Comparative Study of Early Clinical Outcomes of Full Thickness Skin Graft and Local Flap in Post-Burn Inframammary Contracture Reconstruction

Open Access

Abstract

Introduction: Post-burn inframammary contracture presents a significant reconstructive challenge, often affecting breast contour, function, and overall aesthetics. Various surgical techniques, including full-thickness skin grafts (FTSG) and local flaps, are commonly employed to restore symmetry and achieve optimal healing, yet their comparative outcomes remain insufficiently explored. This study aims to compare the early clinical outcomes of full-thickness skin grafts (FTSG) and local flaps in the reconstruction of post-burn inframammary contracture. Methods and materials: This observational prospective study was conducted from August 2017 to June 2019 in the Department of Burn and Plastic Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh. 50 female patients with post-burn inframammary contracture requiring reconstruction were selected using random sampling. Data analysis was carried out by using SPSS version 26. Result: At 30 days postoperatively, 76% of all patients had no complications. Infections occurred in 8% of cases, all within the FTSG group (14.28%), while local flap cases showed no infections but had small rates of marginal (9.09%), tip (9.09%), and partial flap loss (4.54%). Breast symmetry was seen in 78.6% of FTSG and 77.3% of local flap cases, and color match in 57.1% and 59.1%, respectively (both p>0.05). Reconstruction results were rated very good in 42.9% of FTSG versus 36.4% of local flap cases, and healing was excellent in 71.4% of FTSG compared to 50% of local flap patients (p>0.05), indicating better, but not statistically significant-outcomes in the FTSG group. Conclusion: It can be concluded that the inflammatory fold is better reconstructed with FTSG in younger patients but with local flaps in adult patients.  Early clinical outcome and rate of complications were statistically similar across both groups who underwent FTSG and local flap alone.