Post-burn scars are bound to occur even with the best of reconstructive treatments because they depend upon the depth of burn injury. Except for the superficial skin burns, all deep burns (2nd-degree burns) heal by scarring. This scarring can only be minimised with various physical therapy measures and plastic surgery procedures but can not be eliminated.
A burn victim who receives the best of treatment is expected to heal without any contractures. The patients are treated with a broad range of treatments which aim at closing the raw wounds. This leads to the development wound contraction and scarring.
Neck contracture and deformities as consequences of burns pose one of the greatest challenges to plastic surgeons in reconstructive surgery. Exposed regions of the face and neck commonly have severe burns especially in patients who did not use appropriate protective equipment in occupational accidents. Physical and aesthetic deformities resulting from this type of disfigurement in exposed areas can cause significant depression.
The initial step in managing burn deformities is to prioritize reconstructive needs. The management of postburn reconstruction is complicated by the frequent need for multiple reconstructive surgeries in a single patient. The primary aim of a plastic surgeon is to prevent burn scar deformity causing rapid wound closure. The other priorities are the correction of tissue deficiencies and assiduous attention to postoperative splinting and compression therapy. Reconstructive treatments are applied in a hierarchy from the simplest to the most complex. Primary excision and closure of scars by reorienting the scar can significantly improve appearance.
On the other hand, scar contracture is the result of the process of contraction.