Skin stretching for primary closure of acute burn wounds

BackgroundIn 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.MethodsPatients 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.ResultsNo 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 65.4 cm2 (13.6–129.1) to 13.4 cm2 (3.0–36.6) was found at 3 months (p = 0.028) and at 12 months postoperatively (65.4 cm2 (13.6–129.1) to 33.0 cm2 (8.9–63.7), p = 0.046, Wilcoxon signed ranks test).ConclusionsSkin 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.