Background: Neck contracture after burns is a major complication that affects function and cosmesis. The aim of covering the raw area and defects is through using good quality pliable skin. Full thickness skin graft allows a large dimension sheet of good quality skin with low donor-site morbidity. Also it provides similar skin quality to the recipient areas with much less cosmetic difference. Methods: Four men and eight women underwent neck contracture release and reconstruction from December of 2015 to August of 2016. Mean patient age was 29 years (range from 12 to 46 years). Burn scar contracture releases were performed and cervicoplasty was added for optimal neck appearance. Uniformly full thickness skin grafts were applied. Both lateral ends of these grafts (release incisions) were designed with a fishtail shape for sufficient release and to minimize linear scar band formation in the most lateral region of the neck. Results: Full thickness skin grafts as large as 24 ± 12 cm (in length) and 10-15 cm (in width) were used. All grafts were taken without significant complications. Range of neck motion increased, and the cervico-mental angle was regained in all patients. A highly natural neck contour was universally obtained without a secondary debulking procedure. Conclusions: Full thickness skin grafts for treatment of post burn neck contraction give good functional and cosmetic results. They give similar color match and good skin quality, also help in regaining of cervico-mental angle.

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Introduction: Coverage of defects of the distal lower extremity and foot remains a challenging reconstructive procedure. Free tissue transfer remains the standard for the management of these defects. However, there are some disadvantages like; longer operative times, bulky contour, and the need for highly skilled expertise. The reverse superficial sural artery flap (RSSAF) is a distally based fasciocutaneous or adipo-fascial flap that is used for coverage of defects that involve the distal third of the leg, ankle, and foot. A significant advantage of this flap is a constant blood supply that does not require sacrifice of a major artery. Methods: Twenty RSSAF flaps were harvested for reconstruction of different traumatic soft tissue defects of the lower third of leg, ankle and foot. Follow up for 6 months postoperative. Results: Twenty Patients; twelve males and eight females underwent reconstruction of different soft tissue defects over the foot and ankle using RSSAF. The overall complications occurred in 6 flaps; 4 minor and 2 major complications. The remaining 14 flaps passed an uneventful follow up. Conclusions: The reverse superficial sural artery flap RSSAF can be used as a reliable alternative to free tissue transfer in reconstruction of defects over the lower third of leg, ankle, and foot. Venous congestion is the major threat to the flap but its incidence can be minimized by wide pedicle, less kink of the flap, and keep the venae comitants around the artery.