Several studies addressing the properties of post-burn scars or their cicatricial sequelae have characterized the tegument qualitatively by examining coloration, smoothness (texture, flexibility), or thickness. 12- 15 The topical use of tretinoin with glycolic acid in both restored skin and in grafted skin has been shown to increase the extent of mouth opening in burn patients with facial scarring. 10, 11 The use of topical tretinoin improves the appearance of keloids and hypertrophic scars and seems to increase skin elasticity in scar sequelae. 9ĭue to the limitations of surgical techniques, many burn patients require additional treatment to improve the texture and appearance of their skin. Injuries that take longer to epithelize are more likely to evolve with hypertrophy. When spontaneously restored, burns that involved deep dermal injury can take from three to five weeks to epithelize completely. 4, The severity of these changes varies, depending on the depth of the original injury and other factors. ![]() 4 After tissue repair, alterations in ECM composition and organization lead to changes in the mechanical properties of the skin that result in decreased elasticity, especially in hypertrophic scars. ![]() As the scar matures and becomes less rigid, the amount of versican decreases. 4, 5 Versican, a proteoglycan with hydrophilic properties, is usually present in large amounts in recent hypertrophic scar tissue. Within the dermis, changes in the extracellular matrix (ECM) include increased concentrations of collagen fibers, which can be arranged in whorls or nodules, and decreased levels of elastic fibers. Post-burn scars induce profound changes in skin structure, such as epidermal and dermal abnormalities. A specialized multi-disciplinary professional team that can treat the multiple aspects of rehabilitation is critical for the proper re-integration of patients into their familiar professional and social environments. ![]() 1- 3īurn victims live with sequelae that may decrease their self-esteem and, therefore, their quality of life. The evolution of medical knowledge and techniques, including improved intensive care units and surgical procedures, has increased the survival of major burn patients.
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