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Perforator-based flaps for the treatment of burn scar contractures: a review

Patients with burn scars often experience functional problems because of scar contractures. Surgical treatment may be indicated for those burn scar contractures. If the contractures are small and linear, the contraction bands can be treated with local transposition flaps like the Z-plasty. Broader,...

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Autores principales: Stekelenburg, C. M., Marck, R. E., Verhaegen, P. D. H. M., Marck, K. W., van Zuijlen, P. P. M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329961/
https://www.ncbi.nlm.nih.gov/pubmed/28261622
http://dx.doi.org/10.1186/s41038-017-0071-2
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author Stekelenburg, C. M.
Marck, R. E.
Verhaegen, P. D. H. M.
Marck, K. W.
van Zuijlen, P. P. M.
author_facet Stekelenburg, C. M.
Marck, R. E.
Verhaegen, P. D. H. M.
Marck, K. W.
van Zuijlen, P. P. M.
author_sort Stekelenburg, C. M.
collection PubMed
description Patients with burn scars often experience functional problems because of scar contractures. Surgical treatment may be indicated for those burn scar contractures. If the contractures are small and linear, the contraction bands can be treated with local transposition flaps like the Z-plasty. Broader, diffuse contractures are more challenging and require a different surgical approach, such as the use of local tissue. The use of perforator-based flaps is promising; however, their true clinical significance for this type of burn reconstructions still needs to be determined. Therefore, we performed a review to evaluate the role of perforator-based flaps for burn scar contracture treatment. Electronic databases were searched using a predefined search strategy. Studies evaluating the long-term outcome of perforator-based flaps for the treatment of burn scar contractures were included. The methodological quality was tested and data was summarized. Five hundred and ten papers were identified of which eleven met the inclusion criteria. One study was a randomized controlled trial; ten were cohort studies of a pre-postoperative design. The papers described outcomes of free flaps and local flaps. Most studies had methodological shortcomings and used inappropriate statistical methods. Perforator-based interposition flaps appear to be highly relevant for burn scar contracture treatment. However, due to the paucity and low quality of the studies that were assessed, no definitive conclusions about the true clinical significance could be reached. And therefore, only recommendations could be given for improvement of the quality of further primary research on the effectiveness of perforator-based flaps for burn scar contracture release. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s41038-017-0071-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-53299612017-03-03 Perforator-based flaps for the treatment of burn scar contractures: a review Stekelenburg, C. M. Marck, R. E. Verhaegen, P. D. H. M. Marck, K. W. van Zuijlen, P. P. M. Burns Trauma Review Patients with burn scars often experience functional problems because of scar contractures. Surgical treatment may be indicated for those burn scar contractures. If the contractures are small and linear, the contraction bands can be treated with local transposition flaps like the Z-plasty. Broader, diffuse contractures are more challenging and require a different surgical approach, such as the use of local tissue. The use of perforator-based flaps is promising; however, their true clinical significance for this type of burn reconstructions still needs to be determined. Therefore, we performed a review to evaluate the role of perforator-based flaps for burn scar contracture treatment. Electronic databases were searched using a predefined search strategy. Studies evaluating the long-term outcome of perforator-based flaps for the treatment of burn scar contractures were included. The methodological quality was tested and data was summarized. Five hundred and ten papers were identified of which eleven met the inclusion criteria. One study was a randomized controlled trial; ten were cohort studies of a pre-postoperative design. The papers described outcomes of free flaps and local flaps. Most studies had methodological shortcomings and used inappropriate statistical methods. Perforator-based interposition flaps appear to be highly relevant for burn scar contracture treatment. However, due to the paucity and low quality of the studies that were assessed, no definitive conclusions about the true clinical significance could be reached. And therefore, only recommendations could be given for improvement of the quality of further primary research on the effectiveness of perforator-based flaps for burn scar contracture release. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s41038-017-0071-2) contains supplementary material, which is available to authorized users. BioMed Central 2017-02-27 /pmc/articles/PMC5329961/ /pubmed/28261622 http://dx.doi.org/10.1186/s41038-017-0071-2 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Stekelenburg, C. M.
Marck, R. E.
Verhaegen, P. D. H. M.
Marck, K. W.
van Zuijlen, P. P. M.
Perforator-based flaps for the treatment of burn scar contractures: a review
title Perforator-based flaps for the treatment of burn scar contractures: a review
title_full Perforator-based flaps for the treatment of burn scar contractures: a review
title_fullStr Perforator-based flaps for the treatment of burn scar contractures: a review
title_full_unstemmed Perforator-based flaps for the treatment of burn scar contractures: a review
title_short Perforator-based flaps for the treatment of burn scar contractures: a review
title_sort perforator-based flaps for the treatment of burn scar contractures: a review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329961/
https://www.ncbi.nlm.nih.gov/pubmed/28261622
http://dx.doi.org/10.1186/s41038-017-0071-2
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