Skin Stretching for Burn Scar Excision - A Critically Appraised Topic.

Adults with burn scars are a clinical challenge, and the long term sequelae of burns can have a significant impact on the patient. Scar excision is thought to be the best treatment at present, as it results in a smaller scar. Scar stretching has shown promise in a previous study, as it may allow the surgeon to excise more burn scar. The goal of this study was to determine if good evidence exists for the use of burn scar stretching, in routine clinical practice, through the format of a critically appraised topic. A question was formulated using the Patient Intervention Comparator Outcome (PICO) method:-Patient - Adult burn victims-Intervention - Scar excision + skin stretching-Comparator - Scar excision-Outcome - Total remaining scar The PICO question was used to develop a search query: "stretch* burn scar" (where '*' represents a wildcard function). A search was then conducted using PubMed, SCOPUS, the Cochrane Library, and Trip Database. One paper was selected for critical appraisal following identification, screening, and eligibility evaluation. The paper was critically appraised using accepted methodology outlined by Straus et al. and reporting quality was assessed using the CONSORT statement for non-pharmacological trials. Areas of methodological or reporting weakness were highlighted. Burn scar stretching, using the device or technique in question, requires much further research before widespread usage in burns patients.