Local Flap Reconstruction of Burn Contractures in Extremities and Neck: A Nine-Year Experience with Long-Term Outcome Evaluation in Southwestern Iran

World Journal of Plastic Surgery · 6 authors, 2 centres

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TL;DR

This retrospective cohort study evaluated local flap reconstruction for post-burn contractures in 243 patients, finding that techniques like Z-plasty significantly improved joint range of motion with high patient satisfaction and a low complication rate.

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This retrospective cohort study from a single burn center in Iran assessed the outcomes of local flap surgery for burn scar contractures in 243 patients over a nine-year period. The primary surgical techniques were Z-plasty and similar local flaps (70.4% of joints), sometimes combined with skin grafts (26.1%). The overall complication rate was 10.82%, with re-contracture occurring in 3.82% of cases and flap necrosis being rare. The findings support the use of simple local flaps like Z-plasty as a feasible, effective, and safe option for releasing post-burn contractures, particularly in resource-limited settings.

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cohort

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surgery

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ORIGINAL PAPER

PMC10732291

Local Flap Reconstruction of Burn Contractures in Extremities and Neck: A Nine-Year Experience with Long-Term Outcome Evaluation in Southwestern Iran

World Journal of Plastic Surgery

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ABSTRACT

Abstract Background: Treating burn scar contractures remains challenging for reconstructive surgeons; no clear guidelines declare the optimal and most effective technique. We evaluated the efficacy of local flaps in treating patients with post-burn contractures. Methods: This retrospective study included 243 patients with post-burn contractures referred to Taleghani Hospital (Khuzestan, southwest Iran) for local flap reconstruction from 2011 to 2020. Patients’ demographic data, detailed descriptions of scars, surgical procedures, and flap outcomes were assessed. A plastic surgeon conducted all surgical procedures, the goals of which were to release the scar and cover the defect. Joint range of motion (ROM) (according to goniometric measurements), complications, need for second-stage surgery, and patient satisfaction were assessed. Results: After scar release, 70.4% of joints were covered with a Z-plasty and similar local flaps, 26.1% with a Z-plasty plus skin grafts, and 3.5% with only skin grafts. The outcome after one year revealed a significant improvement in mean ROM (by 45.80% of the normal ROM; P < 0.001). The mean functional and aesthetic satisfaction scores were 9.45 and 7.61 out of 10, respectively. The complication rate was 10.82%: re-contracture occurred in 3.82%, flap tip necrosis in 1.27%, and partial flap necrosis in 0.31%. Conclusion: Simple local flaps such as the Z-plasty are safe and effective in covering the joint following post-burn contracture release. Due to the feasibility, minimal need for facilities, steep learning curve, acceptable functional and aesthetic outcomes, and low complication rate, we strongly recommend the Z-plasty for reconstructing burn contractures, particularly in LMICs. Key Words: Contracture, Burn, Z-plasty, Flap, Reconstruction

CITATION EXPORT

Shahram Jahanabadi, Alireza Bakhshaeekia, Roozbeh Rahbar et al.. Local Flap Reconstruction of Burn Contractures in Extremities and Neck: A Nine-Year Experience with Long-Term Outcome Evaluation in Southwestern Iran. World Journal of Plastic Surgery. (2023). https://doi.org/10.52547/wjps.12.2.47

AUTHORS

6 · 2 CENTRES

Shahram Jahanabadi, Alireza Bakhshaeekia, Roozbeh Rahbar, Abdoreza Sheikhi, Mahtab Farhadi, Seyedeh-Sara Hashemi

1Department of Plastic and Reconstructive Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, 71978-54361, Iran