WORLD JOURNAL OF PLASTIC SURGERY

en Local Flap Reconstruction of Burn Contractures in Extremities and Neck: A Nine-Year Experience with Long-Term Outcome Evaluation in Southwestern Iran تخصصي Special مقالات اصيل Original Article  Background: Treating burn scar contractures remains challenging for reconstructive surgeons; no clear guidelines declare the optimal and most effective technique. We evaluated the efficacy of local flaps in treating patients with post-burn contractures. Methods: This retrospective study included 243 patients with post-burn contractures referred to Taleghani Hospital (Khuzestan, southwest Iran) for local flap reconstruction from 2011 to 2020. Patients' demographic data, detailed descriptions of scars, surgical procedures, and flap outcomes were assessed. A plastic surgeon conducted all surgical procedures, the goals of which were to release the scar and cover the defect. Joint range of motion (ROM) (according to goniometric measurements), complications, need for second-stage surgery, and patient satisfaction were assessed. Results: After scar release, 70.4% of joints were covered with a Z-plasty and similar local flaps, 26.1% with a Z-plasty plus skin grafts, and 3.5% with only skin grafts. The outcome after one year revealed a significant improvement in mean ROM (by 45.80% of the normal ROM; P< 0.001). The mean functional and aesthetic satisfaction scores were 9.45 and 7.61 out of 10, respectively. The complication rate was 10.82%: re-contracture occurred in 3.82%, flap tip necrosis in 1.27%, and partial flap necrosis in 0.31%. Conclusion: Simple local flaps such as the Z-plasty are safe and effective in covering the joint following post-burn contracture release. Due to the feasibility, minimal need for facilities, steep learning curve, acceptable functional and aesthetic outcomes, and low complication rate, we strongly recommend the Z-plasty for reconstructing burn contractures, particularly in LMICs.   Contracture, Burn, Z-plasty, Flap, Reconstruction 47 56 http://wjps.ir/browse.php?a_code=A-10-299-6&slc_lang=en&sid=1 Shahram Jahanabadi 100319475328460014571 100319475328460014571 No Department of Plastic and Reconstructive Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Alireza Bakhshaeekia 100319475328460014572 100319475328460014572 No Department of Plastic and Reconstructive Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Roozbeh Rahbar 100319475328460014573 100319475328460014573 No Department of Plastic and Reconstructive Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Abdoreza Sheikhi 100319475328460014574 100319475328460014574 No Department of Plastic and Reconstructive Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Mahtab Farhadi 100319475328460014575 100319475328460014575 No Department of Plastic and Reconstructive Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Seyedeh-Sara Hashemi 100319475328460014576 100319475328460014576 Yes Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz,