Management of postburn contracture of the neck

Five hundred and sixty-two patients with postburn contractures were treated by a plastic surgeon in the Central Hospital of the capital city Lusaka. There were 37 patients with neck contractures of whom 18 were classified as major, all but two were burned by fire and two-thirds were female. Release of contracture and excision of scar tissue followed by surface cover with skin grafting was the mainstay of treatment and was carried out in 31 of 37 patients. Careful perioperative management and the basics of plastic surgery such as skin grafting are within the competence of many general surgeons. Because burn contractures are common in the developing world, it is recommended that plastic surgery be included in the training of general surgeons and that selected cases be managed by them. The more complex cases should be referred to a plastic surgery centre.