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J Reconstr Microsurg 2018; 34(07): 514-521
DOI: 10.1055/s-0038-1641724
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Postburn Neck Contracture: Principles of Reconstruction and a Treatment Algorithm

Yashan Gao   *
1   Department of Plastic and Reconstructive Surgery, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Shanghai, P. R. China
,
Haizhou Li   *
1   Department of Plastic and Reconstructive Surgery, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Shanghai, P. R. China
,
Bin Gu
1   Department of Plastic and Reconstructive Surgery, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Shanghai, P. R. China
,
Feng Xie
1   Department of Plastic and Reconstructive Surgery, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Shanghai, P. R. China
,
Hainan Zhu
1   Department of Plastic and Reconstructive Surgery, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Shanghai, P. R. China
,
Zhichao Wang
1   Department of Plastic and Reconstructive Surgery, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Shanghai, P. R. China
,
Qingfeng Li
1   Department of Plastic and Reconstructive Surgery, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Shanghai, P. R. China
,
Tao Zan
1   Department of Plastic and Reconstructive Surgery, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Shanghai, P. R. China
› Author Affiliations
Funding None.
Further Information

Publication History

22 October 2017

22 February 2018

Publication Date:
03 May 2018 (online)

Also available atMedOne
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Abstract

Background Various techniques have been developed for postburn neck reconstruction, but a treatment algorithm is needed.

Methods We retrospectively reviewed all patients treated for postburn neck contracture at our institution between February 2008 and December 2015. Necks were divided into one anterior subunit and two lateral subunits marked by the sternocleidomastoid muscle. Deformities were categorized into three types according to their size and location. Type I deformities involve less than one subunit, type II deformities involve at least one subunit but less than two subunits, and type III deformities affect two or more subunits. Type II deformities were further divided into type IIa deformities, which mainly involve the anterior region, and type IIb deformities, which mainly involve the lateral region.

Results Local random pattern flaps were constructed for type I deformities. Pedicled flaps from the anterior chest and supraclavicular areas were preferred for type IIa deformities, and pedicled flaps from the back were preferred for type IIb deformities. Pedicled flaps from other areas were the second choice for type II deformities, followed by free and prefabricated flaps. For type III deformities, bipedicled flaps were usually required. At a follow-up of at least 12 months, all patients showed near-normal neck function, and aesthetic features were significantly improved.

Conclusion The proposed classification and treatment algorithm for postburn neck reconstruction may help achieve satisfactory outcomes.

Keywords

burn injury - neck contracture - neck reconstruction - pre-expanded flap - prefabricated flap

* Yashan Gao and Haizhou Li equally contributed to this work and should be considered as co-first authors.