Scar contracture after neck dissection. Causes, prevention, and treatment

Every effort should be made to employ neck incisions that allow for the accomplishment of surgical extirpative goals and at the same time provide maximal functional and aesthetic rehabilitation. Incisions parallel to the normal skin tension lines best fulfill these criteria. When vertical incisions are used, they should be anteriorly directed so as to cross the skin crease lines at an acute angle rather than a perpendicular angle. Such incisions perpendicular to the normal skin crease lines usually result in the greatest degree of scar contracture. Significant improvement in both major and minor scar contractures can be achieved with conventional Z-plasty technics to redistribute the skin tension. A wide resection of the subcutaneous cicatrix in such cases is imperative for a successful result.