title: Management of neck contractures by single-stage dermal substitutes and skin grafting in extensive burn patients.
abstract: OBJECTIVE
  Severe neck contracture is a problem that must be resolved by priority. We consider the best contracture treatment to be the full-thickness skin graft. However, clinicians often encounter patients, especially extensive burn patients, who have insufficient donor sites for the full-thickness skin graft. We treated extensive burn patients with neck scar contractures with a split-thickness skin graft (STSG) combined with dermal substitutes. The purpose of this study was to evaluate clinical outcomes of neck contracture treatment in extensive burn patients performing STSG with dermal substitutes as adjuvant treatment.
  
  
  METHODS
  We analyzed the retrospective clinical and photographic records of 28 patients with severe neck contracture who were admitted to Hallym University Hangang Sacred Heart Hospital, Seoul, Korea, from January 2012 to December 2012. We performed STSG in combination with dermal substitutes to minimize the degree of contracture.
  
  
  RESULTS
  The overall take rate of skin to dermal substitutes was 95.9%, and no grafts failed to affect recontracture except in one patient with a partial loss of artificial dermis who underwent a follow-up skin graft without any problems. Excellent/good outcomes were shown in 27 out of 28 patients.
  
  
  CONCLUSIONS
  In extensive burn patients, skin grafting in combination with dermal substitutes can be an alternative to STSG alone for contracture release.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Burn Center, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea.
authors.forename: Dong-Kook
authors.initials: DK
authors.lastname: Seo
authors.affiliation: Department of Surgery and Critical Care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea.
authors.forename: Dohern
authors.initials: D
authors.lastname: Kym
authors.affiliation: Department of Surgery and Critical Care, Burn Center, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea.
authors.forename: Jun
authors.initials: J
authors.lastname: Hur
keywords: Burn; Dermal substitutes; Neck contracture; Reconstruction