Contracture Release

At BRCA, our surgeons work closely with patients and physical therapists to implement preventive care plans to reduce the possibility of scar contractures through positioning, splinting and exercising the at-risk areas.

In addition, BRCA offers management that ranges from medical massages and injections of certain medications through physical therapy and laser and other tissue rearrangements or new graft insertion. Your strategy for recovery will include plans between you and the surgical team to see what the best option for you is.

What is scar contracture?

At BRCA, our surgeons work closely with patients and physical therapists to implement preventive care plans to reduce the possibility of scar contractures through positioning, splinting and exercising the at-risk areas. In addition, BRCA offers management that ranges from medical massages and injections of certain medications through physical therapy and laser and other tissue rearrangements or new graft insertion. Your strategy for recovery will include plans between you and the surgical team to see what the best option for you is.

Who is a candidate for contracture release?

Candidates for contracture release surgery include those experiencing:

  • Limitations in range of motion
  • Pain or discomfort
  • Deformity
  • Reduced quality of life

What is contracture release?

Contracture release surgical procedures at BRCA include tissue expanders, flap reconstruction and skin grafting.

Tissue Expanders

Depending on the location and desired outcome of the contracture release, tissue expanders may be used to gradually stretch the affected area's tissue. This procedure involves placing a soft, saline or carbon dioxide-filled implant under the scar tissue to stretch it over time gently. Once the tissue is stretched enough to where the patient can move freely without pulling or pressure, the implant is removed.

Flap Reconstruction

A flap reconstruction procedure involves taking a healthy tissue section from one body area and relocating it to another. During this surgery, the restrictive scar tissue will be excised and replaced with healthy, more pliable tissue, relieving the contracture.

Skin Grafting

If there is not enough healthy tissue on the patient for flap reconstruction, the surgeons might use cadaver skin grafts on the affected area. The scar tissue will be excised and replaced with a skin graft, relieving the contracture during this surgery.

Who is a candidate for contracture release?

BRCA strives to give each of our patients the best outcome possible and, while we cannot guarantee that the contracture release surgery will achieve every initiative in your care plan, you can expect to experience some or all of the following:

  • Improved appearance
  • Reduction in pulling or pressure
  • Improved range of motion
  • Reduction in pain or itching
  • Improved quality of life

What to Expect After Contracture Release Surgery

Burn contracture release surgery enables you to regain full range of motion and confidence. While contracture surgery on the hand or fingers is most common, studies have shown that scar contracture release benefits any part of your body that has contracture.  

But what can you expect following your burn scar contracture treatment? It largely depends on the extent of your burns before surgery and which surgical procedures were performed.

Tissue Expanders

It is sometimes recommended that tissue expansion be done adjacent to a contracture release. Tissue expanders may be uncomfortable or painful because the skin is under constant mechanical load. The tissue expander is placed in the operating room but can often be expanded with periodic outpatient visits. Your surgical treatment may be carried out in a clinic or hospital.

Following surgery, you may experience swelling and bruising, and like any operation, signs and symptoms of infection should be brought to the attention of your healthcare team. Most expanders settle within the first few weeks.

Flap Reconstruction

Flap reconstruction has two main types: free flaps and regional flaps. Free flaps are typically used for microvascular reconstruction. Flap reconstruction takes tissue from other parts of the body to create a skin flap where your burns are. Expect redness following this microsurgery and some discomfort. The nature of this procedure means that healing times can be slow, with total recovery taking six to eight weeks of careful monitoring for free flaps. Regional flaps heal must faster and typically typical follow-up in a week. 

Routine wound care is required, and patients must know the risk of large-scale scar tissue forming. It can take up to 12 months for skin flaps to heal completely after surgery.

Skin Grafting

Skin grafting is another excellent option for coping with the damage from burns. These procedures take a few hours, and most patients report complete healing within 10-14 days. You may even experience a faster healing time and improve motor function sooner with a strategic approach to diet and nutrition.

Doctors will advise you to keep your new skin graft covered for three to five days underneath a sterile dressing. This is the time it takes for your new graft to take to your body.

Note that complications resulting from skin grafting options are possible, including bleeding, loss of sensation, and contracture. However, most skin graft complications are not considered severe and are not a threat to your health.

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