Surgical Correction for Severe Post-Burn Neck Contractures
Deep burn injuries of the anterior neck frequently heal with severe, rigid hypertrophic scar contractures that physically tether the chin to the sternum. This disabling deformity obliterates the cervicomental angle, pulls the lower lip and mouth downward (ectropion of the lower lip with chronic drooling), severely restricts head rotation and extension, and creates a difficult airway that makes conventional endotracheal intubation life-threatening.
Reconstructive Approach to Neck Contracture Release
Reconstructive plastic surgery aims to completely liberate neck movement and recreate natural cervical aesthetics:
- Airway Management Safety: Accomplished via awake fiberoptic intubation or tumescent local scar release prior to tube placement, ensuring airway security at all times.
- Radical Transverse Release: Incising the scar band completely from one trapezius margin across to the other, releasing fibrotic platysma muscle bands until full hyperextension of the neck is restored on the operating table.
- Durable Resurfacing: Resurfacing the released defect with thick, unmeshed Full-Thickness Skin Grafts (FTSG) harvested from the abdomen/groin, or transposing a thin supraclavicular artery island flap to prevent secondary graft contraction.
Postoperative Splinting and Cervical Therapy
Following surgical release, customized rigid cervical orthoses (neck collars) and targeted neck physical therapy prevent re-contracture and maintain an attractive, sharp jawline-to-neck transition.