Specific treatments (medical services):
1. Early necrectomy with one-stage autodermoplasty
Radical removal of thermally damaged tissues with simultaneous restoration of the skin avoids the development of burn disease, as such. Early necrectomy with one-stage autodermoplasty is the operation of choice, but significantly shortens the duration of treatment.
2. Osteoperforation
This operation is performed in patients with osteonecrosis to accelerate the formation of the perceiving bed, for subsequent plastics.
3. Autodermoplasty
The operation is performed when it is impossible to independently epithelialize granulating wounds (with deep lesions). It is the only method of radical treatment of deep burns. Autodermoplasty is performed on prepared granulations using a split skin flap removed by an electrodermatoma from the surface of healthy skin (donor areas). The choice of donor sites depends on the localization of the burn and is performed on areas other than those important in functional and cosmetic terms. Skin sampling is made to a depth of not more than 0.3 - 0.4 mm. In children, the thickness of autografts should not exceed 0.2 - 0.25 mm. Sampling autografts are accompanied by blood loss of 40 - 60 ml for every 100 cm2, which limits the possibility of simultaneous taking autografts in large areas. Autodermoplasty is performed in two versions:
- Plastic surgery with solid (solid) grafts - is performed on functionally active areas and on the face.
- Economical plastic (mesh graft). The perforation coefficient is 1:2; 1:3; 1:4, 1:6. The value of the method is not only that it allows you to restore the skin in areas significantly exceeding the area of cut grafts, but also in good outcomes of plastics.
4. Surgical treatment of scars
This type of operation is performed to eliminate contractures and deformities of post-burn scars and restore cosmetic defects using various types of skin plastic methods.
During the period of convalescence and subsequent rehabilitation, the main medical tactic is conservative treatment:
1) drug therapy effectively slowing down the evolution of scar tissue: the use of various ointments and gels, silicone coatings. The introduction of drugs (lidase, longidase) into the scar tissue.
2) physiotherapeutic treatment (phonophoresis with enzymes, ultrasound with hormones, magnetotherapy, electrosleep), hydrogen sulfide baths.
3) therapeutic gymnastics (prolonged stretching).
4) compression clothing (treatment with pressure on the scar area).
5) sanatorium-resort treatment.
6) medical examination