Sustainable effect of skin stretching for burn scar excision: Long-term results of a multicenter randomized controlled trial

• Published in: Burns 2011-11, Vol.37 (7), p.1222-1228
• Main Authors: Verhaegen, Pauline D.H.M, van der Wal, Martijn B.A, Bloemen, Monica C.T, Dokter, Jan, Melis, Paris, Middelkoop, Esther, van Zuijlen, Paul P.M
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Burn scar reconstruction; Burn scars; Burns; Burns - complications; Burns - surgery; Cicatrix, Hypertrophic - pathology; Cicatrix, Hypertrophic - surgery; clinical trials; Critical Care; Female; Follow-Up Studies; Humans; Male; Medical sciences; Outcome Assessment (Health Care); Randomized controlled; Scar outcome; Severity of Illness Index; Skin; Skin stretching; surface area; Sustainable development; Tissue Expansion - methods; Traumas. Diseases due to physical agents; Trial; Young Adult
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2011.04.018

Abstract Purpose Primary wound closure of large defects after burn scar excision may be facilitated by intraoperative stretching of the adjacent skin. In a randomized controlled trial (RCT), the effect of skin stretching for wound closure after scar excision (SS) was compared to scar excision without additional techniques (SE). Short-term results already showed that in the SS group larger scars could be excised in a one-step procedure. In this paper, the long-term scar outcome using reliable and valid measurement tools was evaluated. Basic procedures The percentage of total remaining scar area (i.e. remaining scar compared to preoperative scar), the percentage of linear scarring (i.e. surface area of linear scar compared to excised scar) and scar hypertrophy was measured at 3 and 12 months postoperatively. Main findings At 12 months postoperatively, the percentage of total remaining scar area was significantly lower in the SS group (26%) compared to the SE group (43%). The percentage of linear scarring (SS: 21%, SE: 25%) and the incidence of hypertrophy (SS: 29%, SE: 40%) were not significantly different between the treatment groups. Conclusions This RCT demonstrates the long-term beneficial and sustainable effect skin stretching for wound closure after scar excision without leading to wider linear scars or more scar hypertrophy.