Results of head and neck burn reconstructive plastic surgery

Abstract

Aim. The present research aimed to analyze the results of all reconstruction types (microsurgical and axial flaps) in head and neck post-burn cicatricial defects. Methods. The study included 114 patients who underwent flaps autotransplantation with microvascular anastomoses, options for plasty with axial flaps on a preserved (natural) vascular pedicle, plasty with displaced flaps, and free skin plasty for the period from 1995 to 2021. According to the formed groups for comparative analysis, all patients were divided into a comparison group included of 51 patients (1995-2008 year) and the main group with 63 patients (2009-2021 year). Women predominated with 55.6% and 58.8% in the main and comparison groups, respectively. Medium defects (50-120 cm²) of the upper face and neck area prevailed in equal numbers (11.8%). Most of the patients had a median-lateral unilateral post-burn cicatricial deformity. In terms of functional impairments, grade I up to an angle of 90º and degree II up to an angle of 45º was prevailed. Results. The consolidated long-term results of plastic surgery in the functional value were good in the main group in 69.9% of cases, while in the comparison group it was in 47.1%. The aesthetic indicators of the consolidated long-term results of plastic surgery were good in 57.5% of cases of the main group and significantly was lower in the comparison group (33.3% of cases). Unsatisfactory results were observed in 1.4% of cases in the main group and 17.6% in the comparison group. Conclusion. Improvement in head and neck burn reconstructive plastic surgery with various variants of axial flaps made it possible to increase the proportion of uncomplicated postoperative course, shorten the hospital stay and the total duration of all stages of plasty, and, in general, ensured a decrease in the frequency of unsatisfactory functional and aesthetic results.