All burn surgeons operate with a vision towards the final post-burn form. But for the sake of survival, timely wound coverage may sometimes require compromise. Aesthetic considerations can be addressed later. Immediate reconstruction means to maximize reconstructive efforts during initial closure of the burn wound. Although the wound may be closed with a skin graft, perhaps a free flap is chosen to provide better long term coverage.
Early reconstruction has as many definitions as there are surgeons.
To me, early reconstruction implies surgery while the scars are still very immature, which is generally believed to be within the first six months following the burn injury. For the right patient, I am a strong advocate for early reconstruction efforts. The major disadvantage in this approach is that the patient's scarring process is still hyperactive, and recurrent contractures are frequent. Still, I believe early reconstruction assists the process of recovery. Late reconstruction, then, in my definition, is surgery occurring more than six months post-burn, or when the scars are believed to be mature.