Scar Therapy and Contracture Surgery

scar removal

Scar Therapy and removal treatments are often expensive and invasive, and are only relevant for deep 2nd Degree Burns or 3rd Degree Burns that leave disfiguring or disabling Scar Contractures. The main concerns are Hypertrophic Scars and Keloid Scars

My worst disfigurement on my face was a contracture under my bottom lip on the left side of my mouth. It pulled that side of my mouth down by about 12mm (1/2 inch). The only scar therapy that would work would be by a full thickness skin graft.

That was done several months after my discharge from the burns ward. The skin was taken from my right cheek, and that wound was closed with sutures. A few months after the graft had healed I noticed whiskers growing from the graft, UPWARDS. The 14 X 8 mm piece of full thickness skin had been grafted Upside Down. I had a bit of fun with the plastic surgeon who did the job, saying that a woman couldn't be expected to worry about whiskers. The fact was tho', hair follicles usually die when grafted, but as I healed up particularly quickly, mine didn't.

I had two scar contactures on my left hand that needed relieving, one at the base of my thumb, causing my hand to be cocked inwards, and another between my thumb and first finger which had formed as webbing (Like a Duck's Foot).
The former was relieved by a full thickness graft taken from the inside of my right upper arm, and the webbing was fixed by a procedure called 'Z Plasty', a very clever little piece of Scar Therapy surgery where an incision in the skin is made in the shape of a 'Z', and the elements on opposite sides of the' Z' are transposed.

Pressure Garments are made of an elasticised fabric which is specially tailored to fit, and need to be fitted when the grafted areas have healed. They will also cover any Skin Donor Sites which could be the equivalent of a 2nd degree burn. Besides flattening the scars out, the pressure suit also has a restrictive effect on the supply of histamine to the burnt areas.

two hands

A distinct spiral contracture was forming on my left arm from my wrist, past the elbow, up to my under arm. It was going to worsen to the point that I would not be able to straighten the arm, so a couple of Thick Split Skin Grafts were applied, along the line of the spiral

under arm

Overall the Scar Therapy and surgery did a marvelous job, and it was many years ago. My burns scars are still apparent, but I don't consider them disfiguring or disabling, and hardly ever think about them.

BUT, on the scant occasions that someone does ask me about them, I feel a special warmth toward that person, and without overloading them with detail, I briefly tell them about it.

This has led me to do the same with others who have obviously suffered some trauma. Wheelchair, Prosthetic limbs or whatever, and I am sure that my discreet enquiry has evinced the same response in every case.

Home Remedies. I cannot speak to the effectiveness of home remedies for scar therapy, never having used them, except for the use of Pure Aloe Vera liquid on the Hypertrophic Scars on my arm and ribs. I found that persistent use kept the scars soft so that the Pressure Garment was able to do it's job better. This is just my observation and I cannot back it up with any proper data. The only Keloid Scar showed up on my cheek where a piece of full thickness skin was taken for my lip, this was later excised and has not re-appeared.

Superficial Burns, and shallow 2nd Degree Burns. These do not usually result in scars, and will heal inside of a week, but they can be very painful, and any dressing or ointment that can exclude air currents from causing pain is worth while.

In the interests of completeness of this report, I pass along an old 'Cure' which just might do the trick. This treatment has not been officially approved, so consult your doctor before trying this, or any other any home remedy.

Aloe vera, honey and vitamin c tablets.

mixture of natural aloe vera gel, honey and crushed vitamin c tablets can be applied to burn scars to help reduce their appearance over time. To make and use this mixture, crush one vitamin c tablet in a mortar and pestle and combine it with 1 tbsp. Natural honey in a small container or bowl, and mix thoroughly. Gently massage a small amount of the mixture on the burn scar and leave it on for 30 minutes or until almost dry. Rinse the skin with cool water and wash with a gentle moisturizer. This treatment can be repeated twice per day as long as it does not irritate your skin or cause extreme redness, and unused portions can be kept in the refrigerator for 48 hours.

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