Clinical experience in treatment of peri-anal scar contracture in children.

Thirty-nine children suffering from peri-anal scar contracture as a result of burn injury have been treated since 1987. Among them, 25 were boys and 14 girls. Their age ranged from 6 months to 7 years, mean age 3.5 years. In 4 patients, local excision of scar followed by full-thickness skin grafting was done. The result was poor because of movement of the graft, infection and finally necrosis of the graft. In 3 patients, lysis of the scar followed by a transposition of flap, and in 32 local "Z" or "Y-V" plasty were performed with satisfactory results. In our opinion the latter technique should be the treatment of choice, as it is simple, less traumatic, and resulting to high success rate with less tendency to recurrence of contracture. For patients with chronic intestinal obstruction, adequate pre-operative bowel preparation, meticulous post-operative local care are essential. General supportive treatment should not be neglected to ensure a satisfactory operative result.