Successful Treatment of Post-Traumatic Elbow Scar Contracture Using Combined Approach of Surgical Release & Early Fractional Laser Resurfacing

Abstract

Scarring is mostly fibrous formation that arises from the regeneration of tissue after a traumatic injury or inflammation. One of the most common and most important morbidities of scar is contracture, particularly when located in the nearby joints. Many surgical techniques, including tissue expansion, skin grafting, local and distant flaps, and Z- or W-plasty can be applied to scar contracture. Currently, non-surgical methods play an important role in scar treatment methods with ablative fractional resurfacing being one of the most effective and promising methods for correcting various types of scar. This paper reports the combined approach of surgical and non-surgical methods of scar treatment to release scar contracture successfully. A nine-year-old male patient with a 30 cm-sized posttraumatic scar on his right arm was treated with an ablative fractional laser device after Z-plasty. The patient received a total of four sessions of laser treatment with a one month interval between sessions. The results were evaluated before the procedure and 2 years after the last fractional laser resurfacing treatment. The mean vancouver scar scale score of the scar rated by two physicians decreased from 9.5 to 3.0. The patient also noted significant improvement in aesthetics and function and was quite satisfied with the results. No complications, such as wound disruption, post-inflammatory hyper pigmentation, or dyspigmentation were noted. The combined approach of surgical release and early fractional laser resurfacing for scar treatment can produce significant aesthetic and functional improvements of scar contracture.