الفهرس | Only 14 pages are availabe for public view |
Abstract Summary 94 Summary The post burn scar is inevitable problem even with the best treatment as it depends on the depth of the burn injury, so only superficial dermal burns, heal with no scarring, but the contracture is preventable problem especially with the best treatment . Before attempting release, the patient should be asked to wait preferably 6-12 months from the date of the burn injury, which can be frustrating to the patient. However during this time massage, serial splinting and regular visits to the physiotherapist will pay dividends in the end. This is preferred, as it is better also to operate on mature scar which is less vascular and avoids operating on immature scar with resultant further trauma. In case of associated joints contractures, we proceed first on the most proximal then we go distally, starting with axilla then distal joints relatively. The use of skin graft was popular in the past in the reconstruction of post burn flexion contracture after the release, but it has many disadvantages as graft loss, less aesthetic appearance than the local flaps, recontracture, prolonged splinting and physiotherapy postoperatively. Now it is safe when broadband contracture and unavailable local, healthy, unscarred, non-traumatized tissues for local flaps. As long as, there is possibility for the use of local cutaneous or fasciocutaneous flaps in the reconstruction of post burn axillary contracture, it would be a better option. |