Comparison And Evaluation On The Application Of Expanded Flap And Skin Graft Treatments For Severe Scar Contracture Of The Neck

Objective:The surgical skin grafting method and the method of expansion devices caused by scar contracture of neck and chin to chest adhesions in the postoperative short, long-term follow-up effects of contrast and change in Cervico-Mandibular Angle from the chin of a comprehensive assessment of the merits of the two procedures.Method:Bureau since January 2005 to December 2008 period,67 patients were treated neck scar contracture after burn patients met the inclusion criteria to choose the expansion device and the case of the 20 cases of skin grafting methods, are grouped. Up for 3 years. Scar area:minimum 5cm×5cm, the maximum 10cm×9cm. Time observed in patients with Cervico-Mandibular Angle and the skin graft contracture.Main steps:Two groups of patients were taken before surgery anteroposterior, lateral, 45°, looking up bits were photographed and measured scar size, measured in patients with normal head-neck position and record the angle from the chin.Short-term and long-term effect:a suture removal 2 weeks after surgery,1 month,3 months,6 months,1 year,,2,3-year term and long-term skin graft as the effect of the observation period, according to assessed the following indicators:①Contracture:Fix and flap skin graft after scar contracture rate (the greater the area change, the greater the contracture rate);②Appearance:head-neck position angle from the chin (the appearance of patients); repair the skin's color, texture, etc.③unctions:looking up the neck position angle of the chin angle (function of patients);④Short-term and long-term postoperative satisfaction with personal circumstances (including duration of treatment; patients the thickness of the skin texture repair, flexibility, color, conditions of satisfaction; the complications.)Results:The patients were followed for 36 months, most patients with skin of color restoration, good texture, repairing effect is satisfactory. Beginning 6 months after carotid graft approach angle of head-chin and looked up at bit position angle method to be significantly greater than the dilator group. Skin graft contracture graft group was significantly greater than the expanded flap group also. Pippi Long-term follow-chip group of plants patient satisfaction is lower than the expanded flap group.Conclusion:Application expansion flap and skin graft treatment of severe neck scar adhesions, in the long term to maintain the appearance and function of the neck angle on the chin flap is superior to plant expansion Pippi film method. Contracture in the short term and long-term resistance, the expanded skin flap group was stronger than plant Pippi film group.Functional exercise after the application of a fixed cervical care long-term effects on patients is helpful.