Trapeze-flap plasty: Effective method for postburn neck contracture elimination

Abstract

The new method for postburn neck contracture management is presented. The method is found to be most effective when using the local flap procedures on patients who cannot undergo complex and long surgical procedures that are aimed at both contracture elimination and neck skin restoration (children, elderly patients, patients with inadequate donor sites, and patients with cosmetically acceptable scar appearance). The method consists of the opposite transposition of trapezoid scar-fascial flaps which are prepared one on each antero-lateral neck surface. Both flaps include scars, fat, platysma and deep cervical fascia. As a result of the trapeze-flap plasty, the anterior surface of the neck is lengthened approximately by 100–200%, the contracture is eliminated and mentocervical angle and head movement are restored. The flaps have reliable blood circulation through the superficial cervical artery perforators, therefore flap loss is rare. The functional results were good in 24 out of 26 patients. The flaps surface does not decrease; therefore, the mild contracture becomes an exception.