The neck burn scar contracture:a concept of effective treatment
颈部烧伤疤痕挛缩:一种有效治疗的概念作者机构:Department of Plastic Surgery Wound Repair and Regeneration School of Medicine Fukuoka University 7-45-1 Nanakuma Jonan ku Fukuoka 8140180 Japan Section of Plastic Surgery School of Medicine Shimane University Shimane Japan Department of Plastic Surgery School of Medicine Fukuoka University Fukuoka Japan
出 版 物:《Burns & Trauma》 (烧伤与创伤(英文))
年 卷 期:2017年第5卷第3期
页 面:140-147页
核心收录:
学科分类:1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题:Neck scar contracture Anatomical locations Prophylaxis Severe scar contracture Thin groin flap Radiation injury Adipose-derived stem cell
摘 要:A neck scar contracture can severely and negatively affect the function of mastication, phonic, or breathing and result in neck pain and issues with esthetics. The best way is of course to avoid such contracture by means of non-surgical treatment such as use of a growth factor. The basic fibroblastic growth factor is clinically well proven in decreasing scar formation and improving healing. There are numerous reconstructive methods for neck contracture, especially when the lesions are relatively limited in part of the neck. However, a very severe and full circumferential scar contracture requires extensive reconstruction. The thin groin flap is one of the answers and well matches with the tissue texture and maintains the flexibility. Even with extensive burns and delayed reconstructions due to resuscitation first, the groin area is well preserved and can be safely harvested by dual vasculature systems of the superficial circumflex iliac artery and superficial epigastric artery, which warrant more reliability compared to the perforator flaps in this area. More demanding and stringent forms of the neck burn scar contracture are the sequelae of radiation. A radiation burn or radiation injury can be progressing and hard to heal. Adipose-derived stem cells can reverse the scar contracture as the surrounding tissue is softened and can accelerate wound healing. In this review, different types of neck burn scar contracture and reconstructive methods are summarized, including innovative use of bFGF and ADSCs in the management of difficult wound healing and scar contracture.