Postburn neck contracture reconstruction by interval skin grafting

Introduction: Delayed burn wound healing, due to lack of proper initial treatment, especially in deep partial-thickness and full-thickness burns leads to the formation of burn scar contracture. Because of the loose tissue in the anterior neck and also due to habitual and ignorant use of a pillow in burnt patients during the postburn recovery phase, contracture of the neck is a common sequela. Many reconstructive modalities have been described in the literature which include skin grafting, pedicle flap with or without expansion, and free flap. Keeping the esthetic concern in mind, we modified the method of contracture release and skin grafting into two stages. Materials and Methods: This is a prospective study conducted on 15 patients with extensive postburn contracture of the neck during the period ranging from January 2020 to August 2021. Results: In our study, 80% of the patients were females. The mean age was 25.9 years. The number of type 2 and type 3 neck contractures was 7 and 8, respectively. The mean duration of contracture was 8.26 months. Graft loss was the only complication seen and that too was < 10% in all cases (mean - 4.46). At 6 months, mandibular border and thyroid bulge were distinctly visible, and cervicomental angle was within the normal range (mean - 110.46) giving a youthful and appealing esthetic appearance. The mean of the Patient and Observer Scar Assessment Scale score was 2.06 for the observer component and 3 for the patient component. Conclusion: Interval skin grafting can be undertaken following postburn neck contracture release for better functional and esthetic outcomes.