Vancouver Scar Scale for Assessing the Long-term Cosmetic results of surgical treatment of children with deep neck burns

Abstract

BACKGROUND: Deep neck burns always result in cicatricial changes in the skin. Scars in this area can lead not only to functional disorders but also affect the psychoemotional status of the patient and family. Current studies have reported on the results of the treatment of deep neck burns in both adults and children. However, among foreign and Russian publications available, no studies have assessed the cosmetic results of treatment using validated scales. AIM: This study aimed to analyze the long-term cosmetic results of surgical treatment of deep neck burns in children using the Vancouver Scar Scale. MATERIALS AND METHODS: A non-interventional case control study was conducted. The article analyzes the long-term cosmetic results of treatment of 64 children with deep neck burns. All patients were divided into the main group 1 35 (29%) children who received early surgical treatment] and control group 2 29 (45%) children after staged treatment]. The main group was further divided into subgroups 1a, 1b, and 1c. Subgroup 1a included 13 (20%) children who underwent tangential necrectomy with simultaneous autodermoplasty, subgroup 1b included 12 (19%) children who underwent radical necrectomy with simultaneous autodermoplasty, and subgroup 1c included 10 (16%) children who underwent necrectomy with delayed autodermoplasty. The Vancouver Scar Scale was used to assess the vascularization, pigmentation, elasticity, and size of the scar mass. For statistical analysis, the results of different options for early surgical treatment were compared with a staged method. RESULTS: The best indicators for vascularization, elasticity, size of the formed cicatricial mass, and overall score were obtained in children who received surgical treatment of deep neck burns by early necrectomy (tangential or radical) with simultaneous autodermoplasty in comparison with staged surgical treatment. When analyzing the pigmentation indicator, the scores of patients who underwent all types of early surgical treatment were comparable with those in patients who received staged surgery. CONCLUSIONS: According to the analysis of the Vancouver Scar Scale, the best cosmetic results in children with deep neck burns can be achieved by performing tangential or radical necrectomy with simultaneous autodermoplasty.