title: Sustainable effect of skin stretching for burn scar excision: long-term results of a multicenter randomized controlled trial.
abstract: OBJECTIVE
  Primary wound closure of large defects after burn scar excision may be facilitated by intraoperative stretching of the adjacent skin. In a randomized controlled trial (RCT), the effect of skin stretching for wound closure after scar excision (SS) was compared to scar excision without additional techniques (SE). Short-term results already showed that in the SS group larger scars could be excised in a one-step procedure. In this paper, the long-term scar outcome using reliable and valid measurement tools was evaluated.
  
  
  METHODS
  The percentage of total remaining scar area (i.e. remaining scar compared to preoperative scar), the percentage of linear scarring (i.e. surface area of linear scar compared to excised scar) and scar hypertrophy was measured at 3 and 12 months postoperatively.
  
  
  RESULTS
  At 12 months postoperatively, the percentage of total remaining scar area was significantly lower in the SS group (26%) compared to the SE group (43%). The percentage of linear scarring (SS: 21%, SE: 25%) and the incidence of hypertrophy (SS: 29%, SE: 40%) were not significantly different between the treatment groups.
  
  
  CONCLUSIONS
  This RCT demonstrates the long-term beneficial and sustainable effect skin stretching for wound closure after scar excision without leading to wider linear scars or more scar hypertrophy.
authors: Association of Dutch Burn Centres, Red Cross Hospital, Beverwijk, The Netherlands.
authors: Pauline D H M
authors: PD
authors: Verhaegen
authors: Martijn B A
authors: MB
authors: van der Wal
authors: Monica C T
authors: MC
authors: Bloemen
authors: Jan
authors: J
authors: Dokter
authors: Paris
authors: P
authors: Melis
authors: Esther
authors: E
authors: Middelkoop
authors: Paul P M
authors: PP
authors: van Zuijlen
mesh_terms: D000328:Adult; D002056:Burns / Q000150:complications / Q000601:surgery*; D017439:Cicatrix, Hypertrophic / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D012720:Severity of Illness Index; D015626:Tissue Expansion / Q000379:methods*; D055815:Young Adult