Postburn neck anterior contracture treatment in children with scar-fascial local trapezoid flaps: a new approach.

One of the dramatic consequences of burns is scar contracture and deformities of the neck. Cervical contracture in children is especially dangerous, leading to face disfigurement and kyphosis; therefore, early reconstruction is indicated. Despite the existence of many various surgical techniques, the successful neck contracture treatment in pediatric patients remains a challenge for surgeons.

Postburn Neck Lateral Contracture Anatomy and Treatment: A New Approach.

Lateral contracture of the neck is a rare and insufficiently researched burn consequent. Contracture restricts head motion, can cause a secondary face deformity, presents severe cosmetic defects, and, therefore, requires surgical reconstruction. Literature does not sufficiently address the issue; therefore, anatomy not researched and treatment techniques not developed.

Total cheek resurfacing with split ascending neck flap: a new approach.

Background: Burn scars and other forms of extensive cheek deformities are a tragedy for patients and pose a great challenge to surgeons due to limited availability of well-matching donor sites. The skin of distant regions and skin transplants contrasts with the facial skin. The most suitable site for tissue in cheek reconstruction is the neck, but this resource is limited.

Proximally based sural adipose-cutaneous/scar flap in elimination of ulcerous scar soft-tissue defect over the achilles tendon and posterior heel region: a new approach.

Scar ulcers that spread over the Achilles tendon and posterior heel disturb patients by causing pain, impeding hygiene, and creating difficulty in finding appropriate shoe wear. As this region undergoes pressure, effective reconstruction is based on the flap use. The most popular flaps currently used are distally based sural fasciocutaneous flap, calcaneal artery skin flap, and free flaps.

Shoulder adduction contracture after burn: anatomy and treatment with quadrangular local scar subcutaneous pedicled flap, a new approach.

Background: Axillary adduction contracture is caused by scars that tightly surround the shoulder joint impairing the function of the upper limb. Due to severe scar surface deficiency, contracture release presents a challenge for surgeons since a method of release is transfer of tissue in the form of a large pedicled or free flap(s). Thus, development of simpler, less traumatic techniques, using local tissues, persists.

Postburn shoulder medial-adduction contracture: anatomy and treatment with trapeze-flap plasty.

Background: Shoulder-adduction contractures after burn, most frequent among big joints, cause functional deficiency of the upper limb and, therefore, benefits from surgical correction. Many reconstructive techniques and flaps have been suggested for contracture treatment, but the problem in choosing an adequate reconstructive technique based on the anatomy of the contracture remains. Shoulder-adduction contracture has been given less emphasis in research than any other type and its surgical reconstructive technique remains of concern.

Ankle dorsiflexion postburn scar contractures: anatomy and reconstructive techniques.

Background: Postburn ankle scar contractures cause functional limitations of all lower extremities and create a serious cosmetic defect, not allowing patients to use normal foot wear, and, therefore, needing surgical reconstruction. The anatomic features of ankle dorsiflexion contractures and their treatment have been covered in the literature far less than other joint contractures, and their treatment is still a challenge for many surgeons. A common treatment method is incisional release of the contracture and defect resurfacing with skin graft.

Postburn edge shoulder adduction contracture: anatomy and elimination with trapeze-flap plasty--a new approach.

Postburn scar shoulder adduction contracture is the most common among big joints' contractures. As the contracture impedes all upper limb function, surgical reconstruction is indicated as early as the contracture is formed. Many flaps and techniques have been suggested, yet the problem is not resolved completely.

Burned unilateral half-cheek resurfacing techniques.

Postburn cheek deformities are a tragedy for patients and pose a great challenge to surgeons due to a limited number of well-matching donor sites. In cases of unilateral half-cheek deformity, the flap's skin should match the contralateral cheek and the residual skin of the deformed cheek. The skin of a distant flap does not match the facial skin and resembles a patch.

Unilateral cervical burn scar deformity elimination with contralateral cervicothoracic flap--a new approach.

Unilateral postburn cervical deformity is a severe cosmetic and functional defect and a challenging reconstructive problem. Many flaps have been suggested; however, after surgery, operational scars, located along the anterior neck's middle line, and the flap's skin differ from cervical healthy skin. A small flap resembles a patch.

The elimination of postburn nasal contracture in children with trapeze-flap plasty.

One consequence of a facial burn is nasal contracture. In pediatric patients, scar tension presents a particular problem because of facial growth. The forehead and nasal scar contraction deform the nose dorsum, especially between the eyes.

Post-burn microstomia: anatomy and elimination with trapeze-flap plasty.

Perioral contractures after burn (microstomia) is a common consequence of facial burns. A small oral opening creates a problem for oral hygiene, food intake and intubation. Therefore, contracture treatment is beneficial once severe limitation of function is realised.

Trapezoid adipose scar local flap: postburn lateral truncal contracture elimination with trapeze-flap plasty.

Trunk burns result in various complications, deformities, and contractures. Contracture of the lateral surface of the trunk is one of the serious complications that limits movements of the spine; children experience structural changes in the form of scoliosis. Therefore, the lateral truncal contracture should be the subject of early surgical treatment.

First web space post-burn contracture types: contracture elimination methods.

First web space adduction contractures are a common consequence of hand burns. Many reconstructive techniques are used and investigation for more effective methods continues. Effective hand reconstruction usually considers anatomy as its foundation.

Postburn perineal obliteration: elimination of perineal, inguinal, and perianal contractures with the groin flap.

Deep burns of the perineum result in perineal obliteration, hip adduction contracture, and limitation of hip range of motion. Bodily hygiene becomes difficult to maintain. Perineal obliteration is often combined with inguinal and perianal contractures and genitalia injury.

Postburn hand border contractures and eliminating them with trapeze-flap plasty.

The hand burns can be complicated with the scar contracture of the ulnar or radial hand border. The contracture restricts the mobility of adjacent joints (fifth interphalangeal, wrist joints), causing deviation of the small finger and the whole hand. The contracture and deviation are caused by semilunar fold sheets of which are scars (medial contracture).

Post-burn philtrum restoration.

One of the consequences of face burn is upper lip deformation with philtrum injury. The philtrum's absence poses severe cosmetic defects. A literature review shows no effective developed technique which allows the surgeon to restore the upper lip and the philtrum in a single-stage procedure.

Trapeze-flap plasty: effective method for postburn neck contracture elimination.

The new method for postburn neck contracture management is presented. The method is found to be most effective when using the local flap procedures on patients who cannot undergo complex and long surgical procedures that are aimed at both contracture elimination and neck skin restoration (children, elderly patients, patients with inadequate donor sites, and patients with cosmetically acceptable scar appearance). The method consists of the opposite transposition of trapezoid scar-fascial flaps which are prepared one on each antero-lateral neck surface.

Burned perineum reconstruction: a new approach.

The treatment of postburn contractures of perineum remains a complex and an unsolved problem. Fourteen patients were operated. According to our observations, the perineum contracture can have two formations: (a) transverse scar folds formed between both the thighs and (b) obliteration of perineum by scar tissues.

Restoration of the shape, location and skin of the severe burn-damaged breast.

Thermal injuries to the anterior chest in pre-pubescent girls result in breast contracture. During puberty, the breast parenchyma develops and grows underneath the scars, resulting in being flattened and disfigured. The breast mound, as well as the nipple-areolar complex, is partially or completely levelled out and displaced.

The post-burn elbow medial flexion scar contracture treatment with trapeze-flap plasty.

A medial flexion elbow contracture is characterized by the presence of a fold which has a semi-lunar shape, the sheets of which are scars. The shortage in skin length and the excess in width occurs in the sheets. To estimate the size and form of length deficiency in the fold is the section from the top of the fold to the rotation axis of the joint.