Our experience in reconstructing the burn neck contracture with free flaps: Are free flaps an optimum approach?
Divya Narain Upadhyaya1, Vaibhav Khanna2, Adarsh Kumar3, Romesh Kohli4
1 Department of Plastic Surgery and Burns, Sanjay Gandhi PostGraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
2 Department of Plastic, Craniofacial and Microsurgery, Vivekananda Polyclinic and Institute of Medical Sciences; Department of Plastic, Reconstructive and Aesthetic Surgery, Sahara Hospital, Lucknow, Uttar Pradesh, India
3 Department of Plastic, Craniofacial and Microsurgery, Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
4 Department of Plastic, Reconstructive and Aesthetic Surgery, Sahara Hospital, Lucknow, Uttar Pradesh, India
Divya Narain Upadhyaya
B-2/128, Sector-F, Janakipuram, Lucknow-226021, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
Introduction: The aim of the reconstructive burn surgeon is to remove all the scar tissue in the affected area and resurface the area with supple tissue, which allows proper movement of the neck and is esthetically pleasing. We present our series of 10 patients of burn neck contracture, primary and recurrent, who were treated with free flap reconstruction. Patients and Methods: A retrospective review of all the data of the patients was done and the demographic data, preoperative and postoperative examination findings, surgery offered, results and follow-up details were tabulated and analyzed. Results: All the flaps survived completely. Two flaps showed postoperative congestion on day 1 and were taken to the operating room to be reexplored. All patients showed marked improvement in the degree of neck extension, lateral flexion, and rotation which remained unchanged with successive follow-ups. Conclusion: The results of free flap reconstruction of the burn neck contracture area appear to be better than other methods in terms of functional and esthetic restoration of the normal anatomy. The postoperative morbidities for the patient are also reduced and patient comfort is enhanced. The authors feel that in centers where microsurgical expertise is available, the patients of burn neck contractures may be offered the option of complete scar excision and free flap reconstruction as a primary option instead of scar release and split skin grafting.