Secondary Burn Contractures Basics Burn scar contracture is when there is tightening of the skin after a secondary or a third-degree burn. When the skin is burned the surrounding skin begins to pull together resulting in contracture. Prevention and early intervention Splinting: May be needed after a burn to maintain join alignment and prevent contractures. Often used on top of pressure garments. Range of motion exercises: Helps keep muscles and joints flexible. Important during the healing process to prevent contractures. Scar management Intra-lesional Corticosteroid Injection Steroids injected directly into the scar tissue can reduce inflammation and improve pliability Antihistamines These may help manage itching associated with scars. Hydrotherapy Immersing the affected area in water can soften scar tissue. Dynamic or Static Splinting Custom splints can maintain joint mobility. Laser therapy Some lasers can help improve skin appearance. Compression therapy Pressure garments or bandages can help flatten scars and prevent contractures. Surgical options Skin grafts. See skin graft notes. Local tissue re-arrangements Re-positioning of nearby healthy tissues to cover affected scar area. Local flaps Tissue adjacent to the scar is mobilised to cover the defect. Regional flaps Distant pedicled flaps e.g. groin flaps may be used. Free tissue transfer: Microsurgical techniques -> allow transplantation of tissue from distant sites to replace scar tissue.