Early scar plasticity as a cause of scar contracture

Little is known about the cause of scar contracture. The contractile capability of myofibroblasts in the early scar provides a partial explanation; however, clinical and experimental findings indicate that the early scar possesses plasticity, and that its size and shape can be altered by mechanical forces. Even if a scar possesses no contractile capability itself, scar contracture may develop if: (1) the affected joint (skin) is kept in flexion (relaxation); (2) the scar is over a contracted wound; or (3) compression is applied to the early scar. Many instances of scar contracture may therefore be attributable not to active motility but to the passive response of scar tissue to mechanical forces.