Post-Burns Neck Contracture Release with Free Flap Resurfacing in a Young Woman

Patient Profile

Age	25 years
Gender	Female
Background	History of childhood burns; underwent skin grafting for neck burns twice previously
Presenting Complaint	Neck burn scarring and tightness limiting neck movement
Diagnostic Method	Clinical assessment
Diagnosis	Post-burns neck contracture
Treatment	Contracture release and resurfacing with free flap
Outcome	Aesthetically very pleasing result with full range of neck movement

Patient identity withheld per confidentiality guidelines (referred to as Ms. C).

The Problem

Ms. C, a 25-year-old woman with a history of childhood burns, presented with neck burn scarring and tightness that was limiting her neck movement. She had previously undergone skin grafting for the neck burns on two separate occasions. She was evaluated by Dr. Leena Jain at Plastikos Clinic, and on clinical assessment, the condition was diagnosed as post-burns neck contracture.

Post-burns contractures of the neck are a recognised long-term consequence of burn injuries, particularly when the burn involves the anterior neck, an area of skin that is under constant tension due to the range of neck movement. Scar tissue formed after a burn, or after skin grafting performed to close the original wound, can shorten and tighten over time, restricting movement and, in some cases, recurring even after earlier grafting.

About Post-Burns Neck Contracture and Free Flap Resurfacing (General Information)

A post-burns contracture develops when scar tissue following a burn injury contracts and restricts the normal range of motion of the affected area. When this occurs in the neck, it can limit the ability to extend, rotate, or tilt the head, and may also affect the appearance of the neck.

Where a contracture is significant, or where previous grafting has not achieved a durable result, surgical release combined with resurfacing may be considered. This generally involves:

Release of the contracted scar tissue to restore the underlying range of movement
Resurfacing of the resulting defect with well-vascularised tissue, such as a free flap, to provide durable, pliable cover
Microsurgical connection of the flap’s blood vessels to vessels in the neck region to establish blood supply
Positioning and insetting of the flap to restore both movement and a natural contour to the neck

The use of a free flap, rather than a further skin graft, is generally considered where a more durable and better-vascularised reconstruction is required, since flap tissue carries its own blood supply and tends to be more resistant to further contracture over time compared with a skin graft alone.

Treatment Plan

Following clinical assessment, Dr. Leena Jain planned contracture release with resurfacing using a free flap. Given that Ms. C had already undergone skin grafting twice previously without a lasting resolution of the contracture, a free flap was chosen as the reconstructive option for this stage of treatment.

As a general principle in the management of post-burns neck contractures, the treatment plan is guided by the extent and depth of the contracture, the condition of the surrounding tissue following previous surgery, and the need for durable, well-vascularised cover that can withstand ongoing neck movement without recurrence.

Procedure

The treatment carried out for Ms. C was contracture release and resurfacing with a free flap, performed by Dr. Leena Jain at Plastikos Clinic.

How Contracture Release with Free Flap Resurfacing Is Generally Performed

In general, this procedure follows a structured sequence:

The contracted scar tissue is released to restore the underlying range of neck movement
The resulting soft tissue defect is assessed to determine the size and type of flap required
A free flap is raised from the selected donor site
The flap’s blood vessels are connected to vessels in the neck region under microsurgical magnification
The flap is positioned and inset to resurface the defect and restore neck contour
The donor site is closed

This general sequence reflects the standard approach to contracture release with free flap resurfacing and is provided here as background information on the type of surgery performed for Ms. C, rather than as a detailed account of her specific operative course.

Outcome

The surgery resulted in an aesthetically very pleasing outcome, with full range of neck movement achieved.

Outcomes at a Glance

Outcome Metric	Result
Contracture Release	Successful
Range of Neck Movement	Full
Aesthetic Outcome	Very pleasing

Long-Term Expectation

The long-term expectation for this patient is no recurrence of the contracture.

Patient Feedback

The patient reported being very satisfied and confident with the outcome.

Profile: Female · 25 years · History of childhood burns
Procedure: Contracture release and resurfacing with free flap · Performed by Dr. Leena Jain · Plastikos Clinic

FAQs

Q1. What is a post-burns neck contracture?

A post-burns neck contracture occurs when scar tissue from a burn injury tightens and restricts the normal range of neck movement.

Q2. Why was a free flap used instead of a further skin graft?

A free flap provides durable, well-vascularised tissue with its own blood supply, which is generally more resistant to recurrence than a further skin graft, particularly where previous grafting has already been performed.

Q3. What was the outcome for this patient?

The outcome was aesthetically very pleasing, with full range of neck movement achieved.

Q4. What is the long-term expectation after this surgery?

The long-term expectation is no recurrence of the contracture.

Q5. Where was this treatment carried out?

The treatment was carried out by Dr. Leena Jain at Plastikos Clinic.