Postburn dyspigmented
scar contractures of the upper extremity often require aesthetic improvement. The ideal reconstruction of this
deformity remains a challenge because the various available skin grafts and flaps result in skin colour mismatches, prominent marginal
scars and donor morbidity. Postburn
scar contractures and dyspigmented areas of the upper extremity can be improved by a combination of
dermabrasion and
Alloderm(®) graft over
scar-releasing defect. Their raw surfaces are subsequently re-surfaced with thin split-thickness skin graft (0.005-0007 inches thick). Twenty-seven patients with wide dyspigmented
scar contractures of the upper extremity underwent the combined techniques described by us. The median patient age at
burn incidents was 3 years and at operation was 24 years. Median thin skin graft area was 180cm(2), and the median
AlloDerm(®) graft area was 40cm(2). Thin skin and
AlloDerm(®) grafts took root completely in all patients without re-grafting. Follow-up periods ranged from 30 to 67 months (average 47.6 months). Re-pigmentation was achieved in all cases and all
scar contractures were adequately released and treated with an
AlloDerm(®) graft. Paired differences between preoperative and postoperative parameters as determined by the Vancouver
Scar Scale (VSS) were significant. Focal
hypertrophic scar and reddish-coloured graft sites gradually improved over 3-4 years postoperatively. Graft margin and donor
scars were inconspicuous. Our described combined technique was found to treat these
deformities effectively. We suggest that the use of
Alloderm(®) and thin
skin grafting be considered in patients concerned about this type of cosmetic disfigurement.