Epithelial bridging on burn patients following primary excision and grafting

Early tangential excision and primary grafting of full thickness and deep partial thickness burns has become a widely accepted practice, however, little attention has been paid to the epithelial bridging phenomenon, which occurs most frequently at the edge of these wounds. Over 5 years, 923 burn patients were treated and 407 were grafted, of whom 13 developed sufficiently severe epithelial bridging to require deroofing under general anaesthetic. Histological sections show that the bridges are derived from hair follicles. We advocate that patients with epithelial bridges should be observed in the out-patient department for many weeks and surgical intervention should only be used when they fail to resolve spontaneously.