Severe burn injuries frequently present a therapeutic challenge; fortunately, conservative therapies have proven highly effective in augmenting standard surgical management. Skin substitutes, such as pigskin or cadaveric tissue, aid in acute burn care by limiting fluid and heat loss. In the subacute phase, splint therapy provides direct pressure, maintains soft tissue form at specific areas, and limits scarring. Physical therapy promotes strengthening of local musculature and regain range of motion. We discuss the nonoperative management of severe burns, as well as provide insight into future directions in conservative burn care.