Author(s): Faraz Ahmad Tarar,1 Farrukh Aslam Khalid,2 Abdul Malik Mujahid,3 ZainUlAbidin,4 Amin Yousaf,5 Moazzam Nazeer Tarar6
Received: 23/01/2020 | Published: 27/12/2020 | Pages: 6-9 |
To determine the frequency of successful application of Integra™ and split thickness skin graft in recurrent post-burn neck contracture. Methodology: After informed consent and approval from the ethical board, this descriptive case series was held at Jinnah burn and reconstructive surgery center, from 1st July 2019 to 31st June 2020. Non-probability consecutive sampling was employed and a sample size of 30 cases was included. After release of contracture and excision of scar tissue, Integra™ was applied topped by a silicone gel sheet. The wound was inspected every 3-5 days. A thin split-thickness skin graft was applied after 3 weeks to replace the silicone gel sheet. Patients were followed up for Integra™ and STSG take. Data was analyzed with SPSS 20. For quantitative variables, means and standard deviations were observed. Frequency& percentages were employed to assess qualitative variables. Chi-square test was used and a P-value of<0.05 was taken as significant. Results: The mean age of the patients was 34.51 ± 14.19 years (range 11-59). Out of 30 patients there were 13 (43.33%) male and 17 (57.6%) females. The mean duration of contracture among these patients was 595.42 + 177.31 days with the minimum duration being 225 days and the maximum 1003 days. Successful outcome in terms of complete vascularization at 3-weeks was observed in 28 (93.3%) of the cases, whereas unsuccessful outcome was detected in 2 (6.7%) of the patients. Conclusion: IntegraTM and STSG can be considered as a promising modality in post burn recurrent neck contracture management and reconstructive surgery with the significantly high success rate in terms of complete vascularization and graft take.
1. Saaiq M, Zaib S, Ahmad S. The menace of post-burn contractures: a developing country’s perspective. Ann March 2021 | Volume 09 | Issue 01 | Page 8 March 2021 | Burns Fire Disasters. 2012;25(3):152–58.
2. Goel A, Shrivastava P. Post-burn scars and scar contractures. Indian J Plast Surg. 2010; 43:63–71.
3. Makboul M, El-Oteify M. Classification of post-burn contracture neck. Indian J Burns. 2013; 21:50-4.
4. Mathur R, Jain PK, Chakotiya PS, Rathore P. Anaesthetic and airway management of a post-burn contracture neck patient with microstomia and distorted nasal anatomy. Indian J Anaesth. 2014; 58:210-3.
5. Cuadra A, Correa G, Roa R, Pineros JL, Norambuena H, Searle S, et al. Functional results of burned hands treated with Integra(R). J PlastReconstrAesthet Surg. 2012; 65(2):228–34.
6. Burke JF, Yannas IV, Quinby WC, Bondoe CC, Jung WK. Successful use of a physiologically acceptable artificial skin in the treatment of extensive burn injury.
Ann Surg 1981; 194: 413–28.
7. VanZuijlen PPM, Gardien KLM, Jaspers MEH, Bos EEJ, Baas DC, van Trier AJM, et al. Tissue engineering in burn scar reconstruction. Burns Trauma. 2015; 3:18.
8. Lohana P, Hassan S, Watson SB. Integra™ in burns reconstruction: our experience and report of an unusual immunological reaction. Ann Burns Fire Disasters. 2014; 27(1):17–21.
9. Seo DK, Kym D, Hur J. Management of neck contractures by single dermal substitutes and skin grafting in extensive burn patients. Ann Surg Treat Res 2014;
87(5): 253-259.
10. Fitton AR, Drew P, Dickson WA. The use of a bilaminate artificial skin substitute (Integra) in acute resurfacing of burns: an early experience. Br J Plast Surg 2001; 54(3):208-12.
11. Chalmers RL, Smock E, Geh JL. Experience of Integra in cancer reconstructive surgery. J Plast Reconstr Aesthet Surg 2010; 63: 2081–90.
12. Weigert R, Choughri H, Casoli V. Management of severe hand wounds with Integra(R) dermal regeneration template. J Hand Surg Eur. 2011;36(3):185–93
13. Komorowska-Timek E, Gabriel A, Bennet DC, Miles D, Garberoglio C, Cheng C, Gupta S. Artificial dermis as an alternative for coverage of complex scalp defects
following excision of malignant tumors. Plast Reconstr Surg 2005 Apr;115(4):1010-7.doi:10.1097/01.prs. 0000154210.60284.c6.PMID:
14. Faulhaber J, Felcht M, Teerling G, Klemke CD, Wagner C, Goerdt S, Koenen W. Long-term results after reconstruction of full-thickness scalp defects with
a dermal regeneration template. J Eur Acad Dermatol Venereol. 2010 May;24(5):572-7.doi: 10.1111/ j.1468 – 3083.2009.03473.x. Epub 2009 Nov 3.
15. Hunt JA, Moisidis I, Haertsch P. Initial experience of Integra in the treatment of post-burn anterior cervical neck contracture. Br J Plast Surg 2000; 53(Issue 8): 652-685.
All published material becomes the sole property of the Pakistan Journal of Plastic Surgery, copyrighted by the Pakistan Association of Plastic Surgeons (PAPS). By submitting an article or brief communication, all authors agree to these conditions.
During the submission process, all authors have required to complete a copyright transfer agreement, “Author Consent form” By completing the copyright transfer agreement, you are transferring copyright of figures, tables, videos, and the content of the manuscript to the Pakistan Association of Plastic Surgeons (PAPS).
If you do not wish to or cannot transfer copyright of some or all of your content, please contact the editorial office at pjpspakistan@gmail.com