Паёми Сино (Dec 2017)
OPTIMIZATION OF SURGICAL TREATMENT OF POST-BURNING TIGHTENING SCARS OF FRONT SURFACE OF THE NECK AND THE CHEST
Abstract
Objective: Evaluation the results of surgical treatment of post-burn cicatricial deformities and contractures of the front surface of the neck and thorax. Methods: The results of surgical treatment of 80 patients with post-burn scars on the anterior surface of the neck and thorax analyzed. The age of the patients ranged from four to 40 years and averaged 19.2±6.5 years. There were 13 men (16.3%) and 67 women (83.7%). Patients arrived at the time from 1 year to 36 years after receiving the burn. Four clinical groups identified: isolated constrictive scars of the anterior surface of the neck – 38 (47.5%) patients; extensive contracting scars of the anterior thoracic surface – 16 (20%); combined constrictive scars of the anterior surface of the neck and thorax with deformity of the mammary gland – 8 (10.0%), and post-burn scars of the anterior thoracic surface, extending to the anterior surface of the shoulder joint – 18 (22.5%) patients. Surgical tactics depended on the severity and extent of the scarring process. Results: In the immediate postoperative period, 96.3% (77 cases) in patients noted primary healing implantation grafts and flaps engraftment. Complications noted in 3 (3.7%) cases in the form of marginal necrosis of the skin (2) and venous thrombosis of the vascular pedicle of the flap with necrosis of the graft. Long-term results studied in 75 (93.7%) patients in the period from 6 months to 16 years after the operation. Good results were noted in 67 (89.3%) patients, satisfactory – in 5 (6.6%), unsatisfactory – in 3 (4%) patients. Conclusion: Post-burn cicatricial deformities of the anterior surface of the neck and thorax are a complex and multifaceted problem in reconstructive and plastic surgery; in order to obtain optimal long-term results, the choice of the method of surgical treatment should be differentiated.
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