Scar Contractures

Scar retractions occurring on mobile areas on the body surface, like the neck, the joints, the hand, and the face may induce functional limitations in skin availability during movements. Extensive burns, trauma, and infected wounds may be found as risk factors. The activation of populations of myofibroblasts may explain the occurrence of skin contracture, as they mechanically act on the matrix and induce skin retraction (Kwan and Tredget, Hand Clin 33(2):277–292, 2017). Pathological consequences of the contractures may vary from a moderate limitation of movement over a digital joint to a permanent neck contracture impairing eye vision in the horizontal plane. The shortage of skin capacity may vary from 2 to 10 cm. Most of the contractures respond to an active early treatment when there is an early diagnosis at 1 month after wound healing, but if diagnosed later specific surgical procedures are needed, like skin grafting, local or regional flaps, but also complex microsurgical flaps. Specific indications depend on the necessity to restore the function.