Deficit of Postburn Scar Surface is Contracture Cause and Basis for Adequate Reconstructive Techniques Development and Choice
Of the three outcomes of burns—scar deformity, contracture, and tissue defect—contractures most often lead to disability. Therefore, the efficacious treatment of scar contractures is of the greatest importance in the surgical rehabilitation of burned patients. Complete contracture removal significantly improves the appearance of the contracted region. Over many years, scar contracture treatment has conformed with classic methods, especially concerning local-flap techniques. Triangular-flap techniques—Z-plasty and Y-V plasty and their modifications and combinations—continue to serve as the basis for scar contracture treatment. The techniques based on triangular-flaps have known disadvantages and results with rehabilitation of burned patients with contractures are far from perfect. The development of new techniques is needed. Therefore, complex regional flaps are used in adults and children. According to our research, the main cause of the slow progress in scar contracture treatment with local tissues is insufficient study of: (a) contracture anatomy; (b) contracture cause (scar surface deficit); and (c) anatomical classification of scar contractures.