Background: Several techniques have been defined to be
used in surgical treatment of post burn contracted neck. But,
there were many problems with those techniques, like failure
of graft take and postoperative contracture of the graft. The
commonest problem in those techniques was distal flap necrosis
which is frequently seen. As most of these techniques were
based on random-pattern flaps and there is usually a poor
blood supply to the scar tissue. But, here in this study, we can
benefit from expansion in the distal part of the upper chest
and lower neck caused by continuous traction of the contracted
band which leads to expansion of the surrounding tissue with
excess skin.
Aim of the Study: In this study, we aim to shift the excess
tissue resulted from tissue expansion caused by traction of
the contracture band from the base of the neck and upper
chest to the upper neck by “double V-Y flaps" with direct
closure of the donor site.
Patients and Methods: 17 patients with post burn scarring
of the neck were included in this study. 11 females and 6
males with average age 20 (9-32) years old. 9 patients with
double linear contracture and 8 patients with band contracture.
Release of post burn scarring of the neck by “double V-Y
flaps" was done, the excess tissue of the flap was used and
direct closure of the donor site was done.
Results: The postoperative results represent the success
of this technique in the surgical treatment of post burn scar
contractures of the neck. All patients had an uneventful
postoperative period with no distal flap necrosis. There was
postoperative wound disruption in one patient that was managed
by secondary sutures. The post burn scarring was successfully
managed with this surgical technique “double V-Y
flaps", with no major postoperative complications. One year
follow-up period revealed no recurrence of the contracted
bands.
Conclusion: “Double V-Y flaps" is a good technique in
surgical treatment of post burn contracted neck with double
linear or band contracture lines. This technique offers the
patient a good chance for release of post burn contracted neck
with no need to use graft or to wear postoperative neck collar.