Scarless — The Clinic
Educational

Burn Scar Treatment: Functional Kinematics and Modern Therapies

Introduction

The landscape of burn treatment has evolved significantly in recent years, with increasing survival rates from severe burns creating a greater focus on long-term recovery and scar management. For both patients and healthcare providers, understanding how scars develop and respond to treatment is crucial for achieving optimal outcomes.
Modern approaches to burn scar treatment recognise that successful healing involves more than just treating the visible scar tissue – it requires a comprehensive understanding of how our bodies move and function. This is where functional kinematics comes into play.

What Are Functional Kinematics in Burn Recovery?

Functional kinematics is the study of movement patterns in the human body, focusing on how different body parts work together in coordinated motion. In burn recovery, this concept is particularly important because scars don't develop in isolation – they form and change based on how we move.
Think of your body as an interconnected chain. When one link is affected, it impacts the entire system. For example, a burn scar on your neck isn't just a local issue; it can affect your shoulder movement, which in turn influences arm function and even overall posture.

How Do Burn Scars Develop Along Movement Lines?

Burn scars have a fascinating pattern of development that follows our body's natural movement lines. These patterns aren't random – they typically form along what we call 'kinetic chains' or lines of functional movement. Common examples include:
  • Bands running from the neck to the chest
  • Lines extending from the shoulder through the arm to the hand
  • Patterns crossing major joints like elbows and knees
These scar formations often become more apparent when the affected body parts are fully extended, even if they seem minimal in a neutral position.

Understanding Scar Contractures

Scar contractures are among the more challenging outcomes of burn recovery and wound healing. These conditions, where the skin and underlying tissues tighten, significantly affect mobility and aesthetic appearance. They are categorised primarily into two types:
Intrinsic Contractures:
  • These contractures develop at the site of the original tissue injury or loss.
  • They often occur due to a shortage of tissue, and/or when healing tissues contract, generating tension.
  • This process leads to distortion and deformity of the affected area, significantly restricting local movement.
Extrinsic Contractures:
  • These arise in regions adjacent to the site of tissue loss.
  • Extrinsic contractures pull on surrounding structures, creating tension and potentially leading to functional impairments in areas that initially seem unaffected.
  • They are often not identified in initial evaluations, making them particularly troublesome.

The Importance of Comprehensive Assessment

Identifying the exact nature and extent of scar contractures is crucial. A thorough and careful assessment helps in formulating a precise diagnosis, which is essential for planning effective corrective measures aimed at addressing the root causes of the contracture. This approach not only aids in improving functionality but also in enhancing the overall appearance, thereby contributing to a better quality of life for patients.

Advanced Burn Scar Treatment: Modern Approaches

The landscape of burn scar treatment has evolved dramatically in recent years, moving away from single-approach treatments to more comprehensive care plans. Let's explore these modern approaches in detail:
Ablative Fractional CO2 Laser Treatment (like the most researched Ultrapulse by Lumenis). This groundbreaking treatment works by creating thousands of microscopic treatment channels in the scar tissue. Think of it as aerating a lawn – these tiny channels stimulate the body's natural healing response, promoting the growth of healthy new tissue. Patients often report feeling an immediate difference in scar flexibility, with continued improvements over the following months.
Combination Therapy: The Power of Synergy Modern burn treatment rarely relies on a single approach. Instead, we carefully orchestrate multiple treatments working in harmony:
  • Laser treatments prepare the tissue for surgical intervention
  • Strategic surgical releases target specific contracture bands
  • Physical therapy maintains and builds upon these improvements
  • Customised pressure garments and silicone products provide consistent support throughout the healing process
The magic lies in the timing and sequencing of these treatments – each step builds upon the previous one, creating a comprehensive healing journey.

The Science Behind Scar Formation

Understanding the biology of scar formation helps explain why certain treatments work:
  • Myofibroblasts play a crucial role in wound closure and scar formation
  • Mechanical forces influence how scars develop
  • Tension and movement patterns affect scar tissue organisation

Latest Innovations in Scar Treatment

Recent advances have revolutionised scar treatment:
  • Precision laser treatments targeting specific scar characteristics
  • Combined treatment approaches addressing multiple aspects simultaneously
  • Enhanced understanding of tension release techniques
  • Improved timing and sequencing of interventions

Recovery and Rehabilitation Tips

Recovery is not just about following a prescribed routine – it's about understanding and actively participating in your healing journey. Here's how you can make the most of your treatment:
Early Movement: Finding the Right Balance Beginning appropriate movement at the right time is crucial. Think of it as teaching your healing skin to move naturally again. This doesn't mean pushing too hard too fast – instead, it's about consistent, gentle progress guided by your healthcare team.
Creating Your at Home Scar Care Routine Successful scar management becomes part of your daily life. This might include:
  • Morning and evening massage sessions that help keep tissue pliable
  • Regular stretching exercises that maintain range of motion
  • Proper moisturising and sun protection to support skin health
  • Regular check-ins with your healthcare team to adjust your routine as needed

The Importance of Scar Risk Assessment

A comprehensive approach to scar management starts with thorough assessment and early intervention. Key factors include:
  • Evaluation of burn depth and location
  • Consideration of individual risk factors
  • Assessment of functional movement patterns
  • Goals and expectations
  • Development of personalised treatment plans
Our team of specialists employs a multimodal approach, combining various treatment methods to achieve optimal results. We understand that each patient's journey is unique and requires individualised care planning.
To learn more about your treatment options and receive a personalised assessment, we encourage you to book a consultation with our experienced team. Early intervention can make a significant difference in your recovery journey.

Conclusion

The field of scar management, particularly in burns, continues to evolve with a significant emphasis on functional kinematics. At our specialized surgical scar clinic, we harness these advancements along with modern treatment methodologies to significantly improve both the function and appearance of burn scars.
Choosing our clinic provides access to expert care, the latest in scar treatment technology, and evidence-based protocols. Our team is dedicated to delivering comprehensive assessments, personalized treatment plans, and continuous adaptation of treatments through a collaborative team approach. For more information on functional kinematics in burn scar management, please refer to Dr. Issler-Fisher research paper linked here*.

Remember, successful scar management is a journey, and we are committed to supporting you every step of the way, ensuring the best possible outcomes in your recovery journey.

(*) Issler-Fisher AC. The importance of biomechanics and the kinetic chains of human movement in the development and treatment of burn scars - A narrative review with illustrative cases. Burns. 2023 May;49(3):707-715. doi: 10.1016/j.burns.2022.08.010. Epub 2022 Aug 28. PMID: 36127224.