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Reviews of Scar Contractures by Vikas Gupta





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Reviews of Scar Contractures by
Article Posted: 11/02/2012
Article Views: 69
Articles Written: 650
Word Count: 525
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Reviews of Scar Contractures


 
Health

A contracture is a permanent shortening of the muscle, tendon or scar tissue producing deformity or distortion. Contractures often restrict normal body movement. In these reconstruction procedures, a surgeon excises (removes) an existing scar and applies a graft to the site of the removed scar. Skin grafting for burn reconstruction is a surgical procedure and is usually performed in the hospital on an inpatient basis under general anesthesia.A scar contracture is the result of a contractile wound-healing process occurring in a scar that has already been reepithelialized and adequately healed. Keloids and hypertrophic scars (HTSs) are fibrous tissue outgrowths that result from a derailment in the normal wound-healing process. The exact incidence of keloids and HTSs remains unknown. Beyond the common belief that trauma is the initiating event of keloid and hypertrophic scar formation, the remainder of the process remains uncertain. A combination of biochemical factors, skin tension, endocrinologic factors, and genetic factors are the likely culprits.

Burn scar contracture refers to the tightening of the skin after a second or third degree burn. 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 can result in restriction of movement around the injured area.Burn scar contractures do not go away on their own. A person will need the injured skin to be grafted. There are also drug-store treatments that can heal the contracture.Injuries such as burns that involve damage to the dermis rarely heal without formation of a scar. Scar tissue is not identical to the tissue that it replaces and is usually more fibrous and of inferior functional quality. The scar shows an increase in the thickness of the new epithelial layer but the attachment of epidermis is poor making the surface vulnerable to further injury. Sometimes the scarred skin extends beyond the three-dimensional boundary of the original tissue resulting in a raised or hypertrophic scar. Hypertrophic scarring is seen in up to 50% of healed deep burns and this can lead to wound contracture if the scar affects a joint as the skin over the joint is firmer and less extensible and this in turn then limits movement of the joint.

A contracture scar is a permanent tightening of skin that may affect the underlying muscles and tendons that limit mobility and possible damage or degeneration of the nerves. Contractures develop when normal elastic connective tissues are replaced with inelastic fibrous tissue. Scar contractures, hypertrophic scars, and keloids are all examples of abnormal tissue response to the processes of wound healing. By definition, a scar contracture is the result of contractile wound healing processes oc­curring in a scar that has already been re-epithelialized and adequately healed.25 A scar contracture typically appears as a fixed, rigid scar that causes functional or cosmetic deformities. Hypertrophic scars and keloids produce a clinical picture of an erythematous, tender, elevated, unsightly scar that may itch, become hyperpigmented, or produce a contraction cicatrix.

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