Related Experiment Video
Updated: Jan 14, 2026
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Flap reconstruction of post-burn neck contractures: A systematic review
Aidan Shulkin1, Alexandra Katz1, Gabriel Bouhadana2
1Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
Background And Objectives:
Post-burn neck contractures present a complex reconstructive challenge. Flap-based reconstruction remains the standard in surgical management, yet no consensus exists regarding optimal flap selection or outcome evaluation. This systematic review aims to evaluate the effectiveness of flap reconstruction for post-burn neck contractures and to identify gaps in the literature.
Methods:
A systematic search of MEDLINE, Embase, and Web of Science was conducted following PRISMA guidelines. Studies reporting flap-based reconstruction for post-burn neck contractures published from inception to January 2025 were included.
Results:
54 studies encompassing 1346 subjects and 1466 flap procedures were identified. Scapular/parascapular (27.3 %) and supraclavicular artery (25.7 %) flaps were the most frequently reported among a diverse range of techniques. Functional outcomes, mainly assessed by range of motion, were reported in 83.3 % of studies, with over 90.0 % of patients achieving near-normal mobility. Aesthetic outcomes, mostly based on subjective observations, were reported in 90.7 % of studies, with the majority demonstrating favorable improvements. Patient satisfaction was reported in 33.3 % of studies and was consistently high. Major complications (5.7 %), minor complications (7.2 %), and contracture recurrence (<1.0 %) were rare. There were no significant differences in complication rates between local, pedicle and free flaps (p > 0.05).
Discussion:
Flap-based reconstruction reliably achieves positive outcomes following post-burn neck contractures. However, inconsistent use of contracture classification systems and lack of standardized, objective, and patient-reported outcome measures limit cross-study comparability. While treatment algorithms exist, they remain underutilized in practice.
Summary And Conclusion:
Surgeons can confidently select from a variety of flap options to effectively reconstruct post-burn neck contractures. Nonetheless, significant heterogeneity in outcome reporting limits direct comparisons across studies. To address this, we propose a standardized guide for consistent and comprehensive outcome reporting to improve comparability, inform clinical decision-making, and ultimately enhance patient care.
