Preexpanded Vertical Trapezius Musculocutaneous Flap for Reconstruction of a Severe Neck Contracture After Burn Injury

Ulrich, Dietmar; Fuchs, Paul C.; Pallua, Norbert

doi:10.1097/bcr.0b013e31816677d9

Cited by 13 publications

(12 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the severe neck contractures, many reconstructive options are proposed including local [1, 2, 4–7] and free flaps [24] and combination with tissue expansion. However, in very severe cases, the donor sites can be hardly found.…”

Section: Discussionmentioning

confidence: 99%

“…The flap is growing, while the reduction of skin grafting of the severe contractures in the submandibular and above the clavicles is minimal. The scar release procedure can exceedingly become more enlarged than planned in advance [2], and the patients with a burn contracture itself necessitate awake fiber-optic intubation, use of intubating laryngeal mask airway, intubation without neuromuscular blocking agents, intubation with neuromuscular blocking agents after testing the ability to ventilate by mask, pre-induction neck scar release under local anesthesia and ketamine, or sedation followed by direct laryngoscopy [3]. …”

Section: Reviewmentioning

confidence: 99%

See 1 more Smart Citation

The neck burn scar contracture: a concept of effective treatment

et al. 2017

View full text Add to dashboard Cite

A neck scar contracture can severely and negatively affect the function of mastication, phonic, or breathing and result in neck pain and issues with esthetics. The best way is of course to avoid such contracture by means of non-surgical treatment such as use of a growth factor. The basic fibroblastic growth factor is clinically well proven in decreasing scar formation and improving healing. There are numerous reconstructive methods for neck contracture, especially when the lesions are relatively limited in part of the neck. However, a very severe and full circumferential scar contracture requires extensive reconstruction. The thin groin flap is one of the answers and well matches with the tissue texture and maintains the flexibility. Even with extensive burns and delayed reconstructions due to resuscitation first, the groin area is well preserved and can be safely harvested by dual vasculature systems of the superficial circumflex iliac artery and superficial epigastric artery, which warrant more reliability compared to the perforator flaps in this area. More demanding and stringent forms of the neck burn scar contracture are the sequelae of radiation. A radiation burn or radiation injury can be progressing and hard to heal. Adipose-derived stem cells can reverse the scar contracture as the surrounding tissue is softened and can accelerate wound healing. In this review, different types of neck burn scar contracture and reconstructive methods are summarized, including innovative use of bFGF and ADSCs in the management of difficult wound healing and scar contracture.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

The neck burn scar contracture: a concept of effective treatment

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Six of the studies (75%) reported numeric values (degrees or length) but did not indicated the methods or tools used for measurement. [55][56][57][58][59][60] Two of these studies referenced normative values for neck ROM. The remaining two studies (25%) simply described outcome in subjective terms, such as "no functional problems," or "result was satisfactory from the functional as well as the aesthetic point of view."…”

Section: Burn Literature Review Resultsmentioning

confidence: 99%

Methods and Tools Used for the Measurement of Burn Scar Contracture

Parry¹,

Walker²,

Niszczak³

et al. 2010

Journal of Burn Care & Research

View full text Add to dashboard Cite

After burn injury, scar contracture can cause significant impairment and functional deficit. Many studies have investigated the treatment and prevention of burn scar contracture, but few studies have focused on the methods for measuring contracture. The purpose of this study was to determine whether consistent and objective methods of measurement are used to quantify scar contracture in the clinical evaluation of burn patients and in burn research. A survey was administered to 407 burn therapists to determine the methods and tools used clinically to measure scar contracture, while a review of recent burn literature was conducted to determine the methods and tools used in burn research. The results of the survey indicate that there is a lack of consensus in the methods and tools used for the measurement of scar contracture, both clinically and in research. Instead, a variety of measurement methods was reported, each with varying degrees of objectivity. Clinically, the methods are rarely checked for reliability or performance competency. In burn research, the methods and tools vary, and contracture data obtained are often reported in an inconsistent manner. If the measurement of scar contracture is not done objectively and consistently, then it is difficult to determine reliability, validity, and responsiveness of the measurement methods. Development of standard protocols with reliable measures of scar contracture would improve the quality of burn care and research.

show abstract

“…Many flaps indicated for burned cervical reconstruction (pedicled, island, expanded, and nonexpanded) are used: supraclavicular artery flaps, 6 -8 superficial cervical artery flap, 9 transverse cervical perforator flap, 10 latissimus dorsi myocutaneous flap, 11 trapezius fasciocutaneous 12 and musculocutaneous flaps, 13 dorsal scapular island flap, 14 flap on the pectoralis major muscle, 15 and free flaps (radial forearm flap, scapular/ parascapular flap, anterolateral thigh flap, and thoracodorsal artery perforator flaps). 16 -19 In aforementioned cases, the skin of the flaps differs from the remaining cervical skin in case of unilateral deformity.…”

Section: Discussionmentioning

confidence: 99%

Unilateral Cervical Burn Scar Deformity Elimination With Contralateral Cervicothoracic Flap—A New Approach

Grishkevich

2012

Journal of Burn Care & Research

View full text Add to dashboard Cite

Unilateral postburn cervical deformity is a severe cosmetic and functional defect and a challenging reconstructive problem. Many flaps have been suggested; however, after surgery, operational scars, located along the anterior neck's middle line, and the flap's skin differ from cervical healthy skin. A small flap resembles a patch. A more effective and safer technique is neck resurfacing with cervicothoracic adipocutaneous flap which had been used by the author in 32 burned patients. The flap's peculiarities are as follows: axis blood circulation via superficial cervical artery perforator; exclusion of platysma (flap is thin and elastic); and undamaged donor site. The mobilized healthy neck's skin with thin fat layer and adipocutaneous layer of the chest wall are elevated as a whole large flap. After scar excision, the cervicothoracic flap is advanced on the wound with tension. As a result of flap tension, the skin of neck's back, thoracic wall, and axilla are displaced to the anterior neck surface covering the donor wound. On an average, 6 cm of the deformed neck anterior surface was restored. No flap loss but only local superficial scar necrosis along the flap's border occurred. The cervical contracture and scar deformity (25 patients) were eliminated in all cases by a single procedure. For complete neck skin restoration, seven patients underwent staged reconstruction using the same technique. Excellent functional and good cosmetic follow-up results were achieved. The proposed technique is easy to plan and perform and yields good results; therefore, the author believes that the contralateral cervicothoracic flap's use is an exclusive option for unilateral cervical contracture and deformity elimination in adults and pediatric patients.

show abstract

Preexpanded Vertical Trapezius Musculocutaneous Flap for Reconstruction of a Severe Neck Contracture After Burn Injury

Cited by 13 publications

References 18 publications

The neck burn scar contracture: a concept of effective treatment

The neck burn scar contracture: a concept of effective treatment

Methods and Tools Used for the Measurement of Burn Scar Contracture

Unilateral Cervical Burn Scar Deformity Elimination With Contralateral Cervicothoracic Flap—A New Approach

Contact Info

Product

Resources

About