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Piotr Wójcicki and Dariusz Rychlik

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

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.