Page 73 - Read Online

Greenhalgh. Plast Aesthet Res 2024;11:27 Plastic and
DOI: 10.20517/2347-9264.2024.43
Aesthetic Research

Perspective Open Access

Basic techniques for optimizing burn wound
healing: insights from clinical practice

David G. Greenhalgh 1,2
1
Department of Burns, Shriners Children’s Northern California, Sacramento, CA 95817, USA.
2
Department of Surgery, University of California, Davis, CA 95817, USA.
Correspondence to: Dr. David G. Greenhalgh, Department of Burns, Shriners Children’s Northern California, 2425 Stockton Blvd.,
Sacramento, CA 95817, USA. E-mail: dggreenhalgh@ucdavis.edu
How to cite this article: Greenhalgh DG. Basic techniques for optimizing burn wound healing: insights from clinical practice. Plast
Aesthet Res 2024;11:27. https://dx.doi.org/10.20517/2347-9264.2024.43

Received: 21 Mar 2024 First Decision: 21 May 2024 Revised: 12 Jun 2024 Accepted: 26 Jun 2024 Published: 9 Jul 2024
Academic Editors: Marc Jeschke, Xianwen Wang Copy Editor: Dong-Li Li Production Editor: Dong-Li Li

Abstract
The purpose of this paper is to provide the author’s view on basic techniques to optimize burn wound healing. For
burns that are partial thickness, the goal is to optimize re-epithelialization to reduce the chance of hypertrophic
scarring. For deeper burns, there are principles that lead to better outcomes. For very small burns, such as on the
hand, full-thickness skin grafts can be performed in the outpatient setting. For burns requiring split-thickness skin
grafts, thicker grafts tend to contract less than thinner ones. Using wider skin grafts or breaking up straight seams
with darts also leads to improved results. Choosing donor sites that either minimize scarring or can be hidden
should also be considered. For the massive burn, one must still prioritize better grafts for more functional or
cosmetic areas (face, hands). Early excision and coverage should reduce scarring. Despite the availability of newer
technologies, simple strategies to treat the burn wound still lead to excellent results.
Keywords: Burns, skin grafts, scarring, epithelialization, wound healing

INTRODUCTION
The primary task for treating burn patients is to heal their wounds with minimal scarring. Often, complete
regeneration of the original tissue is not feasible, so the focus should be on optimizing both functional and
cosmetic outcomes. While many new products and techniques exist, optimal outcomes can often be

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

www.oaepublish.com/par