The Technique of Skin Stretching for Acute Burn Treatment and Scar Reconstruction

Eligibility criteria:

Inclusion:

• Acute Burn wounds or scar reconstructions that require surgical treatment; 2. Sufficient healthy skin at (at least) one edge of the wound/scar must be available for the stretching procedure.

• Age >= 18 years

Exclusion:

• language barrier;
• known history of keloid formation;
• systemic diseases: Diabetes Mellitus, immunodeficiency, arterial insufficiency;
• local or systemic application of corticosteroids;
• psychiatric diseases leading to study bias (e.g. automutilation);
• skin diseases that lead to collagen and/or elastin abnormalities such as Ehlers Danlos;
• radiated skin;
• wound located at extremities, exceeding >33% of circumference (acute burn category);

Primary study parameters/outcome of the study:

The primary study parameter is the surface area of the scar after 12 months

Secondary study parameters/outcome of the study (if applicable):

All scars will also be subjected to the scar evaluation protocol after 3 and 12 months by an independent observer for the evaluation of the:

• patient and observer scar assessment scale (POSAS);
• scar elasticity (Cutometer);
• scar vascularisation & pigmentation (DermaSpectrometer);
• scar thickness (histopathology, only after 12 months).

Punch biopsies are taken for morphometry of dermal architecture (Fourier analysis). During surgery one biopsy is obtained of the normal skin. In the experimental group an additional biopsy is obtained at the end of the stretching procedure in order to be able to compare structure of the dermal matrix and orientation of the collagen fibers.

After 1 year, one biopsy is taken from the scar. The experimental group will undergo one additional biopsy of the formerly stretched skin.

Inclusion criteria

• Acute Burn wounds or scar reconstructions that require surgical treatment;
• Sufficient healthy skin at (at least) one edge of the wound/scar must be available for the stretching procedure;
• Age >= 18 years.

Exclusion criteria

• Language barrier;
• Known history of keloid formation;
• Systemic diseases: Diabetes Mellitus, immunodeficiency, arterial insufficiency;
• Local or systemic application of corticosteroids;
• Psychiatric diseases leading to study bias (e.g. automutilation);
• Skin diseases that lead to collagen and/or elastin abnormalities such as Ehlers Danlos;
• Radiated skin;
• Wound located at extremities, exceeding >33% of circumference (acute burn category).