Skip to main content
SpringerLink
Log in

Treatment of Facial Burns

  • Chapter
  • First Online:
Essential Burn Care for Non-Burn Specialists

  • 347 Accesses

Abstract

Our faces allow us to convey subtle emotions and nonverbal communication and perceive the world around us through our eyes, ears, and nose. Facial burns may be devastating, robbing the patients of their sense of self and limiting their ability to interact with others. Special consideration for the aesthetic subunits of the face is a concern even in the initial excision and grafting period. A facial burn should also raise the suspicion of an inhalational injury. This chapter reviews distinctive aspects of the burned face that make its care so challenging and discusses techniques to improve long-term cosmetic outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Dziewulski P, Villapalos JL. Acute management of facial burns. In: Jeschke MG, Kamolz L.-P., Sjöberg F., Wolf SE, editors. Handbook of burns: acute burn care, Vol. 1. Wien: Springer-Verlag Wien, 2012. 291–302 p.

    Google Scholar 

  2. Ye EM. Psychological morbidity in patients with facial and neck burns. Burns. 1998;24:646–8.

    Article  CAS  PubMed  Google Scholar 

  3. González-Ulloa M. Regional aesthetic units of the face. Plast Reconstr Surg. 1987;79(3):489–90.

    Article  PubMed  Google Scholar 

  4. Aly MEI, Dannoun M, Jimenez CJ, Sheridan RL, Lee JO. Operative wound management. In: Herndon DN, editor. Total burn care. 5th ed. New York: Elsevier Inc.; 2018. p. 114–130.e2.

    Google Scholar 

  5. Cole JK, Engrav LH, Heimbach DM, Gibran NS, Costa BA, Nakamura DY, et al. Early excision and grafting of face and neck burns in patients over 20 years. Plast Reconstr Surg. 2002;109:1266–73.

    Article  PubMed  Google Scholar 

  6. Dougherty WR, Spence RJ. Reconstruction of the burned face/cheek: acute and delayed. In: Sood R, Achauer BM, editors. Achauer and Sood’s burn surgery: reconstruction and rehabilitation. Elsevier/Saunders; 2006. p. 234–53.

    Google Scholar 

  7. Jeschke MG, van Baar ME, Choudhry MA, Chung KK, Gibran NS, Logsetty S. Burn injury. Nat Rev Dis Primers. 2020;6(1):11. Published 2020 Feb 13.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Burn incidence fact sheet. Chicago: American Burn Association (http://ameriburn.org/who-we-are/media/burn-incidence-fact-sheet/. opens in new tab).

  9. Greenhalgh DG. Management of facial burns. Burn Trauma. 2020;25(9):1127–30.

    Google Scholar 

  10. Bagby SK. Acute management of facial burns. Oral Maxillofac Surg Clin North Am. 2005;17(3 Spec Iss):267–72.

    Article  PubMed  Google Scholar 

  11. Housinger TA, Lang D, Warden GD. A prospective study of blood loss with excisional therapy in pediatric burn patients. J Trauma. 1993;34(2):262–3.

    Article  CAS  PubMed  Google Scholar 

  12. Woodson LC, Branski LK, Enkhbaatar P, Talon M. Diagnosis and treatment of inhalation injury. In: Herndon DN, editor. Total burn care. 5th ed. New York: Elsevier Inc.; 2018. p. 184–194.e3.

    Chapter  Google Scholar 

  13. Osler T, Glance LG, Hosmer DW. Simplified estimates of the probability of death after burn injuries: extending and updating the baux score. J Trauma. 2010;68:690–7.

    PubMed  Google Scholar 

  14. Tian H, Wang L, Xie W, et al. Epidemiology and outcome analysis of facial burns: A retrospective multicentre study 2011-2015. Burns. 2020;46(3):718–726.15.

    Article  PubMed  Google Scholar 

  15. Darling GE, Keresteci MA, Ibanez D, Pugash RA, Peters WJ, Neligan PC. Pulmonary complications in inhalation injuries with associated cutaneous burn. J Trauma. 1996;40:83–9.

    Article  CAS  PubMed  Google Scholar 

  16. Woodson LC, Sherwood ER, Kinsky MP, Talon M, Martinello C, Woodson SM. Anesthesia for burned patients. In: Herndon DN, editor. Total burn care. 5th ed. New York: Elsevier Inc.; 2018. p. 131–157.e4.

    Chapter  Google Scholar 

  17. Kobayashi K, Ikeda H, Higuchi R, Nozaki M, Yamamoto Y, Urabe M, et al. Epidemiological and outcome characteristics of major burns in Tokyo. Burns. 2005;31(Suppl. 1):S3–S11.

    Article  PubMed  Google Scholar 

  18. Moritz AR, Henriques FC, McLean R. The effects of inhaled heat on the air passages and lungs: an experimental investigation. Am J Pathol. 1945;21(2):311–31.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Cancio LC. Airway management and smoke inhalation injury in the burn patient. Clin Plast Surg. 2009;36(4):555–67.

    Article  PubMed  Google Scholar 

  20. Aggarwal S, Smailes S, Dziewulski P. Tracheostomy in burns patients revisited. Burns. 2009;35(7):962–6.

    Article  PubMed  Google Scholar 

  21. Deitch EA, Wheelahan TM, Rose MP, Clothier J, Cotter J. Hypertrophic burn scars: analysis of variables. J Trauma. 1983;23:895–8.

    Article  CAS  PubMed  Google Scholar 

  22. Bell JL. Treatment of acute thermal burns of the face. Am J Surg. 1959;98:923–9.

    Article  Google Scholar 

  23. Boswick JA Jr. Burns of the head and neck. Surg Clin North Am. 1973;53:97–04.

    Article  PubMed  Google Scholar 

  24. McIndoe AH. Total reconstruction of the burned face. The Bradshaw Lecture 1958. Br J Plast Surg. 1983;36:410–20.

    Article  CAS  PubMed  Google Scholar 

  25. Cubison TC, Pape SA, Parkhouse N. Evidence for the link between healing time and the development of hypertrophic scars (HTS) in paediatric burns due to scald injury. Burns. 2006;32(8):992–9. Epub 2006 Aug 8.

    Article  PubMed  Google Scholar 

  26. McDonald WS, Deitch EA. Hypertrophic skin grafts in burned patients: a prospective analysis of variables. J Trauma. 1987;27(2):147–50.

    Article  CAS  PubMed  Google Scholar 

  27. Leon-Villapalos J, Jeschke MG, Herndon DN. Topical management of facial burns. Burns. 2008;34(7):903–11.

    Article  PubMed  Google Scholar 

  28. Monafo WW, West MA. Current treatment recommendations for total burn therapy. Drugs. 1990;40:364–73.

    Article  CAS  PubMed  Google Scholar 

  29. Chester DL, Papini R. Skin and skin substitutes in burn management. Trauma. 2004;6(2):87–99.

    Article  Google Scholar 

  30. Fraulin FOG, Illmayer SJ, Tredget EE. Assessment of cosmetic and functional results of conservative versus surgical management of facial burns. J Burn Care Res. 1996;17:19–29.

    Article  CAS  Google Scholar 

  31. Friedstat JS, Klein MB. Acute management of facial burns. Clin Plast Surg. 2009;36(4):653–60.

    Article  PubMed  Google Scholar 

  32. Gulati S. Use of fibrin glue in excision and grafting of facial burns. J Burns Surg Wound Care [Serial Online]. 2002;1(1):18.

    Google Scholar 

  33. Adant JP. Skin grafting with fibrin glue in burns. Eur J Plast Surg. 1996;16:292–7.

    Google Scholar 

  34. Greenwood JE, Dearman BL. Comparison of a sealed, polymer foam biodegradable temporizing matrix against Integra® dermal regeneration template in a porcine wound model. J Burn Care Res. 2012;33:163–73.

    Article  PubMed  Google Scholar 

  35. Li A, Dearman BL, Crompton KE, Moore TG, Greenwood JE. Evaluation of a novel biodegradable polymer for the generation of a dermal matrix. J Burn Care Res. 2009;30:717–28.

    Article  CAS  PubMed  Google Scholar 

  36. Parry I, Sen S, Palmieri T, Greenhalgh D. Nonsurgical scar management of the face: Does early versus late intervention affect outcome? J Burn Care Res. 2013;34(5):569–75.

    Article  PubMed  Google Scholar 

  37. Mustoe TA. Evolution of silicone therapy and mechanism of action in scar management. Aesthetic Plast Surg. 2008;32(1):82–92. https://doi.org/10.1007/s00266-007-9030-9.

    Article  PubMed  Google Scholar 

  38. Li-Tsang CW, Zheng YP, Lau JC. A randomized clinical trial to study the effect of silicone gel dressing and pressure therapy on posttraumatic hypertrophic scars. J Burn Care Res. 2010;31:448–57.

    Article  PubMed  Google Scholar 

  39. Momeni M, Hafezi F, Rahbar H, Karimi H. Effects of silicone gel on burn scars. Burns. 2009;35:70–4.

    Article  PubMed  Google Scholar 

  40. Hultman CS, Friedstat JS, Edkins RE, Cairns BA, Meyer AA. Laser resurfacing and remodeling of hypertrophic burn scars: the results of a large, prospective, before-after cohort study, with long-term follow-up [published correction appears in Ann Surg. 2015 Apr;261(4):811]. Ann Surg. 2014;260(3):519–32.

    PubMed  Google Scholar 

  41. Anderson RR, Donelan MB, Hivnor C, et al. Laser treatment of traumatic scars with an emphasis on ablative fractional laser resurfacing: consensus report. JAMA Dermatol. 2014;150(2):187–93.

    Article  PubMed  Google Scholar 

  42. Hunt JA, Moisidis E, Haertsch P. Initial experience of Integra in the treatment of post-burn anterior cervical neck contracture. Br J Plast Surg. 2000;53(8):652–8.

    Article  CAS  PubMed  Google Scholar 

  43. Taylor HO, Carty M, Driscoll D, Lewis M, Donelan MB. Nasal reconstruction after severe facial burns using a local turndown flap. Ann Plast Surg. 2009;62(2):175–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA

    Alen Palackic & Ludwik K. Branski

  2. School of Medicine, University of Texas Medical Branch, Galveston, TX, USA

    Alen Palackic

  3. Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria

    Robert P. Duggan

  4. School of Medicine, University of Texas Medical Branch, Galveston, TX, USA

    Rahul Shah

  5. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    Rahul Shah

  6. Shriners Children’s Texas, Galveston, TX, USA

    Jong O. Lee

  7. Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria

    Ludwik K. Branski

Authors
  1. Alen Palackic
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert P. Duggan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rahul Shah
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jong O. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ludwik K. Branski
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ludwik K. Branski .

Editor information

Editors and Affiliations

  1. Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA

    Jong O. Lee

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Palackic, A., Duggan, R.P., Shah, R., Lee, J.O., Branski, L.K. (2023). Treatment of Facial Burns. In: Lee, J.O. (eds) Essential Burn Care for Non-Burn Specialists. Springer, Cham. https://doi.org/10.1007/978-3-031-28898-2_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-28898-2_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-28897-5

  • Online ISBN: 978-3-031-28898-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation