Reconstruction and Scar
Scar management and regional reconstruction
Burn reconstruction spans scar surgery, contracture release, flap reconstruction, tissue expansion, laser therapy, and intralesional pharmacologic therapy. Hypertrophic scarring affects 32 to 72 percent of burn survivors. Fractional CO2 laser and pulsed dye laser sit alongside…
- Contracture release with local flaps and Z-plasty
Surgical release of a postburn scar contracture restores joint motion by dividing the contracting band and resurfacing the defect. Linear bands with adjacent laxity are lengthened by local tissue…
- Free tissue transfer and perforator flaps in burn reconstruction
Free tissue transfer is a rare but pivotal tool in burn surgery, reserved for defects with exposed vital structures or contractures local options cannot resolve. The anterolateral thigh flap is the…
- Intralesional injection therapy for hypertrophic scars and keloids
Intralesional injection is the workhorse of nonsurgical management for burn-related hypertrophic scars and keloids. Triamcinolone acetonide remains first-line, with triamcinolone plus 5-fluorouracil…
- Laser therapy for burn scars (CO2, pulsed dye, fractional)
Laser therapy improves mature and immature hypertrophic burn scars on validated scar scales. Ablative fractional CO2 reduces Vancouver Scar Scale and POSAS scores, reduces scar thickness on…
- Pressure garment and silicone conservative scar management
Pressure garment therapy and silicone gel or sheeting are the mainstays of nonsurgical hypertrophic burn-scar and keloid management. Garments delivering roughly 15-25 mmHg and silicone over the scar…
- Skin substitutes and dermal matrix in scar reconstruction
Dermal substitutes in post-burn reconstruction restore a dermal layer when scar release, contracture, exposed bone or tendon, or limited donor reserve makes a thin autograft over a regenerated dermis…
- Tissue expansion in burn reconstruction
Tissue expansion grows extra skin of matched color, texture, and hair-bearing quality by serially inflating a subcutaneous silicone expander, then advancing or transposing the expanded flap to…