Functional and Aesthetic Outcome of Reconstructive Surgery for Contracted Neck Scars

Abstract

ABSTRACTBackground: Contracted scars of the neck involving the anterior cervical zone constitute a unique group of challenges compared with post-burn complications in other parts of the body. Many techniques have been advocated for reconstructing neck contractures.Purpose: To determine and recommend the ideal skin cover for neck contracture release defects with regard to both functional and cosmetic outcomes.Methods: A prospective and retrospective cohort study included 20 patients with various degrees of contracted scars of the neck. After releasing contracture band and resection of the unfavorable scarred tissue, remaining defects were surgically reconstructed using multiple Z-Plasties, STSGs, FTSGs and supraclavicular artery island flap with or without prior usage of a tissue expander.Results: Excision and flap group have a higher significant functional outcome than excision with graft and Multiple Z-Plasty groups (p= 0.031). Also, excision and flap have a lower non-significant Vancouver scar scale than other reconstruction methods without significant differences between groups. Excision and flap group have higher Patient Satisfaction score than Excision and graft and Multiple Z-Plasty groups without significant differences between groups.Conclusion: Local and regional flaps especially the supraclavicular artery island flap provide a predictable reconstruction option not only with better color and texture match but also achieves a superior functional outcome.Approval from the Research Ethics Committee in Benha Faculty of Medicine was granted and a fully informed written consents were taken from all patients regarding surgical procedure, photographing, possible complications and follow-up period.Keywords: Post-burn contracture – Contracted neck scar – Neck contracture reconstruction – Supraclavicular flap – Tissue expansion.