Burn Reconstruction and Skin Grafting After Deep Flame Burns on the Forearm
A 29-year-old homemaker sustained deep partial and full-thickness flame burns on her right forearm following a cooking accident at home. She was treated at this best hospital in Navi Mumbai with wound debridement, split-thickness skin grafting, and a structured scar management programme. The burn area healed with good graft take, functional range of motion was preserved, and visible scarring was significantly reduced over the follow-up period.
PATIENT PROFILE
| Name | Kavita Nair (name changed for privacy) |
| Age | 29 years |
| Gender | Female |
| Occupation | Homemaker |
| Chief Complaint | Deep flame burns on right forearm, raw wound not healing |
| Affected Area | Right forearm, dorsal and lateral surface |
| Burn Depth | Deep partial thickness and full thickness |
| Previous History | No significant medical history |
| Date of Treatment | May 2026 |
| Outcome | Excellent |
Name changed for privacy. Case published with patient consent.
THE PROBLEM
The accident happened in her own kitchen. Within seconds, a flame caught her sleeve and the burn was already deep before anyone could reach her.
Kavita was cooking at home when her dupatta caught fire from the gas flame. The burn ran along the dorsal and lateral surface of her right forearm. She was given first aid at a nearby clinic and referred to Echelon Hospital three days later when the wound was not healing and showed signs of depth beyond what topical treatment could address.
On assessment, the burn covered approximately 4% of her total body surface area. Clinical examination and wound mapping confirmed a mixed burn pattern: areas of deep partial thickness where the dermis was severely damaged, and isolated patches of full-thickness involvement where all skin layers had been destroyed. There was no inhalation injury and no systemic involvement. Her vitals were stable. However, the depth of the wound meant spontaneous healing was not a realistic option. Without surgical intervention, the likely outcomes were prolonged raw wounds, dense scarring, and possible contracture affecting wrist and finger movement. The plastic surgery team recommended early debridement and split-thickness skin grafting to achieve stable wound closure, preserve function, and minimise long-term scarring. Patients in similar situations often ask whether surgery is truly necessary — for burns of this depth affecting a functional area like the forearm, it almost always is.
A burn that is not healing within two weeks, or one that appears white, dry, or numb, needs specialist assessment.
CONSULTATION AND TREATMENT PLAN
“Deep burns on the forearm are not just a skin problem — they are a function problem. The goal of skin grafting is to close the wound cleanly, stop the wound from contracting, and give the patient the best possible chance of normal hand and wrist movement. The sooner we do it, the better the outcome.”
– Plastic Surgery Team, plastic surgery in Navi Mumbai
Assessment findings
- Right forearm burn: approximately 4% TBSA, dorsal and lateral surface
- Mixed depth: deep partial thickness with isolated full-thickness patches
- Wound base pale and insensate in full-thickness areas, confirming depth
- No spontaneous re-epithelialisation after 3 days of topical management
- No inhalation injury, no systemic sepsis, vitals stable
- Donor site identified: right thigh adequate, undamaged skin available
- Patient goal: wound closure, preserved hand function, minimal visible scarring
Why split-thickness skin grafting
When a burn involves full-thickness skin loss or deep partial thickness damage that will not heal on its own within three weeks, skin grafting is the standard treatment. Waiting longer increases the risk of wound infection, deepening of the wound, and hypertrophic scarring. Split-thickness skin grafting harvests a thin layer of skin from an uninjured donor site and applies it over the prepared burn wound. The graft takes on a new blood supply and becomes part of the healed surface. For Kavita, whose forearm burn sat right over the wrist and finger tendons, early grafting wasn’t just about closing the wound quickly — it was about giving her hand the best possible chance of moving normally again.
The plan was discussed in detail with Kavita and her husband before surgery, covering the grafting procedure, donor site care, expected healing timeline, and the scar management programme that would follow.
| Procedure | Wound Debridement + Split-Thickness Skin Grafting (STSG) |
| Burn Area Treated | Right forearm, dorsal and lateral surface |
| Donor Site | Right thigh |
| Graft Type | Split-thickness meshed graft |
| Anaesthesia | General anaesthesia |
| Session Type | Single surgical session |
| Complications | None |
Concerned about a burn wound that isn’t healing, or a scar from a previous burn?
PROCEDURE DETAILS
1. Pre-operative bloods, wound swab culture, and anaesthesia review completed
2. General anaesthesia administered; patient positioned for access to forearm and right thigh
3. Burn wound debrided — all non-viable tissue removed until a clean, bleeding wound bed was confirmed
4. Wound bed irrigated and haemostasis achieved
5. Split-thickness skin graft harvested from the right thigh using a dermatome
6. Graft meshed to allow expansion and fluid drainage through the graft surface
7. Meshed graft laid over the prepared wound bed on the forearm and secured with sutures and staples
8. Tie-over dressing applied to hold the graft firmly against the wound bed
9. Donor site on thigh dressed with paraffin gauze and absorbent dressing
10. First graft inspection planned at day 5 post-surgery
POST TREATMENT CARE AND RECOVERY
Graft take is everything in the first five days. After that, the focus shifts to keeping the new skin healthy and managing the scar.
Protecting the graft
- Keep the grafted area completely immobilised for the first 5 days — any shearing movement disrupts graft take
- Do not get the dressing wet
- Attend the day 5 dressing review without fail — this is when graft take is assessed
- If the area becomes hot, smells, or the patient develops fever, contact the hospital immediately
Everyday care after graft take is confirmed
- Apply prescribed emollients to the grafted skin twice daily — new graft skin is fragile and dries out easily
- Keep the area out of direct sun for at least 6 months — grafted skin has no UV protection initially
- Begin physiotherapy for wrist and finger range of motion as directed
- Compression garment to be worn as prescribed to manage scar thickness
When to call the hospital
Contact the hospital straight away if the grafted area becomes hot, develops an odour, or if fever sets in, as these need urgent review. Regular follow-up through the day 5 graft check, physiotherapy phase, and scar maturation period is essential for a full functional and cosmetic recovery.
RESULTS
PATIENT FEEDBACK
Shared at her three-month follow-up. Her own words. K – Kavita Nair (name changed for privacy) • Verified Patient • Echelon Hospital ★★★★★ May 2026
“I was very scared when I came here. The burn was not healing and I was worried about my hand. The plastic surgery team explained everything step by step and after the surgery the wound healed completely. My hand movement is fully normal and the scar has faded a lot. I am very grateful to the team at Echelon.”
Procedure: Burn Reconstruction, Split-Thickness Skin Grafting • Right Forearm Flame Burns • Echelon Hospital • May 2026 • Google Review • Published with written consent
WHY CHOOSE ECHELON HOSPITAL
Echelon Hospital treats burn reconstruction as part of a complete plastic and reconstructive surgery programme, not a one-off procedure handed between departments. For Kavita, that meant acute wound care, skin grafting, physiotherapy, and scar follow-up all managed by the same team from her first visit to her final review. The plastic surgery team works alongside 24/7 emergency care, in-house critical care support, and specialists in orthopaedics and dermatology whenever a case calls for it. Burns that affect movement and function need this kind of continuity, and it’s what Echelon is built to offer under one roof.
Health Line: +91 89895 85050
Talk to our plastic surgery team about a burn, scar, or reconstructive concern.
FAQs
Q1. How do doctors decide if a burn needs skin grafting?
If a burn is deep partial thickness or full thickness and shows no signs of healing on its own within about two to three weeks, grafting is usually recommended to close the wound safely and limit scarring.
Q2. Where does the skin for a graft come from?
It is taken from an undamaged area of the patient’s own body, called the donor site — commonly the thigh — using a thin, even layer that heals on its own within a few weeks.
Q3. Will there be a visible scar after skin grafting?
Some scarring is expected at both the graft and donor sites, but with structured scar management, including silicone gel, compression garments, and follow-up, the appearance typically improves significantly over months.
Q4. How long before normal hand or wrist movement returns after a forearm burn?
With early grafting and physiotherapy, functional range of motion is often preserved from the start, with strength and flexibility improving further over 4 to 6 weeks of therapy.
Q5. What danger signs should be watched for after a skin graft?
Fever, a foul smell, increasing redness, or heat at the grafted area should prompt an immediate call to the hospital, as these can indicate the graft is not taking or an infection is developing.
Disclaimer: This case study is for general information only and reflects one patient’s outcome. Results vary from person to person. It is not a substitute for a professional medical consultation. Please book an assessment to discuss your own condition.