2006 - UZ Leuven

Furthermore, subjective (questionnaires) and objective tools(colourimeters, elastometers, ultrasound, etc.) to assess theseparameters will be critically analysed with regard to their scientifical oradded value in a possible test battery for scar assessment. Finally,based on evidence based articles a short overview will be given of alldifferent conservative therapeutical strategies. Also own research inthe field of the use of pressure on burn related is shown. Although theworking mechanism is still questionable both pressure therapy andsilicone contact media seem to have the best scientifical evidence forefficacy in the conservative treatment on prevention of hypertrophic(burn) scars.VAN DEN KERCKHOVE E., HIERNER R., DEGREEF H., GYSKENS J.:Possibilities and results of scar and compression treatment after freeflap surgery. Chirurgica, 2006; 101: 27.Introduction: The aesthetic result is an important part of a successfulreconstruction. Possibilities to influence the aesthetic result areadequate flap planning (colour, texture), recipient site dissection(aesthetic units), insetting of the flap (intradermal stitches) andpostoperative treatment (conservative and/or operative).Material and Methods: 20 Patients with free flap transfer to the lowerleg after trauma and tumor removal were treated according astandarized protocol in our multidisciplinary “scar clinic”. Aftercomplete wound healing scar massage (3-5x/d) is started andcontinued up to 6 months post-op. In case of hypertrophic scars weare adding a silicon sheat (cica care/R). Compression is started 3weeks after surgery using soft compression (Tubigrip/R) and after 6weeks compression stocking. This crescendo treatment is carried outfor at least 6 months, but best until the scar turned from red to white.In a retrospective study the following criteria were evaluated: 1)patient’s compliance, 2) patients judgment (excellent, good, moderate,fair), 3) reviewer judgment (excellent, good, moderate; fair).Results: All patients followed the treatment at least for 6 months.Patient judged their lower leg reconstruction as excellent (5), good(11), moderate (3), fair (2). The reviewer judged the results asexcellent (3), good (9), moderate (6), fair (2).Summary: Using a standarized program the aesthetic result after flapsugery can be improved with regard to the scar formation and colourchanges and the shape of the flap. We highly recommend such atreatment for the upper limb, lower limb and face.90