Abstract
A nine-year-old girl sustained extreme postburn contractures of the face, neck, both axillae, elbows, wrists, and ankles, due to flame injury 5 years ago. No primary and plastic surgical burn treatment was available in a remote area of China. From October, 2005 to April, 2007, all adhesions were released in five operations and the huge defects covered with local musculo-cutaneous flaps, z-plasties, and with thick split skin gafts. This led to an optimal functional result and an aesthetic restoration of the face, giving her, back her self-esteem in daily life.
Highlights
Physical Examination: 1) lower eyelid ectropion, epiphora, and compulsive bow posture; 2) eversion of the lower lip caused by mandible-chest adhesion; 3) contracture of perioral scars, leading to the impossibility of mouth opening, closing, and drooling; 4) the cervicomental and mandible angles had completely disappeared; 5) the left and right rotation and the extension of the neck were severely restricted and were classified grade IV [1] cervico-thoracic adhesion; 6) The wide scar over the chest fused with both axillary scars inhibiting the abduction of the upper arms; 7) severe scar contractures over both wrists and fingers; 8) scar contractures over the dorsum of both feet, hindering their walking functions (Figures 1-4)
2) Three months later, the girl underwent a second operation for release of the axillary scar contractures and split skin grafting under intravenous anesthesia and thoracic epidural anesthesia
There are many approaches available to release the scar contracture of the neck [2,3,4], including full-thickness or split thickness skin graft, local flaps, free flaps, and tissue expansion
Summary
Physical Examination: 1) lower eyelid ectropion, epiphora, and compulsive bow posture; 2) eversion of the lower lip caused by mandible-chest adhesion; 3) contracture of perioral scars, leading to the impossibility of mouth opening, closing, and drooling; 4) the cervicomental and mandible angles had completely disappeared; 5) the left and right rotation and the extension of the neck were severely restricted and were classified grade IV [1] cervico-thoracic adhesion; 6) The wide scar over the chest fused with both axillary scars inhibiting the abduction of the upper arms; 7) severe scar contractures over both wrists and fingers; 8) scar contractures over the dorsum of both feet, hindering their walking functions (Figures 1-4)
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