Evaluation of Ideal Surgical Method for Management of Post Burn Scar Contracture of Neck

Abstract

Background: Post burn neck contractures not only affect the movements of the neck, but also can affect the function of the lower face as well as result in possible tracheal alteration and distortion of the cervical spine. As these contractures cause major functional and cosmetic problems with resultant economic and psychosocial implications, operative correction is generally recommended, particularly in children in whom they can cause growth imbalance in the head and neck area. Aim: To determine and recommend the ideal skin cover for the post burn scar contracture release defects with regard to both functional and cosmetic outcome. Methods: Patients who were diagnosed as having post burn scar contracture of neck by clinical examination, were taken up for the study. Results: In our study, contracture release followed by skin grafting was done in 28(70%) patients, contracture release and flap cover and multiple z plasty in 6 (15%) each. 11 patients (27%) felt good, and 3 patients (11%) felt excellent on cosmetic appearance. Conclusion: TYPE A contracture, release and flap cover with supraclavicular flap is highly recommended and should be the first choice. For TYPE B contracture, Supraclavicular flap is not sufficient and has to substituted with a skin grafting. For TYPE C scar, release and skin cover with grafting is the ideal choice provided, proper post op care such as immobilization, positioning and splinting and compression therapy are followed up.

Facilitation of intubation and surgical management for advanced stage neck contractures following burns with a single incision technique

“…This technique involves a single-incision approach to release the contracture, thereby facilitating easier and safer intubation. The proposed method aims to reduce the use of advanced intubation equipment and tracheostomies, which are often not available in all healthcare settings, and to minimise the risks associated with conventional intubation techniques [10].…”

“…The ability to simplify the intubation process, reduce postoperative complications, and improve overall patient outcomes could represent a significant advancement in the fields of burn care and reconstructive surgery. This is particularly important in resourcelimited settings, where the prevalence of burn injuries and the lack of specialised equipment and trained personnel make effective treatment challenging [10].…”