Classification of postburn deformities of the breast

Abstract

Introduction/Aim. An increased survival of patients with extensive and critical burns has increased the number of scar deformities in various parts of the human body. Breast lesions particularly affect the physical and mental health of girls and women. Scar deformities manifest in the form of individual scars or large scar fields of the breast and chest. All of this causes a wide variety of possible types of damage and the complexity of their classification. The aim of the work was to develop a classification of postburn scar deformities of the breast based on the definition of key areas of deformity and severity of the lesion to determine the reconstruction plan with optimal use of available healthy tissues of the surrounding areas. Material and methods. The classification of cicatricial deformities of the breast was based on a retrospective study, which was conducted involving 68 patients with lesions of 96 glands (40 unilateral and 28 bilateral). Clinical assessment of the lesion was used, taking into account the segmentation of the breast and adjacent areas, determination of parenchymal deficiency, and the degree of lesion of the mammary-areolar complex. The surface of the breast and adjacent areas of the chest and anterior abdominal wall are divided into 10 segments. The segmentation of areas allowed us to clarify the development of deformities with the selection of their key areas due to scars and to determine the most suitable areas for obtaining the donor tissue for reconstruction. Results. Four types of breast deformities are proposed based on determining the location of scar tissue transformations, the severity of the lesion of the nipple-areolar complex, parenchymal deficiency, and the nature of the deformity. Conclusions. The presented classification of postburn scar deformities of the breast reflects the main features of structural and functional disorders, makes it easy to determine the severity of the deformity, and helps to differentiate and objectively approach the choice of treatment tactics.