OUTCOME OF TISSUE EXPANSION FOR RECONSTRUCTION OF POST-BURN SCARRING/CONTRACTURES OF HEAD AND NECK REGION
Main Article Content
Keywords
Tissue Expansion, Burn injury, Scar and Contractures, Burn injuries in Head and Neck Region, Limitations, Complications
Abstract
Purpose Of the Study: In the H&N region, the study investigates tissue expansion as a reconstructive approach to post-burn scarring and contractures. By assessing its efficacy, identifying potential issues, developing solutions, and boosting safety, it seeks to enhance the treatment of patients and burns reconstructive surgery outcomes. The study also offers evidence-based suggestions, clarifies the benefits and difficulties of tissue growth, and offers advice on therapeutic approaches.
Methodology: 22 patients between the ages of 8 and 55 participated in the head and neck reconstruction trial. The central neck, left face, lower jaw, neck, chest, and right side of the face were all afflicted. Infection, seroma, excruciating pain, and an open wound were all postoperative consequences. The investigation used a cross-sectional questionnaire design.
Results: The study revealed a varied patient population with an average age of 15 years and ages ranging from 8 to 55. 54.5% of the patients are male and come from Quetta. The part of the left face that sustains damage most commonly has scars that endure for two to forty years. Treatment for burn-related disorders is widely used to cure "Post-burn Contracture" and "Post-burn Scar." The majority of patients did not encounter problems, however, infection was the most frequent, occurring in 22.6% of cases. Seroma (9.1%), wound dehiscence (4.5%), and excruciating pain (4.5%) were among the other consequences. With 16 out of 22 cases being successful, the success percentage was 72.7%.
Conclusion: The current study concludes that tissue expansion, particularly in the H&N region, is a very beneficial strategy for post-burn regeneration with a very low complication rate. More research is needed to understand its advantages.
References
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6. Cuthbertson, D. J., Steele, T., Wilding, J. P., Halford, J. C., Harrold, J. A., Hamer, M., & Karpe, F. (2017). What have human experimental overfeeding studies taught us about adipose tissue expansion and susceptibility to obesity and metabolic complications? In International Journal of Obesity (Vol. 41, Issue 6, pp. 853–865). Nature Publishing Group.
https://doi.org/10.1038/ijo.2017.4
7. Duclert-Bompaire, M., Sallot, A., Lardy, H., & Le Touze, A. (2017). Tissue expansion in children: Indications and management of complications. A 10-year experience. Annales de Chirurgie Plastique Esthetique, 62(2), 146–155. https://doi.org/10.1016/j.anplas.2016.02.003
8. Dzonov, B., Daskalov, O., Noveski, L., Zhivadinovik, J., & Isjanovska, R. (2014). TISSUE EXPANSION IN LIMBS VS OTHER BODY REGIONS. CONTRIBUTIONS. Sec. Med. Sci., XXXV, 1.
9. Edward A. Bittner, Erik Shank, Lee Woodson, & Jeevendra Martyn. (2015). Acute and Perioperative Care of the Burn-injured Patient. Anesthesiology , 122, 448–464.
10. Evers, L. H., Bhavsar, D., & Mailänder, P. (2010). The biology of burn injury. In Experimental Dermatology (Vol. 19, Issue 9, pp. 777–783).
https://doi.org/10.1111/j.1600-0625.2010.01105.x
11. Farjo, B., Farjo, N., & Williams, G. (2015). Hair transplantation in burn scar alopecia. Scars, Burns & Healing, 1, 205951311560776. https://doi.org/10.1177/2059513115607764
12. Ferland-Caron, G., Kwan, P. O., & Tredget, E. E. (2023). Free Tissue Transfer in the Reconstruction of Neck Contractures after Burn Injury: A Case Series. European Burn Journal 2023, Vol. 4, Pages 248-258, 4(2), 248–258. https://doi.org/10.3390/EBJ4020022
13. GBD. (2010). Global Burden of Disease (GBD). https://www.healthdata.org/research-analysis/gbd
14. Golpanian, S., & Kassira, W. (2023). Full-Thickness Skin Grafts. Operative Dictations in Plastic and Reconstructive Surgery, 199–201. https://doi.org/10.1007/978-3-319-40631-2_48
15. Goverman, J., Mathews, K., Goldstein, R., Holavanahalli, R., Kowalske, K., Esselman, P., Gibran, N., Suman, O., Herndon, D., Ryan, C. M., & Schneider, J. C. (2017). Adult Contractures in Burn Injury: A Burn Model System National Database Study. Journal of Burn Care and Research, 38(1), e328–e336. https://doi.org/10.1097/BCR.0000000000000380
16. Guo, Y., Song, Y., Xiong, S., Wang, T., Liu, W., Yu, Z., & Ma, X. (2022). Mechanical Stretch Induced Skin Regeneration: Molecular and Cellular Mechanism in Skin Soft Tissue Expansion. In International Journal of Molecular Sciences (Vol. 23, Issue 17). MDPI.
https://doi.org/10.3390/ijms23179622
17. Gupta, S., Garg, S., & Dahiya, N. (2014). Surgical scar revision: An overview. Journal of Cutaneous and Aesthetic Surgery, 7(1), 3. https://doi.org/10.4103/0974-2077.129959
18. Handschel, J., Schultz, S., Depprich, R. A., Smeets, R., Sproll, C., Ommerborn, M. A., Naujoks, C., Kübler, N. R., & Zimmermann, A. (2013). Tissue expanders for soft tissue reconstruction in the head and neck area-requirements and limitations. Clinical Oral Investigations, 17(2), 573–578. https://doi.org/10.1007/s00784-012-0747-8
19. Hoogewerf, C. J., Van Baar, M. E., Hop, M. J., Bloemen, M. C. T., Middelkoop, E., & Nieuwenhuis, M. K. (2013). Burns to the head and neck: Epidemiology and predictors of surgery. Burns, 39(6), 1184–1192. https://doi.org/10.1016/J.BURNS.2013.03.006
20. Huang, X., Qu, X., & Li, Q. (2011). Risk factors for complications of tissue expansion: A 20-year systematic review and meta-analysis. Plastic and Reconstructive Surgery, 128(3), 787–797. https://doi.org/10.1097/PRS.0B013E3182221372
21. Jabir, S., Frew, Q., El-Muttardi, N., & Dziewulski, P. (2014). A systematic review of the applications of free tissue transfer in burns. In Burns (Vol. 40, Issue 6, pp. 1059–1070). Elsevier Ltd. https://doi.org/10.1016/j.burns.2014.01.008
22. Jeschke, M. G., van Baar, M. E., Choudhry, M. A., Chung, K. K., Gibran, N. S., & Logsetty, S. (2020). Burn injury. Nature Reviews Disease Primers, 6(1). https://doi.org/10.1038/s41572-020-0145-5
23. Johnson, T. M., Lowe, L., Brown, M. D., Sullivan, M. J., & Nelson, B. R. (2013). Histology and Physiology of Tissue Expansion.
24. Joseph, P., & Christopher, C. (2020). Skin Grafting - StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK532874/
25. Kim, H. S., Sun, X., Lee, J. H., Kim, H. W., Fu, X., & Leong, K. W. (2019). Advanced drug delivery systems and artificial skin grafts for skin wound healing. In Advanced Drug Delivery Reviews (Vol. 146, pp. 209–239). Elsevier B.V. https://doi.org/10.1016/j.addr.2018.12.014
26. Larrabee, W. F., & Bloom, D. C. (2007). Biomechanics of skin flaps. Local Flaps in Facial Reconstruction, 31–40. https://doi.org/10.1016/B978-0-323-03684-9.50008-6
27. Lotter, O., Held, M., Schiefer, J., Werner, O., Medved, F., Schaller, H. E., Rahmanian-Schwarz, A., Jaminet, P., & Rothenberger, J. (2015). Utilization of laser Doppler flowmetry and tissue spectrophotometry for burn depth assessment using a miniature swine model. Wound Repair and Regeneration, 23(1), 132–136. https://doi.org/10.1111/WRR.12246
28. Mo, J., Park, H. W., & Guan, K. (2014). The Hippo signaling pathway in stem cell biology and cancer. EMBO Reports, 15(6), 642–656. https://doi.org/10.15252/embr.201438638
29. Mody, N. B., Bankar, S. S., & Patil, A. (2014). Post Burn Contracture Neck: Clinical Profile and Management. Journal of Clinical and Diagnostic Research : JCDR, 8(10), NC12. https://doi.org/10.7860/JCDR/2014/10187.5004
30. Motamed, S., Niazi, F., Atarian, S., & Motamed, A. (2008). Post-burn head and neck reconstruction using tissue expanders. Burns, 34(6), 878–884.
https://doi.org/10.1016/j.burns.2007.11.018
31. Nelson, J. A., Shamsunder, M. G., Vorstenbosch, J., Polanco, T. O., Matros, E., Coriddi, M. R., Mehrara, B. J., Allen, R. J., Dayan, J. H., & Disa, J. J. (2022). Prepectoral and Subpectoral Tissue Expander-Based Breast Reconstruction: A Propensity-Matched Analysis of 90-Day Clinical and Health-Related Quality-of-Life Outcomes. Plastic and Reconstructive Surgery, 149(4), 607E-616E. https://doi.org/10.1097/PRS.0000000000008892
32. Nikkhah, D., & Bulstrode, N. W. (2022). Tissue Expansion. Plastic Surgery - Principles and Practice, 56–67. https://doi.org/10.1016/B978-0-323-65381-7.00006-X
33. Nikkhah, D., Yildirimer, L., & Bulstrode, N. W. (2015). Tissue expansion. Plastic and Reconstructive Surgery: Approaches and Techniques, 51–61.
https://doi.org/10.1002/9781118655412.CH6
34. Orgill, D. P., & Ogawa, R. (2013). Current methods of burn reconstruction. Plastic and Reconstructive Surgery, 131(5). https://doi.org/10.1097/PRS.0b013e31828e2138
35. P. Heidekrueger, P. N. Broer, & M. Ninkovic. (2015). LOP21: Optimizing Functional and Aesthetic Outcomes in Post-Burn Head and Neck Reconstruction. Klinikum Bogenhausen, Plastic Surgery, Munich, Germany, 136(2).
36. Radwan, A. M., & Zide, M. F. (2019). Tissue Expansion in the Head and Neck. In Atlas of the Oral and Maxillofacial Surgery Clinics of North America (Vol. 27, Issue 2, pp. 167–173). W.B. Saunders. https://doi.org/10.1016/j.cxom.2019.05.010
37. Rex, S. (2012). Burn injuries. In Current Opinion in Critical Care (Vol. 18, Issue 6, pp. 671–676). https://doi.org/10.1097/MCC.0b013e328359fd6e
38. Reza, M., Yamin, A., Mozafari, N., Mozafari, M., & Razi, Z. (2015). Reconstructive Surgery of Extensive Face and Neck Burn Scars Using Tissue Expanders. World Journal of Plastic Surgery, 4(1), 40. /pmc/articles/PMC4298864/
39. Rojas-Rodriguez, R., Lifshitz, L. M., Bellve, K. D., Min, S. Y., Pires, J., Leung, K., Boeras, C., Sert, A., Draper, J. T., Corvera, S., & Moore Simas, T. A. (2015). Human adipose tissue expansion in pregnancy is impaired in gestational diabetes mellitus. Diabetologia, 58(9), 2106–2114. https://doi.org/10.1007/S00125-015-3662-0/FIGURES/4
40. Serrano, C., Boloix-Tortosa, R., Gómez-Cía, T., & Acha, B. (2015). Features identification for automatic burn classification. Burns, 41(8), 1883–1890.
https://doi.org/10.1016/J.BURNS.2015.05.011
41. Seth, A. K., Friedstat, J. S., Orgill, D. P., Pribaz, J. J., & Halvorson, E. G. (2017). Microsurgical Burn Reconstruction. In Clinics in Plastic Surgery (Vol. 44, Issue 4, pp. 823–832). W.B. Saunders. https://doi.org/10.1016/j.cps.2017.05.014
42. Sethi, R. K. V., Kozin, E. D., Fagenholz, P. J., Lee, D. J., Shrime, M. G., & Gray, S. T. (2014). Epidemiological Survey of Head and Neck Injuries and Trauma in the United States. Http://Dx.Doi.Org/10.1177/0194599814546112, 151(5), 776–784.
https://doi.org/10.1177/0194599814546112
43. Shin, J. Y., & Yi, H. S. (2016). Diagnostic accuracy of laser Doppler imaging in burn depth assessment: Systematic review and meta-analysis. Burns, 42(7), 1369–1376.
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Published
Sep 30, 2023
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How to Cite
Nusrat, Babar Sultan Khaghan, Shafaatullah, Syed Aamer Hussain, Ejaz Ahmed, & Maryum Riaz. (2023). OUTCOME OF TISSUE EXPANSION FOR RECONSTRUCTION OF POST-BURN SCARRING/CONTRACTURES OF HEAD AND NECK REGION. Journal of Population Therapeutics and Clinical Pharmacology, 30(17), 2319-2330. https://doi.org/10.53555/jptcp.v30i17.2973
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Author Biographies
Nusrat
1Plastic surgeon at Bolan Medical Hospital Quetta Pakistan
Babar Sultan Khaghan
Associate Professor General Surgery Ayub Teaching Hospital Abbottabad
Shafaatullah
Associate Professor of Plastic Surgery Department of Surgery and Allied Baqai Medical University, Karachi
Syed Aamer Hussain
Specialist Registrar General Surgery Ayub Teaching Hospital Abbottabad
Ejaz Ahmed
Assistant Professor otorhinolaryngology (ENT) Mohtarma Benazir Bhutto Shaheed Medical College Mirpur AJK
Maryum Riaz
Resident General Surgeon, Ayub Teaching Hospital Abbottabad.
How to Cite
Nusrat, Babar Sultan Khaghan, Shafaatullah, Syed Aamer Hussain, Ejaz Ahmed, & Maryum Riaz. (2023). OUTCOME OF TISSUE EXPANSION FOR RECONSTRUCTION OF POST-BURN SCARRING/CONTRACTURES OF HEAD AND NECK REGION. Journal of Population Therapeutics and Clinical Pharmacology, 30(17), 2319-2330. https://doi.org/10.53555/jptcp.v30i17.2973