Contracture scar

Introduction A contracture scar is a scar named after the dysfunction caused by it. More common after deep burn healing, due to scar contraction, often lead to shape changes and dysfunction, long-term scar contracture can affect the development of bones, muscles, blood vessels, nerves and other tissues, should be treated early. Scars are limited in joint activity, organ deformation and displacement deformity due to their own contraction and hyperplasia. For example, the joints form a scar, the joints are stretched, and the hypertrophic scars of the back of the hand, both hyperplasia and contracture.

Cause

More common after deep burn healing. Not only does it have significant dysfunction, but it also has significant appearance changes. More common in a large area of burn granulation wound healing, the scar is deep and thick, a large range. It can also be seen in straight scars that are deeper across the joint.

an examination

Related inspection

Skin test skin color skin scratch test

Clinically common deformities caused by scar contracture include valgus valgus, lip valgus, chest-thoracic adhesion, hand scar contracture deformity, and flexion or extension of the joints. Among them, the cord-like scar contracture in the flexion of the joint, for a long time, the skin and subcutaneous tissue on both sides of the contracture scar can gradually elongate, becoming a scar-like scar contracture, called a scar contracture scar. Such larger scars are common in the anterior neck, axillary fossa, elbow fossa, ankle joints, etc., and the smaller ones can be found in the medial malleolus, external malleolus, nasolabial fold, mouth, finger, etc. The opening of the body cavity is annular, causing its narrow diameter and affecting normal function.

Differential diagnosis

Differential diagnosis of contracture scars:

1. Unstable scar: refers to the early healing of the wound, and the scar tissue is mostly in the proliferative stage. Clinically, the scar is higher than the leather surface, the color is red, the quality is hard, often itching, the scar tissue is congested, it is easy to blisters, and the wound is getting worse and worse. This process usually takes 6 months to a year.

2, stable scar: refers to the wound healing six months later, the scar tissue gradually matured, the composition of fibroblasts, capillaries gradually decreased, the collagen fibers arranged in a ring-like nodular shape, becoming parallel bundles. At this time, the scar tissue in the clinical area disappeared, the color became lighter, the shape became flatter, the texture became softer, the base became softer, and the itching felt relieved or relieved. This kind of degenerative change can vary from a few months to several years.

3, hypertrophic scar: also known as hypertrophic scar, more common in deep second and shallow third degree burns and thick medium thick skin donor site wound healing. It is thick (up to 1-2 cm) and hard, red or dark purple, painful and itchy, often affecting work and rest. About 6 months later, the scar became softer and slightly flatter, the congestion decreased, the capillaries decreased, and the symptoms of itching gradually diminished or disappeared.

4, atrophic scar: also known as unstable scar, common in the head skull electric shock, after extensive burns and chronic ulcer healing. The scar is hard, the local blood vessels are less, it is reddish or white, the deep tissue is tightly adhered, and it cannot withstand friction and weight. After rupture, it often lasts for a long time, and the late stage can cause malignant changes.

5, keloid: also known as the crab foot swelling, a mass formed by connective tissue. More common in burns, injuries or minor injuries that do not cause the patient's attention. The edge of the scar is significantly higher than the skin, and exceeds the original lesion range, pink or purple, very hard, inelastic, poor blood supply. Keloids are particularly good in the upper part of the body. The head, neck, and sternum are in the middle, shoulders, and upper arms, and the eyelids, areola, and penis are rare.

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