Procedures

Our Procedures

Contractures

Severe burns or other major injuries to the skin can cause a contracture.  A contracture is the type of scar that is formed by the remaining healthy skin around a damaged area pulling in toward each side.  This contracting of the skin can cause serious damage of the body in addition to an unattractive scarring.  When a contracture affects muscle and tendon tissue it can cause severe movement limitations or problems.  Normal and regular bodily movements can become seriously limited.

The tissue of the skin with a contracture is made of typically non-elastic tissues, which, due to the injury sustained, replace normal healthy and elastic tissue.  These tissues become unable to stretch properly or move in a normal manner.

There are varying degrees of severity that a contracture can fall into.  A skin scar contracture affects the skin surface, fat cells, or the fascia (connective tissues).  The skin scar contracture is the most frequently occurring form of a contracture.

A secondary type of contracture consists of damage to the muscles and tendons as well.  A shortening, induration, and severe scarring of tissue surrounding a joint characterize secondary contractures.

The most severe sort of contracture is sometimes referred to as a primary contracture.  These contractures are due to serious deep tissue and joint burns.  Primary contractures of this extremity tend to be very severe and are usually inoperable.

Operations on contractures often require a complete excision of the offending scar.  The area is replaced with an extensive skin graft or flap surgery.  Z-plasty surgery or tissue expansion may also be effective in correcting some contractures.  Long-term physical therapy is usually part of a recovery period after surgery.

Planning for such extensive surgery usually involves a serious examination and preparation.  The extent and scope of the scar is considered, as is its configuration and interaction with the surrounding skin tissue.   Possible skin graft areas are scoped, or alternatives to grafting may be considered as well (animal skin or biologic skin material).

Be sure to discuss all possible occurrences of side effects or inoperable conditions with a board certified plastic surgeon.  With scarring due to contractures, the operations and recoveries are usually more involved and take time.  Aftercare is very important as well, and make sure to keep up with all treatments and therapies after your contracture related surgery.