Post-Burn Cervical Retraction: 2 Cases and a Survey of the Literature

Abstract

Burns are still a fairly frequent accident, affecting more children and women in our society. They generally lead to sometimes dramatic functional, aesthetic and psychological after-effects. Treatment in the acute phase, or at a later stage, conditions the patient's image. The neck, however, remains a high-risk area for the development of retractions, due to its anatomy. The skin is thin, the platysma directly subcutaneous, the hypodermis thin, and immobilization difficult. Once the flange has set in, it can be reconstructed using a variety of plastic and reconstructive surgery techniques, in conjunction with physiotherapy. However, the choice of treatment will depend on the quality and quantity of healthy skin tissue available in the neck. Skin grafting gives good results at a distance, when post-operative preventive measures are followed. Local plasty is a simple and effective solution for the treatment of simple localized bridges. Our work is a case study spread over a 2-year period from November 2021 to November 2023, which includes 2 cases of cervical sprains followed up in the plastic and reconstructive surgery and burns department of the Mohammed VI University Hospital in Tangier. Directed wound healing had been the initial treatment in both our patients, with good compliance in patient N2. Moderate and severe cervical sprains (according to Achauer's classification) were found in both our patients. In both patients, the flange had a functional impact, with limited neck extension and deformity of the cervico-chinese angle. Surgical treatment involved skin grafts in the 1st case, and local plasty in the second. Post-operative re-education remains a therapeutic pillar for obtaining satisfactory results.