title: A systematic review on burn scar contracture treatment: searching for evidence.
abstract: Treating burn scar contracture remains a challenging problem for reconstructive surgeons. At present, no consensus exists on when to use what kind of technique. Therefore, a systematic review was performed on the effectiveness of the different surgical techniques after burn scar contracture release. Electronic databases were searched using a predefined search strategy. Studies evaluating the outcome of surgical techniques for the treatment of burn scar contractures were included. The methodological quality was tested and the data were summarized. One thousand six hundred fourty-nine papers were identified of which 17 met the inclusion criteria. Three papers reported on a controlled trial, 14 were cohort studies, including 10 of a pre-post operative design and 4 of a comparative design. The papers described outcomes of grafts, flaps with random or defined vascularization, and dermal substitutes. All studies had methodological shortcomings and most used inappropriate statistical methods. The current evidence on the effectiveness of reconstruction techniques for burn scar contractures was summarized. Due to the scarcity and low quality of the included studies, no definitive conclusions could be reached about the effectiveness of different techniques. Therefore, no direct implications for daily practice could be made. However, recommendations could be given for improvement of the quality of further primary research on the effectiveness of surgical treatment strategies for burn scar contracture release.
authors: From the *Association of Dutch Burn Centers, Beverwijk, The Netherlands; †Department of Plastic and Reconstructive Surgery, VU Medical Center, Amsterdam, The Netherlands; ‡MOVE Research Institute, VU University of Amsterdam, The Netherlands; §Burn Centre and the Department of Plastic and Reconstructive Surgery, Red Cross Hospital, Beverwijk, The Netherlands; ‖EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; ¶Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands; and #Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan.
authors: Carlijn M
authors: CM
authors: Stekelenburg
authors: Roos E
authors: RE
authors: Marck
authors: Wim E
authors: WE
authors: Tuinebreijer
authors: Henrica C W
authors: HC
authors: de Vet
authors: Rei
authors: R
authors: Ogawa
authors: Paul P M
authors: PP
authors: van Zuijlen
mesh_terms: D002056:Burns / Q000150:complications / Q000601:surgery*; D002921:Cicatrix / Q000601:surgery; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D016038:Skin Transplantation; D013524:Surgical Flaps