The Technique of Skin Stretching for Acute Burn Treatment and Scar Reconstruction

Objective: A randomized controlled trial is performed to evaluate the clinical effectiveness of the skin stretching technique for two categories: 1. acute burn wounds: wound closure by means of skin stretching should lead to a significant reduction of scar surface area in comparison to the standard technique, the split skin grafting; 2. scar reconstructions: wound closure by means of skin stretching during one operative procedure should lead to a comparable scar surface in comparison to the multiple procedures techniques such as serial excision. Study design: Skin stretching will be compared to split skin grafting and should result in burn wound closure with significantly smaller scars. Also, a comparison will be made between the technique of serial excision versus skin stretching for scar reconstructions. Scar evaluation three and twelve months after surgery will include the following parameters: * surface area; * Patient and Observer Scar Assessment Scale (POSAS); * elasticity; * vascularization and pigmentation; * thickness; * dermal architecture. After 12 months adults will undergo a biopsy of the scar under local anesthesia. The experimental group, treated with the skin stretcher will undergo one extra biopsy of the formerly stretched skin. Intervention: At the start of the operation will be determined by randomization if skin stretching or split skin grafting (acute burn wounds) or serial excision (scar reconstruction category) will be performed.