Abstract
Background: Neck contracture after burns is a major complication that affects function and cosmesis. The aim of covering the raw area and defects is through using good quality pliable skin. Full thickness skin graft allows a large dimension sheet of good quality skin with low donor-site morbidity. Also it provides similar skin quality to the recipient areas with much less cosmetic difference. Methods: Four men and eight women underwent neck contracture release and reconstruction from December of 2015 to August of 2016. Mean patient age was 29 years (range from 12 to 46 years). Burn scar contracture releases were performed and cervicoplasty was added for optimal neck appearance. Uniformly full thickness skin grafts were applied. Both lateral ends of these grafts (release incisions) were designed with a fishtail shape for sufficient release and to minimize linear scar band formation in the most lateral region of the neck. Results: Full thickness skin grafts as large as 24 ± 12 cm (in length) and 10 - 15 cm (in width) were used. All grafts were taken without significant complications. Range of neck motion increased, and the cervico-mental angle was regained in all patients. A highly natural neck contour was universally obtained without a secondary debulking procedure. Conclusions: Full thickness skin grafts for treatment of post burn neck contraction give good functional and cosmetic results. They give similar color match and good skin quality, also help in regaining of cervico-mental angle.
Highlights
Neck contracture is both a devastating functional and cosmetic deformity for patients and a challenging problem for the reconstructive surgeons [1]
Full thickness skin grafts as large as 24 ± 12 cm and 10 - 15 cm were used
Given the increasing preference for full thickness skin graft, a wide spectrum of reconstruction cases, resurfacing after contracture release has become another indication for use of full thickness skin graft
Summary
Neck contracture is both a devastating functional and cosmetic deformity for patients and a challenging problem for the reconstructive surgeons [1]. When deep burns are allowed to heal spontaneously patients develop severe neck contracture [2]. Full thickness skin grafts have several advantages, as they provide sufficient tissue with excellent function, and provide a good neck contour without significant donor site morbidity [5]. Given the increasing preference for full thickness skin graft, a wide spectrum of reconstruction cases, resurfacing after contracture release has become another indication for use of full thickness skin graft. Several full thickness skin graft donor sites have been selected for the reconstruction of burn scar contractures in various regions of the body, including the neck [7]. We present 12 cases of severe burn neck contractures reconstructed with good results using full thickness skin graft and cervicoplasty
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