Skin Grafting for Severe Burns: Is It Necessary?

Q: Skin Grafting for Severe Burns: Is It Necessary?

Hello： If a burn wound has not healed after two weeks, it may be a deep second-degree or even a third-degree burn. <br>If the area is large, skin grafting should be considered, which depends on the clinical judgment of the physician. <br>As for the cost of skin grafting, it shoul

Skin grafting after a burn injury?

On July 11, while I was visiting Kenting, I had a minor motorcycle accident where the motorcycle fell on me, causing a burn on my thigh from the exhaust pipe.
The wound is approximately the size of a woman's palm (excluding fingers).
At that time, I went to a local small hospital for emergency treatment, where they performed only preliminary care.
The doctor diagnosed it as a second-degree burn with skin peeling.
Later, I returned to a hospital in Tainan for further treatment, where the doctor prescribed a tube of "Burn Cream" for me, and I have been changing the dressing daily, with follow-up visits approximately once a week until now.
Although the wound has shrunk, the inner part of the skin has not yet grown back, and the wound has not healed.
The doctor mentioned recently that wounds that have not healed after three weeks can result in unsightly scars that may protrude, and my wound is healing very slowly.
He suggested that I might need a skin graft, which would involve taking a small amount of epidermis from my arm, leaving a new wound.

Do I really need a skin graft? (It feels quite serious.) A skin graft will also leave a new wound; will that be difficult to heal? Will it leave a scar? If it is necessary, how much would it cost? (I am just a poor student and worry about affording it /_\ ) Can't I just use some scar treatment ointments (like MEDERMA Scar Gel) instead? Thank you!

cherry, 20~29 year old female. Ask Date: 2005/08/08

Dr. Huang Junxiong reply Surgery

Hello: If a burn wound has not healed after two weeks, it may be a deep second-degree or even a third-degree burn.
If the area is large, skin grafting should be considered, which depends on the clinical judgment of the physician.
As for the cost of skin grafting, it should be covered by health insurance, and the out-of-pocket expenses should not be significant.
Scar creams should not be used indiscriminately; it is best to discuss the condition of the wound with a plastic surgeon before using them.
Wishing you good health!

Reply Date: 2005/08/08

More Info

When dealing with severe burns, particularly second-degree burns, the management and potential need for skin grafting can be a complex issue. Based on your description, it seems you sustained a significant burn from a motorcycle exhaust pipe, and despite ongoing treatment, the wound has not healed adequately after three weeks. This situation raises important considerations regarding the necessity of skin grafting.

Understanding Skin Grafting:
Skin grafting is a surgical procedure where healthy skin is transplanted to cover a wound that has not healed properly. This is often necessary for deeper burns, such as second-degree burns that involve the dermis and have not shown signs of healing after a certain period. The primary goal of skin grafting is to promote healing, reduce the risk of infection, and improve the cosmetic appearance of the scar.

In your case, since the wound has not healed after three weeks, your doctor’s recommendation for a skin graft is based on the concern that prolonged non-healing can lead to complications such as infection, chronic pain, and unsightly scarring. The risk of hypertrophic scars or keloids increases with time, especially if the wound remains open and exposed to the environment.

Is Skin Grafting Necessary?
The necessity of skin grafting depends on several factors:
1. Wound Assessment: If the wound is deep and has not shown signs of healing (such as granulation tissue formation), a graft may be necessary.

2. Location and Size of the Burn: Larger burns or those in areas with less natural skin elasticity may require grafting to ensure proper healing.

3. Patient’s Overall Health: Your age, nutritional status, and any underlying health conditions can affect healing and the decision for grafting.

Concerns About Scarring and New Wounds:
It is understandable to be concerned about the formation of new scars from the graft site. However, skin grafting is often the best option to ensure that the burn heals properly and to minimize the risk of severe scarring from the original burn. The new scar from the graft site typically heals well and can be less noticeable than a poorly healed burn scar.

Cost Considerations:
The cost of skin grafting can vary widely based on the healthcare facility, the complexity of the procedure, and whether you have insurance coverage. It is advisable to discuss your financial concerns with your healthcare provider or the hospital's financial department. They may offer payment plans or financial assistance programs for students or those with limited income.

Alternative Treatments:
While topical treatments like Mederma can help improve the appearance of scars, they are not substitutes for proper wound healing. If the wound is not healing, topical treatments alone will not suffice. It is crucial to follow your doctor’s advice regarding the management of your burn and to consider their recommendations seriously.

Conclusion:
In summary, based on the information provided, it seems that skin grafting may be a necessary step in your recovery process. It is essential to have an open discussion with your healthcare provider about your concerns, the potential benefits of the procedure, and any financial implications. Early intervention can lead to better healing outcomes and minimize the risk of complications associated with untreated severe burns.

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