ABSTRACT
OBJECTIVES: The use of thin skin flaps in the reconstruction of postburn cervical contractures associated with functional impacts. MATERIAL AND METHODS: We conducted a descriptive observational study on about five patients who had reconstruction of postburn cervical contractures using various thin skin flaps in a plastic surgery department. The follow-up period was ranged from 12 to 18 months. We determined the characteristics of the retraction according to the Vandenbussche classification, the indications of the flaps, and the functional and aesthetic results. RESULTS: Most of our patients were young adults presenting segmental retraction of the neck associated with moderate functional impact. The occipito-cervico-dorsal flap was used in three cases. The occipito-cervico-shoulder flap was used in two cases. The aesthetic and functional results were satisfactory for all patients, but a "neck-collar" aspect of the cervical-chin angle was noticed. CONCLUSION: Postburn cervical contractures remain frequent. Their reconstruction is a difficult process as it is ideally done with a skin similar to the original one. The use of thin skin flaps seems to be an excellent option.
ABSTRACT
INTRODUCTION: Burns are among the most frequent injuries in children. They are a major cause of morbidity and mortality in low- and middle-income countries. This study aimed to describe the epidemiological aspects of burns in this environment and to propose preventive measures. PATIENTS AND METHODS: A retrospective study was conducted between 1 January 2012 and 31 December 2013. It included children less than 16 years old who were hospitalized for burn injuries in our department. We adopted the hospitalization criteria proposed by the French Society for the Study and Treatment of Burns. The data were collected from medical records and concerned both patients and burn characteristics. RESULTS: We recorded 67 cases, with 44.7% under 4 years old and boys (61%) more involved than girls (39%). The incidence of burns peaked in winter (31%) and summer (27%). Burns occurred at home in 95% of the cases. Hot liquids were the leading cause of children's burns. The time lapse between the accident and admission to the hospital was less than 24h in 57% of the cases. The average total body surface area (TBSA) burned was 8.8%. Only five patients presented a TBSA≥20%. The depth of the burns was superficial second-degree burns in 59% of cases. The burn involved mainly the upper limbs (65%). The average length of the hospital stay was 20.5 days. Only one patient died from severe sepsis. CONCLUSION: The lack of specialized burn centers in Tunisia associated with the low socioeconomic level of our population worsened the outcome of pediatric burns. The best solution lies in prevention.
