Burns and scars

What can I do about my burn?

Acute burns should be attended to quickly at an emergency treatment centre. Burns require quick treatment and decision about management will depend on the severity of the burn and its size.

Once burns have healed, they often leave a thick scar which may be hypertrophic. Hypertrophic scars are those that are thick and raised but stay within the original parameters of the wound.  This is different to a keloid scar. Hypertrophic scars respond well to several treatment approaches.  Hand therapists are trained to assess your scar and advise you on appropriate care which could include deep tissue massage, using silicone gel products and pressure garments.  Scars take up to 2 years to mature and during this time, therapies can be successful.  If your scar is still red or pink, this indicates it is still possible to influence the end result. 

Burns across joints can cause a tightening of skin and restrict movement.  These respond to being held at length over a long period of time (using splinting) or surgery.  Your surgeon and hand therapist will be able to advise you – even if this contracture is on another part of your body such as your knee or neck.

What can I do about my surgical scar?

All surgery causes scars no matter how brilliant the surgeon!  Scar tissue takes up to about two years to mature and during this time, therapies can be successful.  If your scar is still red or pink, this indicates it is still possible to influence the end result.  Hand therapists are trained to assess your scar and advise you on appropriate care which could include deep tissue massage, using silicone gel products and pressure garments.  This is even for scars that are not on the hand but are elsewhere on the body such as the face or leg.

Keloid scars are different.  They mushroom beyond the original parameters of the skin injury.  These can develop from seemingly small breaks in the skin, are associated with genetic predispositions and do not respond in the same way to treatment.  Advice should be sought from a plastic surgeon about how your keloid scar can be improved. 

Should I have surgery for my hypertrophic scar?

Your plastic surgeon will advise you whether surgery is indicated for your scar.  Conservative methods of treatment are always attempted first (remember any surgery will form a scar).  If your scar is very tight across a joint, this can be removed and replaced with a skin graft ensuring the length is maintained and therefore your movement is restored.  You will need to have therapy after this surgery to ensure the new scar does not tighten.

What happens after surgery?

The same therapies as used conservatively are used post operatively, namely massage, silicone products and pressure garments.  You will need to be monitored by a specialist hand therapist while your scar matures in order to have the right approach throughout.