OPTIMIZATION OF SURGICAL TREATMENT OF POST-BURNING TIGHTENING SCARS OF FRONT SURFACE OF THE NECK AND THE CHEST
1Khatlon State Medical University, Dangara, Tajikistan
2Department of Surgical Diseases № 2, Avicenna Tajik State Medical University, Dushanbe, Tajikistan
3Department of Reconstructive and Plastic Microsurgery, Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Tajikistan
Objective: Evaluation the results of surgical treatment of post-burn cicatricial deformities and contractures of the front surface of the neck and thorax.
Methods: The results of surgical treatment of 80 patients with post-burn scars on the anterior surface of the neck and thorax analyzed. The age of the patients ranged from four to 40 years and averaged 19.2±6.5 years. There were 13 men (16.3%) and 67 women (83.7%). Patients arrived at the time from 1 year to 36 years after receiving the burn. Four clinical groups identified: isolated constrictive scars of the anterior surface of the neck – 38 (47.5%) patients; extensive contracting scars of the anterior thoracic surface – 16 (20%); combined constrictive scars of the anterior surface of the neck and thorax with deformity of the mammary gland – 8 (10.0%), and post-burn scars of the anterior thoracic surface, extending to the anterior surface of the shoulder joint – 18 (22.5%) patients. Surgical tactics depended on the severity and extent of the scarring process.
Results: In the immediate postoperative period, 96.3% (77 cases) in patients noted primary healing implantation grafts and flaps engraftment. Complications noted in 3 (3.7%) cases in the form of marginal necrosis of the skin (2) and venous thrombosis of the vascular pedicle of the flap with necrosis of the graft. Long-term results studied in 75 (93.7%) patients in the period from 6 months to 16 years after the operation. Good results were noted in 67 (89.3%) patients, satisfactory – in 5 (6.6%), unsatisfactory – in 3 (4%) patients.
Conclusions: Post-burn cicatricial deformities of the anterior surface of the neck and thorax are a complex and multifaceted problem in reconstructive and plastic surgery; in order to obtain optimal long-term results, the choice of the method of surgical treatment should be differentiated.
Keywords: Burn, scars, post-burn tightening scars on neck and thorax, pedicled parascapular flap.
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Kurbanov Ubaidullo Abduloevich, Corresponding Member of AS RT, Doctor of Medical Sciences, Full Professor, Rector of Khatlon State Medical University
Saidov Iskandar Saidzhafarovich, Full-time Postgraduate Student of the Department of Surgical Diseases № 2, Avicenna Tajik State Medical University
Davlatov Abdumalik Abdulkhakovich, Candidate of Medical Sciences, Head of the Department of Reconstructive and Plastic Microsurgery of the Republican Scientific Center for Cardiovascular Surgery
Dzhanobilova Sitora Murodilloevna, Candidate of Medical Sciences, Attending Physician of the Department of Reconstructive and Plastic Microsurgery of the Republican Scientific Center for Cardiovascular Surgery
Address for correspondence:
Saidov Iskandar Saidzhafarovich
Full-time Post-graduate Student of the Surgical Diseases № 2, Avicenna Tajik State Medical University
734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139
Tel.: (+992) 918 273398