Analysis of Management and Outcome of Treatment of Late Results of Neck Burns in 321 Patients

• Authors: Piotr Wójcicki , Dariusz Rychlik
• Languages of publication: EN

Abstracts

EN

The aim of the study was to evaluate respectively the effectiveness of therapy of late complications of neck burns in the form of scars and contractures in the material of one clinical centre in the past 31 years (1976-2007).Material and methods. 321 patients aged from 1 to 69 (mean age: 8 years) years with late complications of neck burns were treated in the Plastic Surgery Hospital in Polanica Zdrój in the years 1976-2007. The majority of patients were children aged from 1 to 14 years - 276. In total 589 surgical procedures were performed.The following therapeutic modalities were applied: scar excision followed by local reconstructive flap surgery - 434 cases; full thickness and split-thickness skin grafting - 124 cases; local flap reconstruction with the use of expander - 18 cases; transferred pedicle flap from adjacent tissues - 3 cases, flap from other body regions on microvascular anastomosis - 11 cases; and dermabrasion - 19 cases.Results. 285 (89%) patients were satisfied with the treatment outcome and accepted the appearance of scars without complaints. The remaining 36 patients did not find their esthetic appearance after reconstructive surgery satisfactory and did not accept the deformities.Conclusions. Deciding on the management and choosing a surgical modality in patients with postburn skin scarring, a plastic surgeon must take into consideration the kind and severity of the deformity. Surgical treatment of severe scarring is a complex and multi-stage procedure.

Keywords

EN

cicatrical contracture; local reconstructive operations; free flaps; skin grafting

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2009
• Volume: 81
• Issue: 1
• Pages: 46-52

Dates

published

1 - 1 - 2009

online

20 - 3 - 2009

Contributors

author

Piotr Wójcicki

• Wrocław and Department of Plastic Surgery SMC, University Clinic of Medical Academy, Polanica Zdrój

author

Dariusz Rychlik

• Wrocław and Department of Plastic Surgery SMC, University Clinic of Medical Academy, Polanica Zdrój

References

• Gilboa D: Long-term psychosocial adjustment after burn injury. Burns 2001; 27(4): 335-41.[PubMed][Crossref]
• Van Loey NE, Van Son MJ: Psychopathology and psychological problems in patients with burn scars: epidemiology and management. Am J Clin Dermatol 2003; 4(4): 245-72.[PubMed][Crossref]
• McCann DL: Post-traumatic stress disorder due to devastating burns overcome by a single session of eye movement desensitization. J Behav Ther Exp Psychiatr 1992; 23(4): 319-23.[Crossref]
• Kobus K, Stępniewski J: Surgery of post burn neck contractures. Eur J Plast Surg 1988; 11: 126-31.[Crossref]
• Pitanguy J, Rebello C, Sepulved AC: Post-burn neck contractures. Experience in 71 cases. Med Cir Farm 1960; 290: 245-62.[PubMed]
• Kobus K, Frankowski W: Zastosowanie "Z plastyki" w leczeniu przykurczów kończyn po oparzeniach. Chir Narz Ruchu Ortop Pol 1971; 5: 529-34.
• MacLennan SE, Corcoran JF, Neale HW: Tissue expansion in head and neck burn reconstruction. Clin Plast Surg 2000; 27(1): 121-32.[PubMed]
• Chun JT, Rohrich RJ: Versatility of tissue expansion in head and neck burn reconstruction. Ann Plast Surg 1998; 41(1): 11-16.
• Hudson DA, Arasteh E: Serial tissue expansion for reconstruction of burn of the head and neck. Burns 2001; 27(5): 481-87.[PubMed][Crossref]
• de Agustín JC, Morris SF, Zuker RM: Tissue expansion in the reconstruction of post-burn lesions in childhood. Cir Pediatr 1994; 7(4): 174-78.[PubMed]
• Bakamjian VY, Poole M: Maxillo-facial and palatal reconstructions with the deltopectoral flap. Br J Plast Surg 1977; 30(1): 17-37.[PubMed]
• Bakamjian VY, Long M, Rigg B: Experience with the medially based deltopectoral flap in reconstructuve surgery of the head and Neck. Br J Plast Surg 1971; 24(2): 174-83.[PubMed]
• Lejour M, Dor P, Jortay A et al.: Experience with 38 deltopectoral flaps in reconstructive surgery of the head and neck Acta Chir Belg 1977; 76(2): 179-84.
• Kobus K, Licznerski A, Stępniewski J i wsp.: Ocena przydatności wolnych płatów z grzbietu stopy przenoszonych przy użyciu zespoleń mikronaczyniowych. Pol Przegl Chir 1979; 51: 41-48.
• Kobus K, Stępniewski J: Wolne płaty skórne i płaty złożone w leczeniu oparzeń. Pol Tyg Lek 1986; 49; 1561-65.
• Kobus K, Stępniewski J, Wójcicki P: Wolne płaty skórne i złożone w operacjach rekonstrukcyjnych głowy i szyi. Pol Przegl Chir 1993; 65(12): 1170-78.
• Kobus K: Mikrochirurgia w chirurgii plastycznej. Pol Przegl Chir 1993; 65(5): 501-11.
• Tsai FC, Mardini S, Chen DJ et al.:: The classification and treatment algorithm for post-burn cervical contractures reconstructed with free flaps. Burns 2006; 32(5): 626-33.[PubMed][Crossref]
• Yang JY, Tsai FC, Chana JS et al.: Use of free thin anterolateral thigh flaps combined with cervicoplasty for reconstruction of postburn anterior cervical contractures. Plast Reconstr Surg 2007; 110(1): 39-46.
• Ha B, Baek CH: Head and neck reconstruction using lateral thigh free flap: flap design. Micrsurgery 1999; 19(3): 157-65.[Crossref]
• Das-Gupta R, Bang C: Anterolateral thigh perforator flap from previously burned skin for secondary reconstruction of neck with post burn sequelae, new limits explored. J Plast Reconstr Aesthet Surg 2006; 59(6): 628-30.
• Woo SH, Seul JH: Pre-expanded arterialized venous free flaps for burn contracture of the cervicofacial region. Br J Plast Surg 2001; 54(5): 390-95.
• Bardot J: Cutaneous cicatrix: natural course, anomalies and prevention. Rev Prat 1994; 44(13): 1763-68.[PubMed]
• Haertsch P: Reconstructive surgery using an artificial dermis (Integra). Br J Plast Surg 2002; 55: 362-24.[PubMed]
• Dantzer E, Braye FM: Reconstructive surgery using an artificial dermis(Integra): result with 39 grafts. Br J Surg 2001; 54(8): 659-64.
• van Zuijlen PPM, Vloemans JF, van Trier AJ et al.: Dermal substitution in acute burns and reconstructive surgery. A subjective and objective long-term follow-up. Plast Reconstr Surg 2001; 108: 1938-46.[Crossref][WoS]
• van Zuijlen PPM, Lamme EN, van Galen MJ et al.: Long-term results of clinical trial on dermal substitution. A light microskopy and Fourier analysis based evaluation. Burns 2002; 28: 151-60.[Crossref]
• Toma JG, Akhavan M, Fernandes KJL et al.: Izolation of multipotential adult steam cells from the dermis of mammalian skin. Nature Cell Biol, 2001; 3: 778-84.[Crossref]
• Jahoda CA, Reynolds AJ: Hair follicle dermal sheath cells: unsung participants in wound healing. Lancet 2001; 358: 1445-48.[PubMed][Crossref]
• Potten SC, Booth C: Keratinocyte stem cells: a commentary. J Invest Dermatol 2002; 119: 888.[PubMed][Crossref]

Identifiers

DOI

10.2478/v10035-009-0006-0