Burn scar contracture is the tightening of the skin after a second or third degree burn. After burn, the surrounding skin begins to pull together, results in a contracture. It occurs when burn is across any joint like neck, wrist, elbow, axilla or knee. Pulling of contracted skin leads to abnormal bending of joint crossed by scarred skin.

There are also medical treatments that can be used to help scar maturation, like silicone gel. Prevention of contracture formation is key IN BURNS

1. In hand burn, splinting of the hand and wrapping of each finger individually is done
2. In burns on the neck, hyperextension of the neck (i.e. no use of pillows) is done during the healing process.

If the area of burn is large and across the joint, and whole thickness of the skin is burnt then regular dressings and replacement of burnt skin with split thickness skin graft can prevent contractures in ideal scenario.

It needs to be treated as soon as possible because the scar can result in restriction of movement around the injured area and later may lead to permanent damage of the involved joint; therefore, early treatment is necessary. Although it may improve with the passage of time with occupational therapy and physiotherapy, and with splinting but would still require surgery in maximum number of cases. The methods mentioned above help in preventing and decreasing severity of the contracture. If persistent, the contracture to be surgically released.

Different techniques are used depending on the severity of contracture and the site. Techniques may include

1. local skin flaps (z-plasty) or
2. skin grafting (full thickness or split thickness).
3. Other than this, in few complicated contractures, release may lead to exposure of vital internal body structures, in such cases, it becomes necessary to give a durable thick cover to these structures therefore a cover with thick flaps is done.