A comprehensive reconstruction strategy for moderate to severe faciocervical scar contractures
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ORIGINAL ARTICLE
A comprehensive reconstruction strategy for moderate to severe faciocervical scar contractures Jue Wang 1
&
Jiang Wu 1 & Minghuo Xu 1 & Quanwen Gao 1 & Baoguo Chen 1 & Fang Wang 1 & Hao Niu 2 & Huifeng Song 1
Received: 31 July 2020 / Accepted: 27 October 2020 # Springer-Verlag London Ltd., part of Springer Nature 2020
Abstract The focus of treatment of faciocervical scar contractures includes cervical reconstruction and elimination of hypertrophic scars. Unfortunately, most previous studies have neglected the esthetic appearance of scars. In this study, we tried to combine surgical therapy and ultrapulse fractional CO2 laser (UFCL) to eliminate facial scars while restoring neck reconstruction and to establish the optimal conventional management for faciocervical contracture. Thirty-eight individuals were enrolled and divided into two groups. After received cervical release surgeries, comprehensive UFCL therapy group received treatment of UFCL at 3-month intervals, silicone sheets, and pressure garments, while another group only received treatment of silicone sheeting and compression. Twelve months after the termination of therapy, faciocervical scars of both two groups were assessed by two uninvolved physicians according to the Vancouver Scar Scale (VSS), and patients’ satisfaction survey was also recorded by the study participants using a patient four-point satisfaction scale. Thirty-six patients completed the treatment and follow-up. The results show that the VSS scores of both two groups decreased after 12 months, but comprehensive UFCL therapy group dropped more significantly than the conventional treatment group at follow-up session, which was statistically significant (P < 0.001), and the patient satisfaction was higher than that of the conventional treatment group. This comprehensive treatment combined of surgery, UFCL, silicone sheets, and pressure garments works as an effective and esthetic reconstruction for moderate to severe postburn faciocervical scar contractures. Keywords Faciocervical scar contracture . Comprehensive reconstruction . Laser . Surgery . Vancouver Scar Scale
Introduction As face and neck is the most important regional esthetic units of human body, all the management of faciocervical scar contractures are designed to achieve optimal esthetic reconstruction. In addition to skin grafting, the supraclavicular island flap (SIF), the transverse cervical artery perforator flap (TCAP), and other surgical methods obtained satisfactory results by transferring similar adjacent tissue [1–3]. However, the disadvantages are also obvious: (1) the traditional surgical methods only solved the cervical contractures and restored the
* Huifeng Song [email protected] 1
Department of Burn and Plastic Surgery, Fourth Center of Chinese People’s Liberation Army General Hospital, 51# Fucheng Road, Haidian District, Beijing 100048, China
2
Department of Burn Surgery, PLA Army 32122, Zhifu District, Yantai 264000, Shandong, China
normal physiological function of the neck, but di
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