Burn Center 2 ; Head of the 2 nd Burn Unit 2 ; G.V. Mirzoyan, Pediatric Surgeon, the 2 nd Burn Unit 2 ; R.B. Gabitov, Scientific Consultant, Department of Surgical Diseases and Clinical Angiology 3 ; M.A. Brazol, MD, PhD, Head of the Burn Unit; Deputy Chief Surgeon 4 ; P.V. Salistyj, Head of the Burn Unit 5 ; Y.V. Chikinev, MD, DSc, Professor, Head of the Department of Hospital and Pediatric Surgery 6 ; A.A. Shmyrin, Head of the Unit of Combustiology 7 ; A

Background. The frequency of deep cervical burns in children is four times higher than that of deep face burns. Currently, there is no consensus on the methods for surgical treatment of deep burns in cervical areas; meshed skin autografts continue to be used. Aim. To evaluate the benefits of early surgical treatment of deep сervical burns in children between the third and fifth days from the moment of injury. Materials and methods. Case-control study. Surgical treatment was performed in 81 children with deep cervical burns. The main group with early surgical treatment included 46 children and underwent surgical treatment at 3.37 0.14 days from the moment of injury; the control group received autograft during stage treatment for 35 children at 27.17 0.18 days. The treatment results were evaluated by the following indicators: the number of dressing changes, the period of skin restoration, and the area of graft success. In the long term, functional and cosmetic treatment results were evaluated. Results. In the study and control groups, 7.93 0.45 and 18.75 0.61 dressings were required to complete the treatment, respectively (p 0.001). The skin restoration periods were 16.54 0.68 and 36.94 0.89 days, respectively (p 0.001). The graft success areas were 99.50% 0.13% in the main group and 93.91% 2.68% in the control (p 0.001). During the staged surgical treatment, one patient showed a loss of 90% of the graft, which required regrafting. Other complications in the treatment process have not been noted. When assessing long-term cosmetic results using the Vancouver Scar Scale, the average score was 4.0 0.26 points in the main group and 7 0.28 points in the control (p 0.001). The presence of post-burn cicatricial contracture in the main group was noted in 12 (26%) people and the absence in 34 (74%) children. In the control group, 20 (57%) patients required surgical removal of post-burn deformity, and 15 (43%) children did not need further surgical interventions. Conclusions. Early surgical treatment of deep cervical burns in children on the third and fifth days from injury allows not only to accelerate the process of restoration of the skin but also to directly affect the cosmetic and functional results in a better way.

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BACKGROUND: Deep neck burns always result in cicatricial changes in the skin. Scars in this area can lead not only to functional disorders but also affect the psychoemotional status of the patient and family. Current studies have reported on the results of the treatment of deep neck burns in both adults and children. However, among foreign and Russian publications available, no studies have assessed the cosmetic results of treatment using validated scales. AIM: This study aimed to analyze the long-term cosmetic results of surgical treatment of deep neck burns in children using the Vancouver Scar Scale. MATERIALS AND METHODS: A non-interventional case control study was conducted. The article analyzes the long-term cosmetic results of treatment of 64 children with deep neck burns. All patients were divided into the main group 1 35 (29%) children who received early surgical treatment] and control group 2 29 (45%) children after staged treatment]. The main group was further divided into subgroups 1a, 1b, and 1c. Subgroup 1a included 13 (20%) children who underwent tangential necrectomy with simultaneous autodermoplasty, subgroup 1b included 12 (19%) children who underwent radical necrectomy with simultaneous autodermoplasty, and subgroup 1c included 10 (16%) children who underwent necrectomy with delayed autodermoplasty. The Vancouver Scar Scale was used to assess the vascularization, pigmentation, elasticity, and size of the scar mass. For statistical analysis, the results of different options for early surgical treatment were compared with a staged method. RESULTS: The best indicators for vascularization, elasticity, size of the formed cicatricial mass, and overall score were obtained in children who received surgical treatment of deep neck burns by early necrectomy (tangential or radical) with simultaneous autodermoplasty in comparison with staged surgical treatment. When analyzing the pigmentation indicator, the scores of patients who underwent all types of early surgical treatment were comparable with those in patients who received staged surgery. CONCLUSIONS: According to the analysis of the Vancouver Scar Scale, the best cosmetic results in children with deep neck burns can be achieved by performing tangential or radical necrectomy with simultaneous autodermoplasty.