Burn surgery focuses on the largest organ in the human body - the skin. This specialist field is complicated because burns can cause extreme disfigurement and only heal slowly. The task of the burn surgeon is to maintain life and create quality of life. The burn surgeon treats not only burns but also scalds and burn injuries caused by chemicals. If the burns are recent, the priority is to maintain the vital functions. If major, key areas of the body are burnt, the patient must be given intensive medical care.
Burns are classified according to the degree of severity:
- first degree burns generally heal on their own,
- second degree burns need medical care, but also have very good healing prospects.
- Third degree burns are severe and not infrequently end in death. Treatment of them often require the transplantation of larger key areas of skin, which are taken, for example, from the thigh.
Primary care for burns
In general, burns are emergencies. Because of the severity of the injury, the patient's blood circulation is also destabilized. Their wounds must be cooled, the circulation must be stabilized and the pain alleviated. The medical practitioner must also take care that the wounds are not infected with germs. If a skin transplant is necessary, other specialists are called in.
Special care for burn victims
Germany today has a dense and excellent network of special clinics for severe and very severe burn wounds, which was established in the 1960s. Patient care is complex since most burn victims need skin transplants as well as wound care. It is often the case that skin uninjured by burns in the healthy parts of the body cannot be used for transplants. If the area of the body affected by burns is too extensive, sometimes not enough skin is available. But these days, modern medicine has the means of growing and transplanting artificial skin.
Burn surgery specialists treat acute burn wounds. If no more than 20% of the skin surface is affected and if the patient's general condition is relatively good, burn wounds can be treated by a registered specialist. They are also able to undertake secondary reconstruction of the skin surface and treat scars. If reconstruction is difficult, cosmetic surgery specialists need to be called in. As well as acute wound care, psychological help is needed, which is provided by psychologists and psychotherapists.
Clinics working in the field of plastic, reconstructive and burn surgery are especially well equipped and provide care for patients from a very broad catchment area. The Severe Burn Injury Center in Tübingen is the largest in Baden-Württemberg. The center also treats patients from Switzerland and Austria. Care is provided on a collaborative basis with accident surgeons, because experienced doctors are often routinely faced with workplace accidents. They have not only had at least two years of further training in surgery, they have also had additional training in plastic and cosmetic surgery - and in Tübingen they also have three years of training in hand surgery.
The best way of replacing burnt skin is to transplant healthy skin. The techniques used for this are very gentle, such as enzyme-based wound cleaning. This is fundamental to the care of burn wounds and the start of therapy. In this, necrotic (dead) tissue and discharges such as lymphatic fluid or blood must be removed. This is the point - if fistulas for example are visible beneath the wound - that the overall condition can be assessed.
Childhood burn wounds
If children are not treated appropriately, severe, long-term consequences can develop. Examples of such consequences are:
- neurological harm
- airway defects
- disordered blood flow to hands, arms and legs
- water retention
- increased infections
- pain around the joints injured by burns
Mental after-effects (trauma) must not be underestimated. As a precaution in connection with possible claims for compensation in adulthood, all the documents detailing the medical treatment should be retained.
Burn wounds are almost always emergencies and must receive medical treatment as soon as possible. Patients with burn wounds are in good hands in the nationwide network of emergency clinics. If transplants are needed, the persons affected receive appropriate treatment in the special burn victim centers.
