POST-BURN SCARS and SCAR CONTRACTURES

25 years male.... Burn accident 1 year back... Now burning and pricking sensation at burning areas... What to do this case?

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Long term BURN patients suffer from their changed appearance. Burns of the face and hands are felt as especially disturbing, as they are continuously visible to other people. So , it is essential to consider the esthetic plan of surgery.. Meshed split-thickness skin grafts should be used on the face and hands. The donor skin site should have the same texture as the recipient site. For example, a donor site with low pigmentation should be selected for a site with low pigmentation. This avoids hyperpigmentation . Scar care is an important part of the follow-up in the primary care setting. Fresh scars are initially dressed with simple silicone-based preparations. In this early stage, the scar tissue should be massaged in a circular fashion several times a day . In this way, consistent orientation of the collagen fibers can be obtained, leading to a softer and flatter scar. The scarred tissue should not be exposed to the sun for at least six months. If necessary, SUNSCREEN SPF50 is ideal Matt technology based lotion is best option. In the course of treatment, silicone-based plasters may be useful. These lead to softening and flattening of the scar through occlusive hydration of the stratum corneum . Other topical immune modulatory substances, such as retinoids and calcineurin inhibitors are also used as external agents for the treatment of hypertrophic scar tissue on advise of plastic surgeon. Furthermore, injectable substances such as corticosteroids, 5-fluorouracil, and interferons are used in the local therapy of hypertrophic scars.

Sir some keloids are seen on face ; so ILS will work well along with silicon gel sheet ; for whole face depigmenting agent like glycolic acid ; kojic ; niacinamide along with mild steroid at night ; on neck & hand their are some white patches I have burn pt in my clc so on white patches I did excimer with low intensity & results are good ; hand lesion skin grafting may be the option ; can use Co2 laser over face after

Regeration of nerve endings Rx as Neuropathic pain

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