Surgical Outcomes in Post-Burn Neck Contractures: A Prospective Study of 20 Patients in Ahmedabad

Introduction: Post-burn neck contracture is a common and disabling sequela of thermal injury, particularly in developing countries. The anterior cervical region is prone to severe contracture due to its thin skin, flexor surface, and constant mobility. This study aimed to evaluate the clinical presentation, surgical management, and functional outcome of post-burn neck contracture using objective measurement of the cervicomental angle.

Methods: This prospective clinical study included 20 patients with established post burn neck contracture treated at a tertiary care center. Contractures were classified according to the Achauer classification. Preoperative and postoperative cervicomental angles were measured using a goniometer. Surgical procedures included excisional or incisional release followed by split-thickness skin grafting, multiple Z plasty, or supraclavicular flap reconstruction. Patients were followed up for 3 months. The primary outcome was improvement in the cervicomental angle. Secondary outcomes included graft take, hypertrophy, recurrence, and aesthetic contour.

Results: The mean age was 31.9 years, with female predominance (65%). Thermal burns were the leading cause (65%). Split-thickness skin grafting was performed in 65% of cases, Z-plasty in 20%, and supraclavicular flap in 15%. Functional and cosmetic outcomes were satisfactory in 86.4% patients. Complications occurred mainly in the graft group, including partial graft loss (30%), hypertrophic scarring (20%), and recurrence (15%). Flap reconstruction showed better aesthetic outcome and lower recurrence.

Conclusion: Surgical release with appropriate resurfacing significantly improves neck function and contour. Flap reconstruction provides superior outcomes with lower recurrence compared to skin grafting.