Restoration of Lower Facial and Neck Esthetics by Application of Pre-Expanded Bipedicle Scalp and Free Scapular Flaps

Pei, Jiaomiao; Zhang, Juan; Li, Yang; Liu, Chaohua; Song, Beomyong

doi:10.1097/scs.0000000000008918

Cited by 1 publication

(1 citation statement)

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“…Of the strategies used to manage patients with CR, Z-plasty had the highest success rate at 62.5%. As new strategies for managing postburn neck contracture with flap reconstructions emerge, [15][16][17] larger studies that can inform best practices to prevent CR are needed. When following patients postoperatively, on average, CR (256.4 ± 249.4 days) presented later than initial contracture (128.9 ± 84.9 days).…”

Section: Discussionmentioning

confidence: 99%

The Development and Management of Neck Burn Scar Contracture Recurrence

Jeong,

Alessandri-Bonetti,

Pandya

et al. 2024

Ann Plast Surg

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Introduction Burn neck contractures pose a great challenge for reconstructive surgeons. A paucity of literature exist regarding long-term outcomes based on different surgical management strategies. The aim of this study was to evaluate the long-term outcomes of the treatment of neck burn scar contractures and evaluate surgical strategies according to their long-term effectiveness and associated complications. Methods A retrospective cohort study was conducted to review outcomes of neck contractures release after burn injury. All patients operated on between January 2009 and February 2023 at a single institution were included. Results A total of 20 patients developed neck burn scar contracture and were included in this study. The mean age was 32.9 ± 20.3 years. The burn injuries were most commonly thermal (n = 19, 95%). All burn injuries were full-thickness burns, with an average neck defect size of 130.5 ± 106.0 cm2. Overall, 45 surgical scar release procedures were performed on the 20 patients who developed a neck contracture. Patients underwent 1.65 ± 1.04 surgeries on average to address neck contracture. Although 25% of patients only received 1 surgery to treat neck contracture, some patients underwent as many as 8 surgeries. Contracture recurrence (CR) was the most common complication and occurred in 28.9% of the cases. The mean percentage total body surface area did not significantly differ in CR patients (26.7% ± 14.9%) and no-CR patients (44.5% ± 30.2%). However, there was a significant difference (P = 0.01) in the average neck defect size between CR patients (198.5 ± 108.3 cm2) and no-CR patients (81.1 ± 75.1 cm2). Conclusions This study showed that risk factors for initial burn scar contractures may differ from those associated with CR, highlighting the importance of neck defect size as a predictor. The study also examines various surgical approaches, with Z-plasty showing promise for managing CR. However, the absence of data on neck range of motion is a limitation. This research underscores the complexity of managing CR and emphasizes the need for ongoing postoperative monitoring.

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Section: Discussionmentioning

confidence: 99%