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Introduction and outline of this thesis | 15
1
At the same time, burns were rarely treated surgically and the treatment of acute burns
with the use of skin grafts was still in its infancy
17
. Although Thiersch stated already in
1886 that autografts could be used for the treatment of burns, also to cover larger wound
areas, their use in burn surgery was not implemented in burn surgery for decades
13,18
. This
changed during the Second World War when the pioneering plastic surgeon Archibald
McIndoe introduced revolutionary methods for burn treatment including the use of skin
grafting
17
. Many of the reconstructive techniques used today in patients with burn injury
and hand surgery are highly influenced by his work.
Nowadays, plastic and reconstructive surgery has evolved and established itself as
an individual specialism. Over the years, many studies on reconstructive surgical
procedures for scar contractures have been performed. Studies on the effectiveness
of the treatment of these scar contractures present new techniques or adaptations of
previously established techniques. However, examining the current literature does not
provide us with recommendations on the appropriate reconstructive procedure or clear
algorithms for their treatment. Therefore,
Chapter 4
presents a systematic review on the
effectiveness of the available reconstructive techniques for burn scar contracture release.
Figure 2.
Johannes Esser together with his patients, which were injured during the First WorldWar. Illustration
from the archives of medical historian L. van Bergen, VU University.