Contracture Scars

What are Contracture Scars?

Contracture scars are tight, restrictive scars that form after severe skin injuries, burns, or trauma. They pull the skin, muscles, or underlying tissue, restricting movement and flexibility in the affected area.

They are most common after burns, large wounds, or surgical procedures.

Causes

• Burn injuries → the most common cause.
• Deep cuts, lacerations, or surgical wounds.
• Infections that damage skin.
• Skin grafts that do not stretch properly.
• Delayed wound healing → increases scar contracture risk.
• Genetic tendency → some individuals form more severe scars.

Symptoms / Appearance

• Tight, stiff, or hard skin over the scar area.
• Limited mobility of nearby joints or muscles.
• Thickened, raised, or shiny skin.
• May be painful or itchy.
• Distorted skin appearance, sometimes affecting facial features or hands.
• Treatments

Non-Surgical Treatments

• Physical therapy / stretching exercises → maintain joint mobility.
• Silicone gel sheets or silicone creams → soften scar tissue.
• Pressure garments → help reduce thickening and contracture in burn scars.
• Laser therapy → improves texture, flexibility, and appearance.
• Steroid injections → reduce inflammation and thickening in some cases.

Surgical Treatments

• Scar revision surgery → excises or releases tight scar tissue.
• Z-plasty or skin grafting → repositions skin to restore movement and appearance.
• Flap surgery → for extensive contractures affecting joints or hands.

Supportive Care

• Regular massage to improve scar flexibility.
• Moisturisers and emollients to reduce dryness and tightness.
• Ongoing occupational or physiotherapy for functional recovery.

Prevention

• Early wound care and infection control after burns or injuries.
• Proper dressing and pressure therapy for deep wounds.
• Regular stretching and physiotherapy to maintain mobility.
• Protect healing wounds from excessive tension or trauma.
• Monitor scars and seek early professional intervention if tightness develops.

FAQs

Q1. Are contracture scars dangerous?
They are not life-threatening, but they can limit movement, cause discomfort, and affect appearance, so treatment is important.

Q2. Can contracture scars heal on their own?
Mild scars may improve over time, but severe contractures usually require therapy or surgery to restore function.

Q3. How long does treatment take?
Non-surgical management may take months to a year, while surgical correction can significantly improve mobility immediately, followed by rehabilitation.

Q4. Can contracture scars recur after surgery?
Yes, there is a risk of recurrence, especially if rehabilitation and scar care are not continued.

Q5. How can I reduce scarring after a burn or surgery?
Early wound care, pressure therapy, silicone treatments, and regular stretching/exercises reduce risk of contracture formation.