Ravi Kumar Chittoria Professor, Department of Plastic Surgery & Telemedicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., India
Amrutha J S Senior Resident, Department of Plastic Surgery, India
Address for correspondence: Ravi Kumar Chittoria, Professor, Department of Plastic Surgery & Telemedicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., India E-mail: drchittoria@yahoo.com
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Amrutha JS, Chittoria RK. Review article on management of postburn digital web space contracture. Indian J Anat. 2023;12(4):147–50.
Timeline
Received : October 10, 2023
Accepted : October 20, 2023
Published : November 30, 2023
Abstract
Burn web space contracture refers to the abnormal tightening and narrowing of the skin and underlying tissues that occurs after a burn injury. This condition results from the healing process where scar tissue forms and contracts, leading to limited mobility and functionality in the affected area. In connection with burns, especially in the area between the fingers or other joints, contractures can significantly impair movement and cause functional deficits. Treatment may include surgery, such as skin grafts or releases, coupled with rehabilitation to restore range of motion. This review article covers the different ways to manage digital web contracture.
References
1. Zancolli EA, Cozzi EP. The retinaculum cutis of the hand. In: Zancolli EA, Cozzi EP, editors. Atlas of Surgical Anatomy of the Hand. 1st ed. New York: Churchill Livingstone; 1992. p. 1–135.
2. Dautel G, Merle M. Direct and reverse dorsal metacarpal flaps. Br J Plast Surg. 1992;45(2):123–30.
3. Chang LY, Yang JY, Wei FC. Reverse dorsometacarpal flap in digits and web-space reconstruction. Ann Plast Surg. 1994;33(3):281–9.
4. Gulgonen A, Ozer K. Correction of postburn contractures of the second through fourth web spaces. J Hand Surg Am. 2007;32(4):556–64.
5. Smith MA, Munster AM, Spence RJ. Burns of the hand and upper limb: a review. Burns. 1998;24(6):493–505.
6. Salisbury RE, Bevin AG. Burn syndactyly: the “hourglass” procedure. In: Salisbury RE, Bevin AG, editors. Atlas of Reconstructive Burn Surgery. 1st ed. Philadelphia (PA): Saunders; 1981. p. 180–5.
7. Dantzer E, Queruel P, Salinier L, Palmier B, Quinot JF. Dermal regeneration template for deep hand burns: clinical utility for both early grafting and reconstructive surgery. Br J Plast Surg. 2003;56(8):764–74.
8. Frame JD, Still J, Lakhel-LeCoadou A, Carstens MH, Lorenz C, Kelly C, et al. Use of dermal regeneration template in contracture release procedures: a multicenter evaluation. Plast Reconstr Surg. 2004;113(5):1330–8.
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
Whether all authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
The authors report no conflicts of interest in this work.
About this article
Cite this article
Amrutha JS, Chittoria RK. Review article on management of postburn digital web space contracture. Indian J Anat. 2023;12(4):147–50.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Variants of Z-plasties. (A) The classic 60-degree angle Z-plasty. (B) The 90-90 degree four-flap Z-plasty. (C) The 120- 120 degree four-flap Z-plasty. (D) The Z-plasty in series (E) Double-opposing Z-plasties (butterfly flap). The dotted line refers to the axis of contracture. The figures on the right reflect the appearance after flap rotation
Description: No description available.
Three-flap rotation-advancement web-plasties. (A) Triangular flaps of tissue are rotated around the advanced rectangular flap. (B) Rectangular flaps of tissue are rotated around the rectangular flap. The flaps in (B) may be more tenuous and care should be taken in elevating these flaps in tissue that has previously been injured. The dotted line refers to the axis of contracture. The figures on the right reflect the appearance after flap rotation
Description: No description available.
T V-Y advancement flaps. (A) Opposing V-Y islands as described by Savaci and coworkers