wound treatment services include mechanical debridement, a procedure in which loose tissue and blisters are removed. Patients are medicated to 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.

Skin Grafting

For third-degree, or full thickness, burns, skin grafting is used because the skin will not heal on its own. General anesthesia is administered so that the patient experiences no pain or memory of the surgery. If the burn wounds are over large areas, several trips to the operating room for grafting may be needed. The exposed healthy tissue underneath may be covered with one or a combination of the following:

  • An autograft, or skin obtained from a non-burned area of the patient’s body
  • An allograft, or skin obtained from a human donor
  • Cultured epithelial cells, or skin that has been grown in a laboratory from a small sample of the patient’s own skin
  • Integra artificial skin, composed of a top layer that serves as a temporary synthetic epidermis and a bottom layer that serves as a foundation for the regrowth 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 three to five 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 your child has a donor site from an autograft procedure, a protective dressing will be placed over this area. The donor site will heal in about 10 to 14 days but may require dressing changes on a daily basis.

Read more about plastic surgery at Johns Hopkins Children's Center.

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