Surgery of post-burn neck contractures

Kobus, Kazimierz; Stepniewski, J

doi:10.1007/bf00539274

Cited by 12 publications

(4 citation statements)

References 7 publications

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“…Advancement of homologous tissue by means of "Z" plasty or "W"plasty releases contractures and changes the course of scars. The outcome of such a therapy is usually permanent, and additional scars remaining after alternate incisions are usually of a good quality (4,5,6).…”

Section: Discussionmentioning

confidence: 99%

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Analysis of Management and Outcome of Treatment of Late Results of Neck Burns in 321 Patients

Wójcicki¹,

Rychlik²

2009

Polish Journal of Surgery

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The aim of the study was to evaluate respectively the effectiveness of therapy of late complications of neck burns in the form of scars and contractures in the material of one clinical centre in the past 31 years . Material and methods. 321 patients aged from 1 to 69 (mean age: 8 years) years with late complications of neck burns were treated in the Plastic Surgery Hospital in Polanica Zdrój in the years 1976-2007. The majority of patients were children aged from 1 to 14 years -276. In total 589 surgical procedures were performed. The following therapeutic modalities were applied: scar excision followed by local reconstructive flap surgery -434 cases; full thickness and split-thickness skin grafting -124 cases; local flap reconstruction with the use of expander -18 cases; transferred pedicle flap from adjacent tissues -3 cases, flap from other body regions on microvascular anastomosis -11 cases; and dermabrasion -19 cases. Results. 285 (89%) patients were satisfied with the treatment outcome and accepted the appearance of scars without complaints. The remaining 36 patients did not find their esthetic appearance after reconstructive surgery satisfactory and did not accept the deformities. Conclusions. Deciding on the management and choosing a surgical modality in patients with postburn skin scarring, a plastic surgeon must take into consideration the kind and severity of the deformity. Surgical treatment of severe scarring is a complex and multi-stage procedure.

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Section: Discussionmentioning

confidence: 99%

“…Small, elastic scars may be visible only on turning the neck, but there are patients in whom extensive scarring immobilizes the head in adduction to the chest like a suit of armour (4).…”

mentioning

confidence: 99%

Analysis of Management and Outcome of Treatment of Late Results of Neck Burns in 321 Patients

Wójcicki¹,

Rychlik²

2009

Polish Journal of Surgery

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“…1 The resulting disfigurement because of scarring, and especially the often-developing contractures, may severely limit the patients functional and social rehabilitation. 2 As such, the ultimate goals of post burn reconstruction have virtually remained unchanged in that the ideal reconstruction, includes aggressive and complete release of all contractures and replacement with tissue of matching quality compared with the remaining face and surrounding areas. Although doing so, adhering to the principles of reconstructing the facial subunits should always be considered.…”

Section: Introductionmentioning

confidence: 99%

Role of split thickness skin grafting in post burn contracture neck

Chittoria¹,

Nuli

P³

2022

JSAS

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Optimizing functional and aesthetic outcomes in post burn head and neck reconstruction remains a surgical challenge. Recurrent contractures, impaired range of motion, and disfigurement because of disruption of the aesthetic subunits of the face, can result in poor patient satisfaction and ultimately, contribute to social isolation of the patient. Despite advancements in post burn head and neck reconstruction, such as the advent of free-tissue transfer, split thickness skin graft remains the mainstay of cover in most burn care institutions around the world. Usually skin graft is required to cover raw area after release of contracture. But in case contracture is associated with non-healing ulcer which may become source of infection then skin grafting for non-healing ulcer should be done before release of contracture. In this study we are sharing our experience of post burn neck contracture associated with non-healing ulcer in which first skin grafting was done for ulcer & then release of contracture & skin grafting was done.

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“…Multiple reconstructive methods have been used for the treatment of postburn scar contractures, including excision followed by reconstruction using skin grafts, local flaps with or without tissue expansion, free-tissue transfer, and a combination of these methods. 1,2 In addition, free flaps have been used with tissue expansion to enlarge the flap size while minimizing donor-site morbidity. [3][4][5][6][7] Unfortunately, satisfactory results are difficult to achieve.…”

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confidence: 99%

Free Split-Cutaneous Perforator Flaps Procured Using a Three-Dimensional Harvest Technique for the Reconstruction of Postburn Contracture Defects

Tsai

Yang

Mardini

et al. 2004

Plastic and Reconstructive Surgery

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With recent advances in free-tissue transfer, microsurgical techniques have been used more frequently for the reconstruction of postburn contracture defects. Traditional methods, including full-thickness skin grafts and local flaps, often result in a good outcome; however, multiple operative procedures, long periods of splinting, and physical rehabilitation are often required. Free split-cutaneous perforator flaps, consisting of one large cutaneous paddle with two perforating vessels split into two separate skin regions, were used for two kinds of postburn contractures: rectangular and spatially separate defects. From September of 2000 to October of 2002, seven patients underwent this method of reconstruction at Chang Gung Memorial Hospital in Taiwan. A three-dimensional flap harvest method, in which the skin paddle is circumferentially elevated early in the harvest, was used. Postburn scar contractures had resulted from flame burns in six cases and an electric burn in one case. The reconstructive regions included the neck in two patients, the breast in one patient, and the hand in four patients. There were six male patients and one female patient, with a mean age of 34.8 years (range, 25 to 49 years). The size of the excised scar ranged from 120 cm2 to 308 cm2 (mean, 162.3 cm2). The size of the unsplit flaps ranged from 144 cm2 to 337.5 cm2 (mean, 192.1 cm2). The average time for flap harvest using this three-dimensional harvest technique was 39.1 minutes. The average total operative time was 4.3 hours. The average total hospital stay was 7.3 days (range, 6 to 11 days). All flaps survived without major complications. The donor site was closed primarily in all cases. At a mean follow-up time of 9 months, the functional and aesthetic outcomes showed significant improvement as compared with the preoperative condition. In this study, a new method of flap harvest using a three-dimensional technique is introduced, and its application in the reconstruction of postburn contractures is evaluated.

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Surgery of post-burn neck contractures

Cited by 12 publications

References 7 publications

Analysis of Management and Outcome of Treatment of Late Results of Neck Burns in 321 Patients

Analysis of Management and Outcome of Treatment of Late Results of Neck Burns in 321 Patients

Role of split thickness skin grafting in post burn contracture neck

Free Split-Cutaneous Perforator Flaps Procured Using a Three-Dimensional Harvest Technique for the Reconstruction of Postburn Contracture Defects

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