If the burn wound is allowed to heal without intervention then the skin heals with contraction thus forming contractures which can lead to serious deformity and disability if overlying a joint or other vital areas of the body besides being cosmetically very demoralising for the patient.
The initial management of a burn patient involves resuscitation of the patient for shock, taking care of the fluid balance and preventing infection. The long term management involves preventing the formation of contractures as any other subsequent deformity.
Earlier, the contractures were initially allowed to form and treated with skin grafting at a later date. These days early skin grafting can be done within the first week ( specially for face, hand and joint surface burns ) if the patient is stable, which prevents the formation of contractures. Skin grafting involves taking skin from the healthy areas of the body ( usually the thigh area if it is not involved ), meshing it and putting it on the wound. The donor area also heals with new skin growth.
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