Conventional and Emerging Surgical and Non-surgical Approaches to the Management of Skin Burn Scars: A Comprehensive Review

Burn cases pose a significant burden on the healthcare system worldwide. The acute loss of the barrier function of the skin can lead to severe shock and sepsis. Burn wounds can evolve into hypertrophic scars and keloids that impair function and aesthetic appearance. Early intervention with both non-surgical and surgical management strategies is crucial to curtail severe consequences. This review aims to provide a comprehensive assessment of treatment modalities ranging from topical and intralesional therapies to surgical procedures, while also highlighting the role of adjunct and emerging strategies. Topical emollients, corticosteroid creams and injections, and silicone gel help restore barrier function and reduce inflammation in patients with superficial or partial-thickness burn injuries. Autologous and allogenic grafts and flaps have proven effective in restoring function and increasing patient satisfaction in treating deep partial-thickness and full-thickness burns. However, the appropriate timing for employing these conventional therapies to gain maximum benefit remains debatable and can result in undesirable complications. Adjunct therapies, including microneedling, platelet-rich plasma (PRP), laser, and physical therapy, have shown mixed results in improving outcomes. Newly emerging techniques, such as stem cells, nanomedicine, and 3D bioprinting, have demonstrated promising potential in enhancing patient outcomes. Nonetheless, large clinical trials with human participants are needed before these modalities can be widely implemented in clinical practice without reservations. It is imperative to establish definitive treatment guidelines and explore advanced avenues to further augment the quality of life among burn victims.