title: Skin stretching for primary closure of acute burn wounds.
abstract: BACKGROUND
  In burn care, a well-acknowledged problem is the suboptimal scar outcome from skin grafted burn wounds. With the aim of improving this, we focused on a new technique: excision of the burn wound followed by primary closure, thereby using a skin-stretching device to stretch the adjacent healthy skin. The short- and long-term effect of Skin Stretch was compared to split skin grafting (SSG) in a randomized controlled trial.
  
  
  METHODS
  Patients with burn wounds were randomized for SSG or primary wound closure using Skin Stretch. Follow-up was performed at 3 and 12 months postoperatively. The scar surface area was calculated and the scar quality was assessed, using subjective and objective measurement methods.
  
  
  RESULTS
  No significant differences between the SSG and the Skin Stretch group were found for scar surface area. In the Skin Stretch group, a significant reduction of the surface area from 65.4cm(2) (13.6-129.1) to 13.4cm(2) (3.0-36.6) was found at 3 months (p=0.028) and at 12 months postoperatively (65.4cm(2) (13.6-129.1) to 33.0cm(2) (8.9-63.7), p=0.046, Wilcoxon signed ranks test).
  
  
  CONCLUSIONS
  Skin Stretch for primary closure of acute burn wounds is a suitable technique and can be considered for specific circumscript full-thickness burn wounds. However, future research should be performed to provide additional scientific evidence.
authors.affiliation: Association of Dutch Burn Centers, Red Cross Hospital, Beverwijk, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, The Netherlands; Burn Center, Red Cross Hospital, Beverwijk, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, VU Medical Center, Amsterdam, The Netherlands. Electronic address: paulineverhaegen@hotmail.com.
authors.forename: Pauline D H M
authors.initials: PD
authors.lastname: Verhaegen
authors.affiliation: Association of Dutch Burn Centers, Red Cross Hospital, Beverwijk, The Netherlands; Burn Center, Red Cross Hospital, Beverwijk, The Netherlands.
authors.forename: Monica C T
authors.initials: MC
authors.lastname: Bloemen
authors.affiliation: Association of Dutch Burn Centers, Red Cross Hospital, Beverwijk, The Netherlands; Burn Center, Red Cross Hospital, Beverwijk, The Netherlands.
authors.forename: Martijn B A
authors.initials: MB
authors.lastname: van der Wal
authors.affiliation: Burn Center, Red Cross Hospital, Beverwijk, The Netherlands.
authors.forename: Adrianus F P M
authors.initials: AF
authors.lastname: Vloemans
authors.affiliation: Burn Center, Red Cross Hospital, Beverwijk, The Netherlands.
authors.forename: Fenike R H
authors.initials: FR
authors.lastname: Tempelman
authors.affiliation: Burn Center, Martini Hospital, Groningen, The Netherlands.
authors.forename: Gerard I J M
authors.initials: GI
authors.lastname: Beerthuizen
authors.affiliation: Association of Dutch Burn Centers, Red Cross Hospital, Beverwijk, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, The Netherlands; Burn Center, Red Cross Hospital, Beverwijk, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, VU Medical Center, Amsterdam, The Netherlands.
authors.forename: Paul P M
authors.initials: PP
authors.lastname: van Zuijlen
mesh_terms: D000328:Adult; D000368:Aged; D002056:Burns / Q000150:complications / Q000601:surgery*; D002921:Cicatrix / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015626:Tissue Expansion / Q000379:methods*; D014945:Wound Healing; D055815:Young Adult
keywords: Burns; Primary closure; Randomized controlled trial; Skin stretching; Wounds