Skin Graft Versus Local Flaps in Management of Post-burn Elbow Contracture

Area of Science:

• Plastic Surgery
• Burn Reconstruction
• Scar Management

Background:

• Contractures result from pathological scar tissue after skin damage, restricting joint mobility and causing deformity.
• Post-burn elbow contractures significantly impair function and quality of life.
• Effective reconstruction is vital for restoring mobility and preventing long-term disability.

Purpose of the Study:

• To compare the outcomes of skin grafts versus local flaps for reconstructing post-burn elbow contractures.
• To evaluate functional recovery, range of motion, recurrence rates, and wound complications.
• To determine patient satisfaction following different reconstructive approaches.

Main Methods:

• A retrospective study of 21 patients undergoing elbow reconstruction for post-burn contractures over 12 months.
• Patients were categorized into three groups: graft alone (G1), local flap (G2), or combined approach (G3).
• Exclusion criteria included previous surgery, associated elbow stiffness, and non-adherence to physiotherapy.

Main Results:

• Local flaps showed a significantly lower re-contracture rate (22.8%) compared to grafts (60%) after 12 months.
• Flap take (91.1%) was comparable to graft take (83.3%), with an overall infection rate of 28.6%.
• Patient satisfaction was higher with local flaps (100%) versus grafts (70%), with overall satisfaction at 85.7%.

Conclusions:

• Both skin grafts and local flaps are viable options for post-contracture release surgery.
• Local flaps demonstrate superior outcomes in preventing re-contracture and enhancing patient satisfaction.
• Coverage choice should consider tissue loss and deep structure exposure; physiotherapy is essential.