Background: 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 ZPlasty 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. |
