Purpose: To evaluate treatment of pretibial full thickness burns in our patient population.

Methods: In our patient population with full thickness pretibial burns wounds, we have chosen to treat these wounds with conservative methods, rather than with free tissue transfer. The calf burns are debrided and grafted with split thickness skin grafts up to but not including the pretibial burns wounds. The eschar covering the pretibial wound is left as a biologic dressing over the tibia which gradually sloughs. After sloughing of the eschar, a clean bed of granulation tissue readily accepts skin grafting, avoiding the need for free tissue transfer and its concomitant morbidity.

Results: In our institution over the past decade, the coverage of pretibial full thickness burn wounds has been successfully completed with split thickness skin grafts over granulation tissue.

Discussion: Conservative management of pretibial full thickness burns can be successfully accomplished in difficult cases.