Burn Contracture Reconstruction by Delayed Skin Grafting

Burn contractures may change according to the defect after release operation depending on the contracture’s localization. The larger the joint, the larger the flap requirements following the contracture release. Generally, flexor surfaces of the body include some important neurovascular structures, and covering the area with a thick and uncontractable tissue following the release operation is of importance. This can be best done by a proper flap selection. However, flap elevation is not devoid of morbidity, and the morbidity changes with the size of the flap. Furthermore, a patient may require many flaps from time to time to treat such a problem, and at the same time the patient may not have enough flap donor site. This paper presents nine burn contractures treated with split-thickness skin grafting after 3 weeks following contracture release. During this interim 3-week period, the granulation tissue filled the defect up to the level of the adjacent healthy
skin. A nonadherent dressing material was applied to the wound to prevent pain and hemorrhage during the waiting period. In the second operation, only the superficial unhealthy granulation tissue was removed and then the defect was covered with split-thickness skin graft, without any complications. The obtained results were as excellent as can be obtained from a flap transfer.