الفهرس 
AnatomyOnly 14 pages are availabe for public view
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Abstract
SUMMARY
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The skin is an anatomically and physiologically specialized
boundary lamina which is of major importance in the life of the
individual. It is composed of two layers of distinctive structure,
properties and embryological origin the dermis, and the epidermis
which cover it. Within the skin, the blood supply and
drainage along well determined pathways. The appendages of skin
are nails, hairs, sebaceous glands and sweat glands.
When skin is exsposed to burn the process of healing is conducive
to the formation of hypertrophic and contracted scars, as
it is characterized by a marked increase in vascularity, fibroblasts,
myofibroblasts, collagen deposition, interstitial material,
and edema.
Scar contractures and hypertrophic scar formation following
thermal injury can be markedly lessened by prop~r positioning of
the patient, utilisation of splints to maintain good position of
all joints during acute stage and long term use of splints and
pressure dressing following healing. Early surgical excision and
skin grafting of fullthickness burns minimize the development of
contractures.
When scar contracture is well established and matured,surgical
correction is indicated. The generally accepted methods of con-
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tracture release are Z-plasty and incisional release with graft.
Also local, distant, island and myocutaneous flaps have been
used. When Skin flaps are raised including the deep fascia, this
will increase the reliability and length to breadth ratios.
With the advent of microvascular free-tissue transfer, burn
surgeons have begun to use this new technique to treatment of
postburn contractures.