Supraclavicular artery flap "its weightage in reconstructing burn neck contracture"

ABSTRACT

Flexion contractures of neck are a common sequel of deep burns. Severity varies from discrete linear bands to severe labiomentosternal contractures leading to functional and cosmetic impairment. Use of local flaps can produce best restoration of form and function. This study was meant to analyze clinical utility, advantages and any complications specific to islanded supraclavicular artery flap. This was a descriptive study carried out at department of plastic and reconstructive surgery Mayo hospital Lahore between January 2005 and November 2006. Ten patients presenting with neck contractures with out evidence of trauma in supraclavicular fossae, shoulder and deltoid region were included in the study. History and physical examination details including extent of contracture and cosmetic impairment were endorsed. Essential preoperative workup was done accordingly including assessment by anesthetist. Ten patients with varying severity of neck contractures were included in the study. Age range was 15-35 years. Average hospital stay was 10 days. Five patients had severe labiomentosternal contractures. Eight patients reported neck wound appearing excellent at 6 months postoperatively. In contrast donor area appearance was reported satisfactory by 7 and poor by 3 patients at 6 months. Functional consequences were most with 6 patients having full range of motion [ROM] and 4 patients having limited but satisfactory ROM. There is no reported recurrence so far. Supraclavicular artery based islanded fasciocutaneous flap is a reliable reconstructive tool ideally suited to cover defects in the region of neck to restore form and function