Burns can result in different types of scars, among them, keloid scars, hypertrophic scars and contractures. Keloid scars are tough, itchy clusters of scar tissue that are formed due to excessive collagen production after the scar has healed.
Sometimes red in colour, keloids are more common in people with dark skin. Hypertrophic scars are similar to keloid scars but tend to form within the boundaries of a burn wound.
Second and third degree burns can result in a tightening of the skin known as burn scar contracture. In delayed wound healing (longer than 3 weeks) the wound edges pull in to form a contracture.
This may affect the muscles, joints and tendons, and may limit movement if located on a joint; also creating an unsightly appearance of the affected area due to the pull on surrounding healthy tissue.
Mr Kode performs Scar Revision Surgery for scarring and contractures, and the surgical technique he uses depends on the type and extent of scarring and its location. For keloid and hypertrophic scars, the affected tissue is removed and the exposed area covered with a skin graft – which involves taking a piece of healthy skin from another area of the body (donor site) and attaching it to the wound site.
Contractures may be corrected with a technique called Z-plasty, in which a Z-shaped incision is used in an effort to decrease the skin ‘pull’ of a contracture. This technique also allows Mr Kode to attempt to conceal the scar in the natural folds of surrounding skin.
Other surgical techniques which may be employed are skin flap surgery, in which skin and underlying fat, blood vessels and occasionally, muscle, are moved from a donor site to the wound. Tissue expansion is useful. It is a technique used to expand normal tissue to be used to cover scarred areas. It may be moved by local flaps or free flaps involving the use of micro surgical techniques.
Range of treatments from non-surgical, topical treatments to surgery, depending on the case. Needling of large areas of burn scars seems to cause micro releases of contracting bands, casual marked softening and relaxation of the hard sheets of scar tissue.
Mr Kode and his team have decades of experience in scar revision and Reconstructive Plastic Surgery. For more information about please contact our practice.