Our surgeons regularly treat burnt victims and have vast experience attending to wounds and treating various types of scars.
Some patients wear their scars as a badge of honour, though many more are troubled by problematic scars. Certain scars are in more exposed areas that cannot be covered by clothing, such as the face, neck and hands. Less than ideal scars may be broad and depressed, thick and discoloured. There may also be “dog ears” – excess tissue at the ends of scars.
Due to factors such as genetics and scar location, some scars can be more raised than normal. Such hypertrophic scars do not extend beyond the boundaries of the original scar and usually become flatter with time. Keloid scars, on the other hand, usually grow and expand beyond the original scar. They also cause itch and pain.
Basic scar treatment consists of silicone-based gel or tape, sunblock and massage. This is generally sufficient for normal and hypertrophic scars. Certain types of acne scars are treated by subcision and filler or fat injection.
A keloid scar requires much more intense and frequent treatment to control its growth. This consists of steroid tape, injections and laser treatment. In some cases, excision and local flap treatment or even radiation therapy is required.
Our plastic surgeons regularly managed burn patients at the Burn Centre in Singapore General Hospital. The Burn Centre is the only specialised facility and tertiary referral centre managing major burn injuries in Southeast Asia. Our surgeons are thus well-versed in the treatment of all types of burn wounds.
Scalds and burns are common injuries at home or in the workplace. Although a burn wound often starts out superficial, due to the process of burn conversion, the burn wound becomes deep. A deep wound can get infected easily. Even if heals, the prolonged healing time (>21 days) stimulates the development of thick, problematic scars.
It is important to seek consultation early as there are new biological dressings (such as Biobrane) that can reduce the conversion risk. They enable the wound to heal on its own with minimal scarring. Specialized wound care can hasten healing.
A burn wound that is deeper will require excision and skin grafting. Post-operative care consists of compression dressings, silicone sheets, lasers and injections.
An acute wound heals within 3 weeks. If healing is prolonged beyond this, the wound has become sub-acute (3 weeks to 3 months) or chronic (more than 3 months).
For chronic wounds, there is usually an underlying pathology that produces a delay in the healing process. This includes peripheral vascular disease, diabetes, infection and so on. These factors should be optimized to create a better wound healing environment.
Cleaning the wound and using advanced wound products such as vacuum-assisted therapy can sometimes be sufficient to kickstart the healing process again.
Procedures such as skin-grafting, dermal matrix application or flap closure can help expedite the process when the wound bed is ready.
