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Burn Scar Contracture

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Huifeng Song – 1st expert on this subject based on the ideXlab platform

  • surgical treatment of severe or moderate axillary Burn Scar Contracture with transverse island scapular flap and expanded transverse island scapular flap in adult and pediatric patients a clinical experience of 15 cases
    Burns, 2015
    Co-Authors: Baoguo Chen, Minghuo Xu, Jiake Chai, Huifeng Song

    Abstract:

    Abstract Background Axillary Burn Scar Contracture is common and troublesome. With the aim of restoring the function of the upper extremities, a proper local flap with minor damage and preclusion from recurrence should be developed to guarantee satisfactory results. A minor webbed Scar Contracture was rectified by Z-plasty. However, severe or moderate Contracture must be constructed by a local flap. An island scapular flap has been used in pediatric patients for repairing axillary Contracture. However, no detailed description of the use of a transverse island scapular flap (TISF) was reported to correct the deformity. Moreover, an expanded transverse island scapular flap (ETISF) used for increasing the volume of skin for severe axillary Contracture in adults and developing children was also not presented. Methods From 2006 to 2013, TISFs were harvested for 12 pediatric patients (5–12 years of age) with 15 sides of severe or moderate axillary Burn Scar Contractures. Four ETISFs were designed for two adult patients (38 and 32 years of age). The flap size was between 10 cm × 5 cm and 20 cm × 10 cm. In one pediatric patient, a cicatrix was observed on the surface of the flap’s donor site. Handheld Doppler was applied to detect the pedicle. Results The patients were required to lift their upper arms regularly each day after the operation. All 19 flaps survived completely. Axillary Burn Scar Contractures were corrected successfully in 11 patients with no expander implantation. The lifting angle was enhanced considerably with 1–3 years of follow-up in the 11 patients. Only one pediatric patient with cicatrix on the donor site displayed tight skin on the back and a little restraint on the shoulder. The patient’s parents were told to intensify the chin-up movement on the horizontal bar. She was in the process of a 3-month follow-up. The lifting angle was also improved significantly in the latter three cases of expander implantation although they were followed up for a short duration of 3 months. Due to poor flap design, the donor site of one adult patient was not closed directly with the help of skin grafting on the left side of her back. Conclusions Considering the flap’s negligible level of later Contracture and minimal trauma, local TISF based on the transverse branch of the circumflex scapular artery is a good choice for reconstruction of axillary Burn Scar Contractures. If the TISF is not able to meet the demand, the expander implanted in advance can be more beneficial.

Yen Chang Hsiao – 2nd expert on this subject based on the ideXlab platform

  • chin projection creation in patients with facial and cervical Burn Scar Contracture
    Burns, 2013
    Co-Authors: Chun Yuan Huang, Jui Yung Yang, Yen Chang Hsiao

    Abstract:

    Abstract Background Loss of cervicomental angle is characteristic of severe facial and cervical Burned patients due to Scar Contracture. This micrognathia-like deformity is also seen in patients following chin and neck reconstruction using skin expanded flaps. The aim of modern plastic surgery is to restore a harmonious and symmetrical facial appearance for Burn survivors. Methods Six facial and cervical Burned patients with micrognathia-like deformity after neck reconstructions were reported. Chin augmentation with Medpor implant through submental approach was performed in 4 patients and intraoral access in 2 cases to restore their favorable chin projections. Five of them received cervicomental contour reconstruction simultaneously. Results Patient follow-up ranged from 12 to 18 months. No implants became exposed nor infected. All patients had satisfactory results. We reviewed our experience with the use of the Medpor implant in Burn chin reconstruction including preoperative and postoperative radiograph analysis. Conclusions With proper patient selection, pre-operative planning, and taking care of details during operation, augmentation genioplasty with Medpor implant offers a reliable, simple and satisfactory solution for improving micrognathia-like facial configurations in patients with Scar Contracture following severe Burns.

  • free medial thigh perforator flap for reconstruction of the dynamic and static complex Burn Scar Contracture
    Burns, 2010
    Co-Authors: Chung Ho Feng, Chun Yuan Huang, Jui Yung Yang, Shiow Shuh Chuang, Yen Chang Hsiao

    Abstract:

    Abstract Introduction Dynamic and static complex Scar Contractures after Burn commonly cause tendon adhesion, deep adipose tissue stiffness and further limitation of major joints motion. Skin autografting or locoregional flaps are not adequate reconstructive options, because of the easy recurrence and limitation of donor sites. Therefore, free perforator flaps are playing increasing role in reconstruction of complex Scar Contractures. Patients and methods The free medial thigh perforator (MTP) flap is an addition to the reconstructive armamentarium and is particularly useful since the medial thigh is commonly spared in Burn injury. Between December 2001 and October 2005, eight patients with severe post-Burn Scar Contractures received free MTP flaps treatment in the Linkou Burn Center. The free MTP flap harvest was modified to enhance its reliability and versatility. Flap sizes ranged from 5 × 15 cm to 8 × 24 cm. The follow-up period was from 12 to 26 months. Flap harvest is rapid, averaging 37.8 min. Results The significantly improved range of motion of the Contracture joints approximated to normal activity at 6–22-month follow-up ( p  Conclusion The free MTP flap with new modified harvest is a good choice for dynamic an static complex Scar Contractures of major joints, due to short harvesting time and few variations of the pedicle. However, thick skin paddle was considered in secondary hand reconstruction.

S Y Li – 3rd expert on this subject based on the ideXlab platform

  • superior extension of the parascapular free flap for cervical Burn Scar Contracture
    Plastic and Reconstructive Surgery, 1995
    Co-Authors: Jia Xu, Senkai Li, Yangqun Li, X B, S Y Li

    Abstract:

    A newly designed superior extension of the parascapular free flap and its free transfer clinically for the repair of 11 cases of cervical Burn Scar Contracture without any loss are presented. The flap sizes ranged from 16 X 7 cm to 32 X 11 cm. Based on the anatomic distribution of the circumflex scapular vessels, the flap in the scapular territory can be taken much longer and wider than before. There is less tension in this vertically oriented flap than in the horizontally oriented flap in obtaining primary closure. This method extends the application of the scapular territory as a donor site for free flaps. (Plast. Reconstr Surg. 96 : 58, 1995.)