CONTRACTURES DUE TO BURNS: TREATMENT WITH FREE FULL THICKNESS GRAFTS AND PEDUNCULATED FLAPS

There are many sound reasons for substituting normal skin and subcutaneous tissue for the deforming, contracting scar tissue whose formation is so prominent a feature of the reparative process following deep and extensive burns. If the scar tissue contraction affects the face or body surfaces whose function depends to a considerable degree on unrestricted freedom of movement, as the neck, the axilla and the flexor surfaces of the elbow, wrist, hand and knee, and if the patient is a child in whom the distortion of facial features and the disabling effect of limiting contractures tend to become more marked as the years go by, the indications for replacing scar tissue with normal tissue are still more imperative. During the past twelve years we have had under our care seventy-seven patients with contractures following burns. In forty-nine of these the contracture involved the hand, in six the flexor surfaces of the