By Abramenko P., Van Maldeghem H.

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Since skin is bilaminate, it is logical that a bioengineered skin organ substitute should also be bilaminate. Integra consists of a temporary silicone “epidermal” substitute and a permanent dermal regeneration template made of collagen and the glycosaminoglycan, chondroitin-6-phosphate. Once applied to the wound, the dermal matrix is invaded with fibroblasts and becomes vascularized, integrating with the recipient bed and directing cellular activities. Once this dermal matrix is vascularized, the temporary silicone “epidermis” is removed and a thin split-thickness autograft is applied to complete the process.

1007/978-3-642-05070-1_8, © Springer-Verlag Berlin Heidelberg 2010 Diagnosis, Assessment, and Classification of Scar Contractures Assessment and Classification of Postburn Contractures “Scar contractures” are diagnosed by abnormal resting position of anatomical structures or movement disturbance of joints and other tissues. 2). Shape and depth of scars should be diagnosed pre- and/or intraoperatively. Postoperative assessment is also important to evaluate the selected methods. 1. Periorbital region 2.

5) Short linear contractures can be released using single z-plasty or small local flap (type I). However, long linear contracture extended to next unit should be reconstructed by multiple z-plasties, local flaps, or skin grafting (type II). With respect to the skin grafting, FTSG should be selected to prevent recontracture. Broadband contracture should be released completely and reconstructed by Diagnosis, Assessment, and Classification of Scar Contractures FTSG or thin flaps. If the wounds, after removal of scar tissues, have platysma at the base, FTSG can be selected (type IIIa).

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