Correction of Postburn Neck Scar Contracture Using Thick Split Thickness Skin Graft

ABSTRACT

Hypertrophic scar contracture is an unfavorable and critical phenomenon in deep second or more serious degree burn patients, particularly when these hypertrophic scar contractures involve face, neck, upper extremities, lower extremities and perineal area. In the neck, preservation of contour of cervicomental angle and good range of motion is important in deeply burned patients. Traditionally cutaneous free flap or full thickness skin graft were used to restore this skin defects after release of scar contracture. Using one large piece of thick skin graft for covering the defect of neck is important key point. We applied thick split thickness skin graft instead of full thickness skin graft or free flap treating these patients who had hypertrophic scar contracture of neck. We experienced 12 patients of hypertrophic scar contracture of neck treated with thick split thickness skin graft of 30/1,000 inch in thickness. All patient were followed up for one year and evaluated for ROM(Range of motion) by means of A.M.A.(American Medical Association) method. All patients restored the ROM near to normal after one year. In conclusion, thick split thickness skin graft can be easily harvested from thick thigh and allows patients to restore good range of motion of neck and contour.