How Plastic Surgeons are Improving Quality of Life for Burn Patients

Arlington Heights, IL – Ninety-seven percent of people treated in burn centers will survive their injuries, reports the American Burn Association, but many will sustain serious scarring and life-long physical disabilities. With National Burn Awareness Week February 4-10, the American Society of Plastic Surgeons (ASPS) is shedding light on how the specialty aids patients through the recovery process.

Statistics from ASPS show more than 16,000 reconstructive burn procedures were performed in 2016, a four percent increase from 2015. Plastic surgeons who specialize in burn care treatment may provide acute burn care, such as burn debridement, skin grafts and amputations; or secondary burn care, such as scar revisions after acute burn care, flaps and tissue expansion.

"Nearly 50 percent of burn patients experience chronic pain and itching as they go through their rehabilitation process, which often gets in the way of work, school and other day-to-day activities," said C. Scott Hultman, MD, Professor of Plastic Surgery at the University of North Carolina. "This is a problem plastic surgeons have been trying to solve. We've taken all different techniques we've learned over the years from aesthetic and reconstructive surgery and applied them to the burn population."

The Evolution of Burn Care

Survival rates for burn patients have dramatically improved within the past decade. Today's technologies and techniques include laser resurfacing of burn scars, fat grafting and nerve decompression to reduce pain and itching, and biologic materials to simplify reconstructive procedures.

"We first had a breakthrough roughly 10 years ago when we noticed that laser treatment not only improved burn scars, but it also reduced the patient's pain by decreasing the inflammation of the scar and making the skin a little more supple," Dr. Hultman said. "Many of these patients had real anatomic causes of their pain, which led me to operate on the nerves on a macro level and perform nerve releases."

Dr. Hultman concedes he never envisioned himself using fat grafting procedures for burn scars at the beginning of his career but says the surgical technique has an 80 percent success rate.

Laser treatments help the outer layer of the skin, but fat grafting—the injection of fat cells between the skin and nerve fibers—addresses the undersurface of the skin. "The most exciting thing is that only 10 percent of this patient population had a surgical solution a decade ago, but today 90 percent have undergone some type of surgery that benefited them," said Dr. Hultman.

Treating the Burn Patient

Lesia Cartelli, Founder and CEO of Angel Faces, who suffered severe burn injuries on more than 50 percent of her body in a natural gas explosion nearly 50 years ago as a child, credits her plastic surgeon for providing optimal burn care and helping her recover from the traumatic experience.

"Plastic surgeons have seen countless devastating injuries, and their sense of knowledge, artistic vision and experience bring comfort and trust to the burn patient," she said. "The natural gas explosion left me terribly scarred. I remember my plastic surgeon telling me, 'You are a sweet and brave young girl, and we are going to take good care of you.' I knew he would, and I knew I could trust him."

Barbara Kammerer Quayle sustained second- and third-degree when her car exploded in flames during a rear-end collision in 1977.

"I feel a tremendous amount of gratitude and appreciation that I was guided to my plastic surgeon to do my reconstructive surgery so that I felt comfortable and confident in myself, Quayle said. "Since my recovery, I've dedicated my life to teaching burn patients how to assimilate and feel confident again."

Dr. Hultman says the relationship between burn patients and their surgeons lasts for years, as rehabilitation is a long process.

"Plastic surgeons are incredibly qualified to take care of all burn care because we are constantly thinking with the end in mind," Dr. Hultman said. "We don't place a skin graft on a wound and then move on to the next case. We are constantly trying to solve problems that are at the forefront of our patients lives through our training and experience. The core competency of plastic surgery is innovation. We develop and implement surgical solutions. The innovations of plastic surgery today allow us to focus on improving quality of life for burn survivors."