Burn Scar Contracture
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Burn scar contracture is the tightening of the skin after a second or third degree
burn A burn is an injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or ultraviolet radiation (like sunburn). Most burns are due to heat from hot liquids (called scalding), solids, or fire. Burns occur ma ...
. When skin is burned, the surrounding skin begins to pull together, resulting in a contracture. It needs to be treated as soon as possible because the
scar A scar (or scar tissue) is an area of fibrous tissue that replaces normal skin after an injury. Scars result from the biological process of wound repair in the skin, as well as in other organs, and tissues of the body. Thus, scarring is a n ...
can result in restriction of movement around the injured area. This is mediated by myofibroblasts. __TOC__


Diagnosis


Treatment

Burn scar contractures do not go away on their own, although may improve with the passage of time, with occupational therapy and physiotherapy, and with splinting. If persistent the person may need the contracture to be surgically released. Techniques may include local skin flaps (z-plasty) or skin grafting (full thickness or split thickness). There are also pharmacy and drug-store treatments that can be used to help scar maturation, especially silicone gel treatments. Prevention of contracture formation is key. For instance, in the case of a burned hand one would splint the hand and wrap each finger individually. In the instance of burns on the neck, hyperextension of the neck (i.e. no use of pillows) should be maintained during the healing process. Carbon dioxide laser therapy is now also used to aid in the loosening of surrounding skin, although is yet to form as part of an official global rehabilitation program.


References

Hariharan N C, Sridhar R, Sankari B, Valarmathy VS, Asirvatham E, Geetha K
"Reconstruction of postburn crippled hands: A study of functional outcome"
Indian J Burns 2018;26:9-14.
Skin conditions resulting from physical factors {{Cutaneous-condition-stub