The treatment of tightly stretched unstable scars that frequently break down has long been a source of worry to the surgeon, and of distress to the patient.
This type of scar usually follows extensive deep burns, or loss of tissue by trauma when the wound has been allowed to heal by the slow process of cicatrization, without the aid of skin grafting or of plastic operation.
The original wounds are always large and usually involve the entire circumference of a part, such as the leg or thigh, or occasionally the calvarium. In other words, the scar surrounds and compresses the part.
Some of the scars are bluish red with fine superficial vessels, while others are pale and seem to have little or no blood supply. Frequently there are superficial ulcers of varying size scattered over the surface. The scars are as unstable as wet tissue paper, and the slightest injury will start an ulcer that