Primary excision of third degree burns

Fresh third-degree burns with a diameter up to that of a hand should be excised primarily and the wound edges closed under tension. Fasciocutaneous flaps can be designed for wound closure especially on the extremitites. This treatment requires half the time of skin grafting. Since patients with huge burn areas often react with hypertrophic scarring for years, a simple reduction of the areas by wide excision and closure under tension appears to be the method of first choice. In contrast to scar tissue healthy skin has a natural ability to stretch when wound margins are closed under maximal tension. The efficacy of possibilities is proven by the many favourable results.