Burns occur when a person goes too near a fire or catches fire or when something hot like boiling oil or some acids or alkalies falls on the person. The scar tissue formed by burns is generally rough and tough and maybe raised. It may itch and look quite awful. It is formed if the primary excision is delayed by more than ten days after the burn. Due to inflammation it is not advisable to operate before the first eight months or so after the burn unless the scar causes functional disorders.
There are three types of possibilities of burn related scars. There may be abnormalities like keloids, hypertrophic or contractures. Hypertrophic scars are red, raised and probably thick but they remain confined to the area of the wound and do not spread. Most burn scars are hypertrophic in nature. After a fire or oil burn, one is not too sure of the quality of the scar. The body forms the scar as part of the healing process. Preventive measures like using fatty ointments or using pressure over the wound may help in reducing the intensity of the scar. Maintaining a fatty milieu around the scar lessens the period of aseptic inflammation and also prevents irritation. Using pressure tactics prevents the formation of interstitial edema and restricts the formation of new capillaries. There are special garments, which can be used to prevent further damage. They can be used about two weeks after the grafting or when spontaneous healing has occurred. They can make the scar flat, soft and pale in color. Splints are also useful, especially if the burn scars form around the neck, the upper extremities and the hands. They lead to a softening of the scar and diminished contractures as well. There are several methods of scar revision but none of these are perfect and hence prevention of abnormalities by early excision of the primary burn wound.
The formation of a scar depends on various factors, some of which can be altered by therapeutic measures. Some can influence the scar formation in a negative way, like the site of the scar, its healing process, age, sex and race of the patient and other such things. Burn scars may result in tightening f the skin so much that mobility or movement may be hampered and that is why treatment of burn scars is important and it should be timely and preventive. |
