Improving Treatment Outcomes in Deep Facial and Neck Burns Through Optimization of Surgical Technique

Objective : To improve the surgical technique in the treatment of deep burns of the face and neck in order to enhance treatment outcomes. Materials and methods : A total of 210 patients with deep burns of the face and neck were treated and evaluated at the Combustiology Department of the Samarkand Branch of Republican Research Centre of Emergency Medicine in 2010-2022. The patients were divided into two groups, and the treatment outcomes were analyzed. The study group comprised 108 (51.4%) patients who were treated using the following surgical approaches: early necrectomy for deep burns of the face and neck, and placement of split-thickness autologous skin graft on granulating wounds parallel to the direction of the underlying muscle fibers. In patients with deep burns involving 0.1%–1.5% of the total body surface area, single-stage necrectomy followed by autodermoplasty was performed. In the control group, 102 (48.6%) patients received conventional treatment. The patients’ ages ranged from 4 months to 70 years, with a mean age of 20 ± 3.0 years. Results : The use of early necrectomy in patients of the study group promoted the formation of granulation tissue in deep facial and neck burns by days 12–14, enhanced wound cleansing, and enable skin grafting on days 14–17 after injury. The application of singlestage necrectomy and autodermoplasty reduced the duration of treatment from 21.5 ± 2.4 to 16.5 ± 1.5 days and decreased the incidence of postoperative complications from 62.7% to 24.1%. Conclusion : Early surgical necrectomy in the treatment of deep facial and neck burns is a highly effective method. This approach enables earlier skin grafting and shortens the treatment period; it not only enhances wound cleansing but also decreases the incidence of postoperative complications following skin grafting. The treatment duration was significantly reduced by an average of 8-10 days, which is important for early patient rehabilitation. The incidence of postoperative complications decreased from 62.7% to 24.1%. Furthermore, this method reduces pain and discomfort associated with daily dressing changes and wound care procedures, decreases the severity of pigmentary changes, and contributes to improved aesthetic outcomes, representing an important aspect of burn care in this patient population.

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