Burn scars are common injuries that can affect anywhere from the toes to the scalp. Smaller burns are easier to treat while burns that affect critical body areas or large burns are usually treated at a burn verified center. Once healed, the burns result in burn scars.

Some types of burn scars are severe and can result in deformity causing difficulty in functioning of the area affected. Such types of burn scars are known as contractures and tend to become prominent over time in addition to minimizing movement of joints and other mobile structures.

Burn scar contractures can be treated with reconstruction burn surgery after the initial wound has healed or once the scars have matured which can take eighteen months or longer. However, some cases have severe functional problems, and they require much earlier treatment. An example is post-burn scarring of the eyelids which can result in closure of the eyelids. Such a case requires urgent measures to prevent eyelid closure.

The goal of reconstructive burn surgery is to improve both cosmetic appearance of the burn scars and function of the affected part. The relationship between the reconstructive burn surgeon and the patient can last for years. This is because treatment of scar tissue can take several months to be effective and also new scars can form long after the injury.

Benefits of Burn Scar Contracture Surgery

Although burn scar contracture surgery will not be able to remove the burn scars entirely, it will help in improving the appearance of the scars and the basic functions of the affected part. Scarring can limit the motion of the legs, hands, shoulders, and neck. Surgery to release the contracture can help the patient regain his/her normal range of motion.

Consultation for Burn Scar Contracture Surgery

Scheduling a consultation with a Board Certified Plastic Reconstructive Surgeon is the first step in reconstructive burn treatment. During the consultation you’ll communicate to your Plastic Surgeon the results that you’d like to see. Your Plastic Surgeon will then take you through what to expect from the procedures and the long-term benefits. Each patient is different, and your Plastic Surgeon will choose the appropriate technique for you.

You will also be expected to provide a complete medical history in addition to your surgeon performing a physical exam and explaining the possible risks and complications of the surgery.

Pre-Procedure Guidelines for Burn Scar Contracture Surgery

You will be given pre-operative instructions for the surgery. These will include:

• Whether your surgery will be done on outpatient or inpatient basis
• Preoperative skin cleansing
• What to eat and drink
• Avoid smoking or taking alcohol
• Avoid taking certain medications, vitamins, and supplements

Burn Scar Contracture Release Procedure

Burn scar contracture release surgery is carried out under either local anesthesia with sedation or general anesthesia.

The procedure involves the surgeon freeing the affected tissues from the tethering by the scars. The resulting wound is covered or resurfaced with various techniques such as local or distant flaps, split or full thickness skin grafts. The technique used is customized depending on the results that the patient desires.

Post burn scar release is usually done on outpatient basis as it is a short procedure but in situations where complicated or extensive reconstruction is required a hospital stay may be needed.

Techniques Used

• Serial excision: This technique involves removal of the scar in a staged manner. A broad scar is partially excised, and the wounds are approximated. Once the surrounding normal tissues expand to accommodate the increased tension, the remaining scar is removed. This tends to give a good aesthetic outcome.
• Tissue expansion: This technique involves placing a balloon like device under the skin during surgery. The device is then filled with saline during follow-up visits. This results in progressive expansion of the soft tissue and the overlying skin. Once the required volume is reached, the device is removed, and the expanded skin is used to cover the scarred area.

Post-Procedure Guidelines for Burn Scar Contracture Surgery

It is important to follow post-op instructions as it helps to obtain the best possible outcome. There will be long-term follow-up appointments to access the results.

Smaller operations usually require small, soft dressings while skin grafts require a bolster kind of dressing to keep them in place for about a week so as not to cause any kind of movement to the skin graft.

A variety of procedures may be performed after the first initial surgery so as to attain something closer the desired results.

Get in Touch

Reconstructive surgery at Kings College Hospital Dubai focuses on the safety and care of every patient in a compassionate environment with state-of-the-art facilities. To book an online or in-person consultation and a detailed evaluation by one of our world class plastic and reconstructive surgeons in Dubai, get in touch using the contact details given, and our patient-care staff will book an appointment for you.